Pregnancy and postpartum is a time of profound change within the body, and that certainly is true for skin function. Changes during this time are common, whether skin becomes symptomatic for the first time, underlying skin symptoms surface, or, more positively, the coveted ‘pregnancy glow’ reveals itself. We often hear from clients that they’re unsure, confused, and sometimes even fearful of skin symptoms arising during pregnancy and postpartum, especially if they’ve had issues in the past. We want to help alleviate that fear. By trusting and supporting your body’s innate intelligence (instead of constantly trying to “fix” it), you can appreciate this time as the truly phenomenal experience it is. After all, humans have evolved to do this over many millennia – the body rarely needs your brain’s interference.
At Marie Veronique we focus on education because if we understand why something is happening, we can better cope with supporting and/or treating it. We trust that changes aren’t always bad, nor do they always result in prolonged symptoms. That perspective makes them a little easier to deal with.
In our practice of working with clients as an esthetician and an acupuncturist, we see a wide range of hormonal influences on the skin, from factors such as irregular cycles and hormonal imbalances, fertility goals and treatments, pregnancy and postpartum, menopause, and beyond. An important distinction in how we approach hormonal imbalances is that we view them as having an indirect impact on skin function, that is, they typically are not the sole reason or cause for unwanted symptoms. Instead of viewing fluctuating hormones as a problem, we find that leaving the hormones alone and supporting the organ systems allows the body to balance hormones naturally.
That said, the pregnancy and postpartum time frame is extremely unique in the sense that the profound hormonal changes do influence the system and skin function (we will tell you why). In this post, we’ll go over the four phases of pregnancy and postpartum, which will help you understand the changes your body and skin are undergoing; then we’ll talk about the common skin concerns people experience during pregnancy; and finally, we’ll give you some advice and suggestions for how you can support your body and your skin during this time.
From a skin perspective, we consider there to be four major transition phases of pregnancy and postpartum: first trimester; second and third trimester; post-birth/breastfeeding; and post-breastfeeding. Here’s a brief look at what’s happening during each phase on an internal and hormonal level, and how the skin is affected.
Phase 1: First Trimester – "Excess"
The volume of blood increases, the immune system is suppressed to protect the embryo, and increased pregnancy hormones flow through the blood system. Additionally, the endocrine system secretes an increase of hormones that stimulate vascular growth and changes to the vascular system. Histamine levels are also highest during the first trimester (and then very low in second and third trimesters), which is why it’s common to experience histamine symptoms in the respiratory system (itchy, stuffy “allergic” reactions) and, potentially, histamine triggers in the skin.
Overall systemic levels of inflammation are also high during the beginning stages of pregnancy, due to implantation and hormone changes, which may result in skin changes as well. Changes to the digestive system (nausea, bloating, food aversion, heartburn, etc.) can also lead to skin changes, such as increased oil production in the skin (breakouts), inflammatory response in the skin, swelling, redness and flushing, microbial changes in the mucous membranes (dermatitis, nasal congestion), and fluid retention.
During the first trimester, intestinal microflora remains similar to that of your pre-pregnancy microbiota (which is hopefully robust, depending on your gut health) but pH levels of the vaginal biome do start to shift, which means that women are more vulnerable to pathogenic activity such as yeast infections (locally) and yeast overgrowth on the skin.
Phase 2: Second and Third Trimester – "Ease"
Estrogen and progesterone levels continue to rise, but the body has a better ability to adjust and find its course (and the placenta starts to play a major role!). However, this does remain a phase of obvious fluctuations. Increased hormone levels can stimulate rapid hair growth (not always where you want it, and/or ‘blocking’ pores resulting in breakouts), as well as pigment changes in your skin. Cortisol levels also continue to rise, as well as water retention, all of which has the potential to affect skin.
There is good news for the skin during this time: inflammation levels decrease mid-pregnancy to protect the fetus, and that continues until birth. Additionally, if you’re able to support your system and ease its hormonal transitions, this is the phase where you may experience the coveted ‘pregnancy glow,’ as balanced hormone levels can add a natural blush to the skin’s surface.
This is a very important time to support microbial function, both internally and topically, as microbial diversity in both the gut and oral mucous membranes steadily declines until birth. If microbial function is not supported during this time, it can result in starting the postpartum period with a more vulnerable immune and digestive system (during an already highly vulnerable time). A few other changes that are common and relate to skin function include sweat gland changes, skin tags, bleeding gums, and other oral issues. The goal at this time is to support the “ease” of changes and transitions so that symptoms do not have to become problematic for the skin.
