Hormonal changes throughout the menstrual cycle can influence the skin and hair for some women. It is during the second half of the menstrual cycle, following ovulation when the progesterone levels peak, that women notice changes in their skin and those with a skin condition can experience an exacerbation.
During pregnancy some specific changes do occur, specifically a deepening of the normal pigmentation of the nipple, the areola, the genital area and the midline of the abdominal wall. Following delivery this pigmentation will fade, but seldom back to the usual colour. For a proportion of women (around 70%), the second half of pregnancy sees chloasmal pigmentation which is characterised by an irregular, sharply marginated area of pigmentation which develops in a symmetrical pattern over the cheeks and/or forehead. It is also common for women to see their moles darken whilst pregnant and it is also possible for new moles to appear. It is advisable for pregnant women to take additional precautions when going out into the sun; they should wear a hat and use a high factor sunscreen.
Vascular changes mean that women notice flushing of the palms of the hands and spider naevi appear on the face, upper trunk and arms. Oedema of the lower legs and increased appearance of varicose veins occur due to a rise in venous pressure caused by the increased pressure of the growing foetus impeding venous return. Dermal changes include stretch marks which occur due to weakened tensile strength of dermal fibres (caused by the increase corticosteroid output) and the stretching of the skin due to the growing foetus. A study carried out in Southern India showed that nearly 80% of women experienced stretch marks following pregnancy (Kumari
et al., 2007). Marks appear as raised reddish/purple lines during and just after pregnancy, which fade to more skin- coloured slightly depressed shiny lines. Avoiding stretch marks during pregnancy may be down to genetic good fortune; however, the following strategies may help decrease the likelihood of stretch marks or at least their severity:
- Gradual and moderate weight gain during pregnancy (a woman with a normal body mass index should aim to gain between 25 and 35 lbs during pregnancy.);
- Gentle exercise;
- A Cochrane review considered studies that looked at topical products which might alleviate stretch marks. The review highlights one product containing Centella asiatica extract, alpha tocopherol and collagen–elastin hydrolysates, which when compared to a placebo was associated with women developing fewer stretch marks. A second study suggested that a product containing tocopherol, panthenol, hyaluronic acid, elastin and menthol was associated with women developing fewer stretch marks. But this study did not include a control and the improvements may have been associated with the massage (Young and Jewell, 1996).
