Have you ever wondered what that line was down your pregnant belly but was too shy to ask? You’re not alone. There is not an organ in a woman’s body that is not affected by pregnancy and her skin is no exception. Skin is the largest organ in the pregnant body and undergoes significant changes that are usually not discussed. Did you know that 91% of pregnant women will have what is known as hyperpigmentation or more color or melanin? Most of the added melanin or color is based on hormonal changes on certain cells of the skin.

Hyperpigmentation is usually seen on areas of breast, neck and under the arms as well as the long line on the abdomen called the linea nigra. These changes are very normal and usually become less noticeable after the baby is born but does not completely disappear. Women may also have additional pigment on the face especially on the forehead, cheeks and bridge of the nose. This condition was originally called chloasma or mask of pregnancy but is now referred to as melasma. Melasma occurs in 70% of pregnant women but non-pregnant women who take birth control pills may also be affected as well. Melasma usually resolves after delivery but may persist in 30% of patients. Can this condition be avoided? Not entirely but it can be minimized by avoidance of the sun during the bright sunny months if at all possible. Sunscreens and sun blocks should be used with a sun protective factor (SPF) of 15 or greater and this applies to all women regardless of ethnicity. Melasma usually disappears after a year but if it persists after the delivery, “bleaching” creams and solutions such as hydroquinone are used initially used as a first line defense. The FDA has approved Lustra, Alustra, Melanex or Solaquin to treat Melasma and is sometimes useful. Cosmetics can certainly help but if the problem persists for more than a year after the birth of a child daily retinoic acid, commonly known as tretinoin or Retin-A is also helpful. Chemical peels to the skin might be affective as well.

A discussion of additional skin disorders related to pregnancy will be discussed in the next blog post but until then, remember, a healthy pregnancy doesn’t just happen – it takes a smart mother who knows what do to.