When you become pregnant, your body undergoes a major change and is affected both externally and internally. This is largely due to the hormonal surge during pregnancy. During pregnancy, blood volume increases by between 30-50%, which usually has a positive effect on skin health. After enjoying the glow of pregnancy, many women may experience skin problems after giving birth. Most of these skin conditions are caused by hormonal changes. The levels of hormones like progesterone and estrogen, which are responsible for maintaining a healthy pregnancy, suddenly decrease after childbirth causing changes in the body, especially in the skin. In this article, we review the most common changes affecting the skin during pregnancy and give our top tips on how to deal with them.
Our top skin tips for pregnant and breastfeeding women, in brief:
The most common skin complications during pregnancy and breastfeeding are stretch marks, changes in skin color (hyperpigmentation/melasma), hormonal acne, dry skin, broken veins or sensitive skin. These are our tips for those who have:
- Melasma: Sun protection is essential and really the most important thing to consider in melasma because the pigment cell is hypersensitive to sunlight.
- Hormonal acne: Drug treatment is usually postponed until breastfeeding is completed. To balance the skin in acne, you should use skincare that balances the sebaceous glands.
- Varicose veins: It is difficult to get rid of varicose veins with skincare. To treat varicose veins, you often have to turn to heat/laser treatment or injection of astringent substances to get rid of the varicose veins.
- Dry skin during the breastfeeding period: The best way to treat postpartum dryness is to invest in a good moisturizer that contains three components: skin endogenous fats, moisture binders and barrier strengthening substances.
- Stretch marks Studies show that mainly massage and softening of the skin can reduce the appearance of stretch marks. Here it works with oil or cream to massage the area.
How do my hormones affect me and my skin?
During pregnancy, our female hormones are vital for the continuation of the pregnancy. Of the 6 key hormones during pregnancy - HSG, progesterone, oestrogen, prolactin, oxytocin and relaxin - by far the most research has been done on oestrogen, progesterone and prolactin and their effects on the skin.
Oestrogen is a hormone produced in early pregnancy. Together with progesterone, it causes the lining of the uterus to grow and thicken so that the egg can attach and the pregnancy continue. Estrogen also helps with fetal development and the development of placental function. It also affects your breasts, so if you experience growth and tenderness, it's because oestrogen prepares them for breastfeeding in the first trimester. Oestrogen also makes you more sensitive to smell, taste and touch, which can be wonderful but sometimes cause nausea. The high levels of oestrogen during pregnancy also mean that you lose less hair than usual and your nails grow faster.
Both progesterone and oestrogen affect the firmness and elasticity of the skin. However, the negative effects of these hormones are that they make the pigment cell more sensitive to sunlight, so the risk of developing hyperpigmentation or melasma is high during pregnancy.
In mid-pregnancy the production of prolactin increases. Prolactin's main role is to form breast milk and, together with oestrogen, to stimulate breast growth. However, prolactin is not just a milk-producing hormone, but also works in many other areas, including our immune system, mental health and metabolism. It is also the hormone that makes us humans, and mammals too for that matter, incubate and feel the instinct to protect our children. Like oxytocin, prolactin helps with bonding with the newborn baby and is secreted during breastfeeding.
Many people notice a change in their skin, hair and nails during breastfeeding. If you have a skin condition, it can also often get worse during breastfeeding. This is largely due to the effect of prolactin on the skin. An accepted concept in dermatology is now the prolactin-skin connection which explains many skin changes during breastfeeding where prolactin affects virtually all our skin cells including sebaceous glands and hair follicles as well as the immune system in the skin 1.
Figure 1. The hormones progesterone, estrogen and prolactin during pregnancy.
Most common skin changes during pregnancy and after childbirth
Melasma
Also known as pregnancy mask, is a skin condition characterized by spots and dots similar to freckles. It occurs mainly on the sunlit parts of the face and often on the cheeks, chin, temples and nose. The condition is more common in women with medium to dark skin tone and is caused by increased melanin production due to a combination of hormonal and genetic factors and sun exposure. Pregnancy, use of birth control pills and sun exposure are the most common triggers.
