The Common Skin Changes of Pregnancy

The skin changes that can occur in pregnancy are not often discussed, and they can be concerning if you do not know what is considered normal.

The most common skin change associated with pregnancy is hyperpigmentation, or darkening of the skin, which occurs in more than 90% of pregnant women. The most common areas of hyperpigmentation are the nipples, genitalia, and an area between the belly button and groin that presents as a brown vertical line known as the linea nigra, or dark line.

The increase in pigmentation is thought to be due to an increase in certain hormones, including estrogen and progesterone. Although the hyperpigmentation typically regresses after delivery, some areas may never return to their pre-pregnancy state.

Melasma: The “Mask of Pregnancy”

Melasma is a specific hyperpigmentation of the face, sometimes called the “mask of pregnancy,” that occurs in approximately 70% of pregnant women. It can also occur outside of pregnancy, especially in women taking oral contraceptive pills or other hormonal treatments. The increased pigmentation (darkening) typically occurs on the forehead, cheeks, and bridge of the nose.

Avoidance of sun exposure and the use of sunscreens can help to prevent or minimize melasma. Although it typically resolves after delivery, it may persist for months or even years in up to 30% of women. The available treatments postpartum (after the pregnancy) for those patients in whom the darkening of the skin does not improve include various topical medications, chemical peels, and more expensive skin regimens, including intense pulse light or fractionated photolysis laser.

Pregnancy Can Cause Skin Tags and Moles

Lastly, pregnancy can cause the growth of new moles or enlarge preexisting moles, as well as induce the growth of skin tags. Skin tags are soft growths of tissue that are typically skin-colored to dark brown, and usually appear on the neck, under the arms, or in the groin. Skin tags will not regress postpartum, but they can easily be removed with scissors or electrocautery.

Be Aware of Skin Changes and Talk with Your Doctor

The formation of melanoma (skin cancer) in pregnancy is not increased over that in the non-pregnant population. You should discuss with your provider any changes in moles with irregular non-rounded edges, patriotic coloring (slight tints of red, white or blue) or that occur in areas not exposed to the sunlight. It is important to be aware that there are additional skin changes that can occur during pregnancy that may affect your health or that of your baby, and you should inform your doctor if you have any concerns.