Phase 3: Postpartum Period – "Depletion"
Birth! This phase starts with the ultimate high – adrenaline, oxytocin, increased blood volume, new baby, etc. – but quickly shifts to a state of depletion for your body. Around 3-5 days after birth, hormones sharply decline, and so does sleep, as cortisol and prolactin levels increase. Additionally, milk production for breastfeeding adds a new demand on the system. This highly variable phase makes sense in the grand scheme of things – your body is going through big changes to allow you to care for your baby – but the drastic swings can result in skin symptoms.
The shift of nutrients from mother to baby can lead to dry skin, increased inflammation, and a decrease of blood flow to the surface of the skin. As mother and baby adjust to all the changes, the body remains in a state of flux as the system attempts to find new balance. Additional factors that can impact skin during this time include continued changes to the hair follicle, changes to thyroid function, and changes toadrenal function in response to fatigue.
It is extremely important to support and restore your system to the best of your ability during this time to avoid depleting your body even further. Systemic depletion impacts skin function significantly, and can result in a sudden surge of inflammatory and immune conditions including rosacea, dermatitis, eczema, dandruff, acne, dull skin, and other signs we may interpret as ‘aging’ skin.
Phase 4: Post-Breastfeeding/Menstrual Cycle Returns – "Renewal"
During this phase, your body starts reducing the production of prolactin, which signals the pituitary gland to produce estrogen and stimulate the ovulation process, which in turn leads to the return of your period. New surges of hormones can again make the body symptomatic, especially if it's depleted of vitamins and minerals (e.g. Vitamin D, Vitamin B, iron/ferritin, selenium, zinc, magnesium, EFAs). For many women this stage is welcome, as more estrogen means more collagen! Collagen production alleviates that depleted look caused by loss of elasticity that many complain of while breastfeeding, helping the skin resolve and replenish itself. This really can be a phase of renewal for the body and skin if you support yourself correctly. You can think of it as an opportunity to sort of “reset” your system and begin anew.
If the above is a map of what's happening on an internal level, what exactly does that mean for the surface of the skin? Here are the most common skin conditions that we see throughout pregnancy and postpartum:
While there is also some evidence that suggests that stress hormones increase stretch mark vulnerability, from a purely mechanical perspective it’s not likely you’ll get stretch marks if your pregnancies are later on in life. Conditioning the skin and keeping it nourished and moisturized can always help, and also feels amazing, but we suggest avoiding investing in specialized products, as they often are not clean/safe for pregnancy, ineffective, and just generally not worth the expense.
And finally, let’s talk about how you can best support your skin through all these changes, both topically and internally.
The most important factor when it comes to topicals is to select products that are both safe *and* effective – for both yourself and your baby. Here we’ve compiled a list of our favorite skincare and supportive practices, including products, tips, and resources. There is never a perfect guidebook for anything, but we want to offer our support by giving you guidance on tools we trust, and you can bet we have done our research. Not surprisingly, we are obsessed with the microbiome, so all of our recommendations are supportive of maintaining healthy microflora in and on the body.
Select well-formulated products that are deemed safe for pregnancy: choose products made fromhigh-quality, natural ingredients that also may include lab-grown ingredients that are bioidentical to those found in nature. (Ahem, this is Marie Veronique’s philosophy for product formulation, so no need to look any further!) Focus on ingredients that nourish the skin instead of stripping it, supporting barrier function, replenishing deficiencies, supporting microbial balance, and naturally reducing inflammation. Now is not the time to use active ingredients like acids/peels, retinoids, or skin bleaching agents, nor for at-home devices such as microcurrent, LED, or infrared. It’s good to be gentle and simple with your skin during this time, and facial massage during product application is a great way to be hands on with your skin.
Here are Marie Veronique’s suggested Pregnancy Skincare Products, which include the top three most important products we recommend for most people. (If you have questions, please email us for specific advice.)
In regards to skin function, we focus a lot of attention on the internal systems. Supporting the body during pregnancy and postpartum is so important, and while it can be very individual to everyone, we have found that holistic and comprehensive support of microbial balance, immune function, nervous system and blood system, and circulation is crucial for skin health, especially during pregnancy and postpartum.
Here’s a brief overview of how to support your internal body during pregnancy and postpartum, along with some additional resources for more information. As always, find practitioners and support systems that you trust and can guide you in the right direction.
Pregnancy, and pregnancy skin, is such a unique life experience. Amidst a surge of so many changes, the skin and the body adapt and evolve, and if we are supportive, we have the ability to create positive and meaningful changes. Sometimes support means doing less, and that’s actually something we strive for in skin care. When you are strategic (rather than reactive) with your products, support, and rest, you will have achieved what you set out to do in the first place – set your baby (and yourself) up for the best care possible.
Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.
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