Although melasma does not cause pain or itching and can go away on its own, it can cause cosmetic concerns for patients.
Tips for melasma: Sun protection is essential and really the most important thing to consider for melasma because the pigment cell is hypersensitive to sunlight.
You can also treat melasma with ingredients such as retinol, tretinoin (after breastfeeding has stopped), azelaic acid, N-acetyl glucosamine and/or in combination with niacinamide and vitamin C.
You can find these substances in our products Sun Emulsion SPF 50+ and Night Active Retinol.
Hormonal acne
Postpartum acne can appear in many forms, white or blackheads, pustules and painful cysts. Many women develop acne during their pregnancy that disappears after childbirth. However, for some women it continues even in the postpartum period. Developing acne during pregnancy is normal and is mainly caused by an increase in progesterone levels. After pregnancy, progesterone levels return to normal and acne disappears. However, it can take longer for some women to normalize their hormone levels, so they may continue to have acne even after giving birth.
Tips for hormonal acne: Medication is usually delayed until after breastfeeding.
To balance the skin in acne, you should use skincare that balances the sebaceous glands. Look for ingredients such as zinc, niacinamide (vitamin B3), vitamin A, azaleic acid and PHAs (such as lactobionic acid).
You can find these substances in our products Night Active Control, Light Emulsion and Rich Emulsion.
Can you use retinol during pregnancy and breastfeeding?
High doses of vitamin A should be avoided during pregnancy because of the fetal damage caused by vitamin A acid. For example, pregnant women are advised from not to eat liver containing high levels of vitamin A (retinol). However, foods with lower levels of vitamin A are fine, such as dairy products and eggs.
What about skincare containing retinol? If we calculate a concentration of 0.1% retinol in a skincare product, it is incredibly little vitamin A that we can possibly get through the skin. Example calculation. 0.1%, (2 mg/cm2), application on the face which is about 40cm2 and maximum 10% absorption through the skin gives 0.008 mg Retinol which is absorbed with each application.
The equivalent of 0.008 mg retinol equivalent is found in about 30 grams of carrots.
Carrots contain about 10mg/g of beta-carotene. There is about 30% absorption of beta-carotene from in the gut, 12 mg of beta-carotene corresponds to 1 mg retinol. It follows that 0.008 mg retinol corresponds to the amount of beta-carotene that we get if we eat about 32 grams of carrots (0.008/0.01/0.3*12), which is a very small carrot .
With topical use of retinol (about 0.1%), there is thus very little systemic absorption of retinol via the skin.
You can find these substances in our products Night Active Control and Night Active Retinol.
Varicose veins
Also known as spider veins, is a postpartum skin condition characterized by abnormally swollen veins. Varicose veins are associated with increased estrogen levels and often appear in the third trimester of pregnancy. They can sometimes persist for several months up to a year after delivery. The increased blood volume in the body during pregnancy creates pressure in the blood vessels, causing blood to back up in the veins. This can cause the veins in the lower limbs to become enlarged and look like swollen and tangled veins.
Tips for varicose veins: Unfortunately, it is difficult to get rid of varicose veins with skin care. To treat varicose veins, you often have to turn to heat/laser treatment or injection of astringent substances to remove the varicose veins.
Dry skin
Especially after giving birth, hormonal changes due to breastfeeding can affect the structure of the skin and cause dryness. Lower levels of estrogen during the breastfeeding period affect the production of hyaluronic acid, collagen and elastin in the body.
The low levels contribute to increased transepidermal water loss which can lead to dehydration and make the skin flaky and dry.
Tips for dry skin during the breastfeeding period: The best way to treat postpartum dryness is to invest in a good moisturizer that contains three components: skin endogenous fats (ceramides, cholesterol, squalane), and moisture binders (e.g. urea, glycerin/erythritol, ectoine) and barrier strengthening substances (niacinamide). A good moisturizer helps to protect the skin barrier, prevent transepidermal water loss and maintain moisture in the skin.
These substances are found in our Light Emulsion, Rich Emulsion, Rich Intense and Probiotic Concentrate products.
