Conclusion of a two-part column
Increased melanin can cause darks spots, especially on the cheeks, forehead, upper lip and arms. These pigment changes will become worse if you don’t protect yourself from the sun. The medical term for this discoloration is melasma.
What to do: Protect your face by using a sunblock that offers both UVA and UVB protection with an SPF of 30 or higher, wearing a hat with a broad brim and sun-protective clothing (Coolibar Sun Protective Clothing). If melasma develops, there are several approaches to treating it including topical fade creams, skin peels and lasers. Consult your dermatologist to see what is best for you.
Also, we see a vertical dark line developing on the abdomen. This is called linea nigra and is quite common and usually fades after delivery. Darkening can also occur under the arms and inner thighs.
Larger and darker nipples and areolas
You may find that your nipples and the dark area around them (the areolas) are getting bigger and darker. The little bumps on your areolas (known as Montgomery’s tubercles) may also become larger. These bumps are oil-producing glands that help fight off bacteria and lubricate the skin. Some women also notice larger, more pronounced veins in their breasts. These changes will normally and slowly resolve after delivery.
Moles can become larger and darker with pregnancy. Nevertheless, have any changing mole checked by your doctor.
Medical conditions change during pregnancy
Some medical conditions may improve with pregnancy such as acne, arthritis, psoriasis, eczema and sarcoidosis. Other conditions may worsen, such as recurrent infections, lupus, skin lymphoma and acne.
This is an itchy rash that starts as bumps on the stretch marks on the stomach. PUPPP stands for Pruritic Urticarial Papules and Plaques of Pregnancy. It is very itchy. It occurs most commonly during the first pregnancy’s last 12 weeks and resolves after delivery. Because the itching can be quite intense, I use topical prescription anti-itch lotions and special light treatments. This usually brings great relief.
There is a condition known as pruritus gravidarum or cholestasis of pregnancy where the skin can become very itchy. This can occur in all pregnancies, usually after week six, and is associated with elevated levels of bile acids. Use gentle cleansers like Dove or Vanicream, and gentle moisturizers like Cerave. In resistant cases I use topical prescription anti-itch lotions and special light treatments. This can bring significant relief.
Your feet may go up half a shoe size or more. The ligaments in your feet may expand and produce permanent changes in your feet. The main thing is to make sure you have comfortable, well-fitting shoes during your pregnancy to maximize your comfort. Most of the swelling will resolve after delivery, but you may find that you are a shoe-size or so larger.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.