Stretch marks are a natural and harmless part of pregnancy. Nearly 90% of all pregnant women develop stretch marks (striae gravidarum), most commonly on the abdomen but also in other areas of the body. This is due to the stretching caused by the growing fetus and the weight gain of the pregnant woman, as well as genetic and hormonal factors. Stretch marks appear as bluish-violet and whitish streaks and bands. There is no well-documented preventive treatment. Stretch marks may become lighter and fade over time after pregnancy, but they usually do not disappear completely.
Pigment (or melanin) causes brownish skin changes, such as freckles. Most pregnant women experience several pigment changes, including:
Freckles may become darker during pregnancy, and new ones may appear. This is normal and not dangerous. However, any freckle that stands out, is irregular, or grows rapidly should be examined by a doctor, just as with non-pregnant individuals.
In addition to new or changed freckles, about 75% of pregnant women also develop melasma(s). Melasma is caused by an overproduction of melanin, which deposits in the upper layer of the skin. This overproduction is caused by hormonal changes. Sun protection is the most important preventive measure. Most melasma will resolve on its own within the first year after childbirth, but some may persist. If the melasma persists over time, prescription creams can be tried.
Many pregnant women also develop a vertical, brownish stripe (linea nigra) from the navel to the pubic area during the latter half of pregnancy. This is also due to hormonal changes and will usually disappear within a year after childbirth. Individuals with darker skin types are more prone to such skin changes. Sun protection can partially prevent linea nigra and help normalize the skin.
Hormonal changes during pregnancy can cause both increased and decreased hair growth. Some women experience increased hair growth on the face, and occasionally on the arms, legs, back, and pubic area. The hair may also appear thicker. However, in the period of 1-5 months after childbirth, there may be transient increased hair loss or thinning, known as telogen effluvium.
Itch without a known cause occurs in about 20% of all pregnant women. It is typically localized in the scalp, genital area, around the anus, and on the abdomen (in the third trimester). The itch can be relieved with measures such as oatmeal baths, light therapy, antihistamines (allergy tablets), and corticosteroid creams. In cases of severe itch, or if there are accompanying skin changes, it is important to rule out pregnancy-related skin diseases.
The growing fetus can cause pressure on the blood vessels in the pelvic area that transport blood back to the heart (known as veins). This creates increased pressure, which can result in dilated, visible blood vessels in the legs called varicose veins. Most varicose veins become less visible after pregnancy, but some may persist. Only a few require treatment. Varicose veins can be partially prevented by wearing compression stockings during pregnancy.