Striae gravidarum - Stretch marks
Stretch marks, stretch marks or striae gravidarum have many names. This is common and affects around 90% of women during pregnancy.
Studies show that mainly massage and softening of the skin can reduce the appearance of stretch marks. Here, oil or cream can be used to massage the area.
Rich Body Cream, which is formulated completely without additives, can be used in conjunction with the massage. If you want even more oil, we recommend taking a few drops of Probiotic Concentrate and mixing it in. This contains live lactic acid bacteria (L. reuteri) from human breast milk. This is the same bacteria used in Semper's drops that you might give your baby after to build up a balanced gut flora.
Here you will find Rich Body Cream and Probiotic Concentrate.
Avoidance list for pregnancy and breastfeeding
Since pregnancy is completely controlled by this fine orchestra of hormones, it is obviously important not to disturb the hormonal balance. Therefore, special care should be taken with the intake of endocrine disruptors.
What do endocrine disruptors mean?
According to the Swedish Chemicals Agency, the word has the following explanation: Many important processes in the body are controlled by hormones that act at very low levels in the body. Endocrine disruptors are substances that are foreign to the body and can disrupt the body's own hormone system. They may, for example, contribute to the development of cancer or affect metabolism, fertility and possibly child development.
Unfortunately, the current system for assessing the risks of chemicals is not sufficient to detect how the child's development is affected when a woman is exposed to different chemical mixtures during pregnancy. This is according to a new study (SELMA study) published in the prestigious journal Science 2.
Facts about the SELMA study:
The SELMA study is run at Karlstad University and follows about 2,300 mother-child pairs from early pregnancy through delivery and up to the child's school age. The aim is to investigate the importance of exposure to endocrine disrupting chemicals during early fetal life for the child's health and development later in life. The study has shown links between mixtures of different chemicals and the child's sexual development, respiratory problems, cognitive development, growth and chronic diseases later in life.
List of known endocrine disruptors that are particularly important to avoid during pregnancy
All endocrine disruptors should be avoided during pregnancy. In the past, the focus has been on environmental toxins that are likely to accumulate in certain types of fish, i.e. dioxins, PCBs and mercury.
We now know that some substances in packaging materials also have endocrine disrupting properties, such as some plasticizers in plastics (phthalates) and bisphenol A, which can be found in the varnish used on the inside of cans.
Some parabens in skincare products and cosmetics are also on the list of endocrine disruptors. Some sunscreen products also contain UV filters with known endocrine disrupting effects (see table below).
How much of what you apply gets into your body?
The concentration of substances that penetrate the skin and go into the body depends on the nature of the molecule and also on the size of the molecule.
For example, both parabens and some UV filters can be measured in urine as a measure of uptake from the skin into the body, all of which have a molecular weight of less than 300 Daltons.
If you want to know more about which chemicals you should avoid as a pregnant woman, we recommend that you read the Swedish Society for Nature Conservation's list of dangerous chemicals to avoid during pregnancy. You can find the list here.
Skinome products are safe to use during pregnancy and breastfeeding*.
The absorption and supply of retinol to the body from Night Active Control and Night Active Retinol is small, the maximum amount you get corresponds to the amount of beta-carotene (which is converted to retinol in the body) that you get by eating a small carrot (about 30 grams of carrot). We therefore do not generally advise against from using our products even if you are pregnant or breastfeeding.
*However, when using medicines with high levels of vitamin A or if you are taking higher levels of vitamin A from other sources, you should consult your doctor about the use of our products containing retinol (Night Active Retinol and Night Active Control).
You can find all our products here.
References
- Kerstin Foitzik, Ewan A Langan, R. P. Prolactin and the skin: a dermatological perspective on an ancient pleiotropic peptide hormone. J Invest Dermatol (2009).
- Svensson K, Tanner E, Gennings C, Lindh C, Kiviranta H, Wikström S, B. C. Prenatal exposures to mixtures of endocrine disrupting chemicals and children's weight trajectory up to age 5.5 in the SELMA study. Sci Rep. 2021 May 26;11(1)11036. doi 10.1038/s41598-021-89846-5.
