Summer and pregnancy: Precautions and solutions for the skin

The skin changes enormously during pregnancy, so face and body care routines should also be modified and even more so in summer, with the arrival of constant exposure to the sun.

We spoke with Fátima Albízuri , a dermatologist specializing in pediatric, vulvar and adult women's dermatology, pigmented lesions and melanoma.

Why does a pregnant woman's face get more stained?

During pregnancy a very important hormonal change occurs, it is physiological or normal but it usually affects many organs and one of them is the skin. Melasma, chloasma (some grandmothers even call it “pregnancy cloth”) is the main cause of dermatological consultation during pregnancy.

Why is this pigmentation?

The melanocyte is the cell in charge of synthesizing melanin (the substance that gives our skin pigment) and they are found in the lowest layer of the epidermis, which is the most superficial layer or structure of the skin, and they pass that melanin to keratinocytes, cells that make up most of the rest of the layers of the epidermis. This process is called melanogenesis. To form melanin, a precursor is needed, the main one in this process is called tyrosine and an enzyme is also needed that converts tyrosine into melanin, and this enzyme is tyrosinase.

During pregnancy, sex hormones greatly stimulate this enzyme and the melanocyte becomes more unstable, more “crazy” and increases melanin production. We will also see how it not only affects the face, but the nipples, the midline of the abdomen (called linea alba) and even the vulvar area become much more pigmented .

Be careful, the second is acne in pregnant women, called gestational acne, we will talk about it if you are interested, because the marks left by this acne also tend to become much more pigmented.

Is there any truth to the fact that pregnant women get darker?

We have talked about how sex hormones (especially estrogen and progesterone) stimulate the production of melanin and in many articles on the internet we read that we get darker during pregnancy. If we look for scientific evidence, it is not something that is very proven either. What we do know is that pregnant women's skin is more reactive, more sensitive, women who have never had skin problems may start with dermatitis, or some products may irritate us more than normal.

Dermatologists do not recommend sunbathing directly, that is, seeking tan by exposing ourselves, lying on the lounger for hours to achieve that skin color throughout the days, whether pregnant or not pregnant.

What precautions should they take when exposing themselves to the sun and heat?

As we have said, the skin may be more reactive and even more dehydrated and dry.

• Be careful with the heat. The pregnant woman, by having more "dilated" vessels, can lose more water and more heat through the skin, therefore hydrate (drink water), be careful with the heat to avoid dizziness, fainting (avoid those hours on the beach with more solar radiation and more heat, frequent baths,...).
• When it comes to sun exposure, the most important thing is physical measures (glasses, hat, yes, better hat than cap, by covering the cheek area more and using the umbrella). Use sunscreen, it does not need to be 90 or 100, but rather a 50+ sunscreen and reapply every 2-3 hours or after bathing.
• Don't forget to use sunscreen as a cosmetic routine, every day even if you don't go to the beach or pool, because it is the day-to-day sun that can cause pigmentation (don't forget that the blue light from electronic devices, especially for women with a predisposition to melasma, it can make melasma worse).
• Try to avoid those central hours of the day (from 12pm to 4pm) to expose ourselves to the sun (I know it is difficult, our Spanish culture goes against it, but try to limit it, eat at home, etc.)
• Don't wait for spots to appear before starting to use depigmenting cosmetics. If not, do it from the beginning and even in some cases, we recommend it beforehand (cases of previous melasma or patients who are more prone to hyperpigmentation).

Is there a risk for the baby if the belly receives a lot of direct sun?

Not the baby, don't worry.

Once the spots appear, what treatment should we follow?

As we have said, don't wait for stains to appear! Use antioxidant and mild depigmenting compounds from the beginning of pregnancy and if we already start with spots, use more specific compounds.

As for cosmetics, I like to recommend antioxidant compounds that contain vitamin C and apply them every day, in the morning.

For melasma, or with the onset of spots appearing, I recommend treatments that are safe for pregnancy, which include: niacinamide starting at 4%, topical tranexamic acid, azelaic acid or kojic acid. I also like to combine a serum or cream that includes glycolic acid to perform a gentle chemical exfoliation and so that all the compounds penetrate the skin better and are therefore more effective, while also helping to manage acne.

Once you have given birth, we have many more and more effective options, among which retinol and also hydroquinone cannot be missed if we see it indicated (always prescribed by a specialist to adjust the guidelines and doses) and in cases For more severe cases, we also have oral medication and different medical-aesthetic procedures such as microneedling, peelings or lasers, which should always be options associated with a good base topical treatment regimen. That is to say, the most important thing is everything that we do every day with good cosmetic guidelines and, if necessary, associate some more treatment.

Don't forget sunscreen, even months after giving birth, melasma can still develop, so keep up the care.

Some examples of products that I like to associate with pregnant patients who begin to develop melasma.

- Discoloration defense serum by Skin Ceuticals

- Advanced dark spot concealer from Laboratorios ds

- Brightalive from Zo skin Health

- Martiderm pigment zero line

- Pure niacinamide 10 from La Roche Posay Serum