Here’s how to care for your skin post-pregnancy

Pregnancy is a beautiful experience during which a woman nurtures and grows a baby for a period of 9 months. During this time, the body experiences many changes both internally and externally as it turns into a space of nourishment and protection for the growing foetus. Hormonal fluctuations, stretching of the skin, greater storage of fats, etc can also lead to significant apparent changes in the skin. While many women often feel self-conscious and mourn the loss of their pre-pregnancy skin, it is important to know that these changes are completely normal, and that many women feel the way you do! These issues can be managed during the pregnancy and also minimised post-pregnancy. Avoid comparing how your body reacts to pregnancy as it largely depends on factors beyond your control such as your genetics. Having said that, below are some of the most common skin issues that women face during and post-pregnancy with some simple steps that one can take to manage them -

Melasma

Often known as "the mask of pregnancy," is a pigmentation disorder which is caused by a combination of hereditary, hormonal factors, as well as due to sun exposure. It shows up as mottled dark spots on the cheekbones, forehead, nasal bridge, upper lips and rarely, over the jawline.

How to tackle it:

• Sun protection is the most important step to avoid and prevent worsening of melasma. Physical protection like opaque umbrellas, wide rimmed hats, scarf should be used while stepping out in the sun
• Use liberal amounts of sunscreen with minimum SPF 30, in the morning, at least 15 minutes before stepping out and repeat it in the afternoon after 3-4 hours. Sunscreen use should not be restricted to only while stepping outdoors or when it's sunny but also while indoors. Remember to use only a physical sunscreen during your pregnancy and breastfeeding period.
• Using skin lightening products that contain kojic acid, glycolic acid and vitamins C, E, and A in lower concentrations can assist to brighten and rejuvenate your complexion.

Stretch Marks

Stretch marks affect around 90% of women at some point in their life, with pregnancy being one of the most prevalent times when this occurs. These marks, reddish-purple scars become white over time and are produced by the damage to its elastic fibres when it is stretched due to weight increase. These are particularly noticeable on the abdomen after delivery.

How to tackle it:

• Prevention is better than cure. Start using moisturising lotions containing cocoa butter and Shea Butter during pregnancy itself and continue post your delivery.
• Massages will also enhance the elasticity of skin, however do take care to do it gently.
• In the initial stages, the stretch marks are red in colour (striae rubra) and these respond best to treatment, so do visit your dermatologist early.
• Various cosmetic procedures like lasers, PRP, microneedling with dermaroller can be done to lighten the scars.

Acne

Acne or pimples, is caused by an inflammation of the sebaceous glands of the face. While a few women report clearing of their pre-existing acne during pregnancy, others may experience a severe flare. This is due to the hormonal changes that occur during pregnancy.

How to tackle it:

• Always use cosmetics which are non-comedogenic.
• Increased fluid intake and staying hydrated may help your acne naturally.
• Remember to remove makeup before bed time and avoid frequently touching your face.
• Products containing benzoyl peroxide may be used to penetrate clogged pores and remove pollutants; it is also safe to use during and after breastfeeding.
• Although products containing retinol are great for acne treatment, they are contraindicated during pregnancy and breastfeeding.

Dermatitis/ Eczema

Eczema, also known as dermatitis, is a common yet non-infectious skin condition that will not transmit to the infant. It's usually the result of an underlying sensitive skin disease that's been there for a while. Hand eczema has become quite common of late due to frequent handwashing with harsh soaps and hand sanitisers.

How to tackle it:

• Use a mild soap with a skin friendly pH.
• Gently pat dry the skin after each wash and apply a moisturising cream immediately which helps to lock in the moisture content of the skin.
• Topical steroid creams are used to treat severe eczemas, however they should always be prescribed by a dermatologist after careful evaluation and never to be taken OTC from pharmacies. They are safe during pregnancy and lactation.
• Do not wear anything too tight or shape-fitting. Tight clothes may trap the heat and make the skin irritable. Better to pick natural fabrics, like cotton

PUPPP

The most common pregnancy rash is PUPPPs, or pruritic urticarial papules and plaques of pregnancy. These itchy, red spots appear around stretch marks and can spread to the arms, legs, and buttocks. They generally appear at the end of pregnancy, when the tummy is stretched the most.

How to tackle it:

• Try applying something cold to your rash to receive some relief. Apply an ice pack for 15 to 20 minutes or cover the rash with a cold, damp cloth.
• Have lukewarm water baths as very hot water dries the skin and aggravates the itching
• Keep the skin moisturised with a good moisturiser or coconut oil.
• Visit your dermatologist who will further guide you on use of safe treatment options during pregnancy and lactation.

Dr. Swathi Shivakumar, Consultant Dermatologist, Aster RV Hospital, JP Nagar, Bengaluru