The adaptation of the organism during pregnancy leads to typical morphological and functional changes in the skin. These are completely normal and do not need treatment. They include the following;
■ Pigmentation. Spotty hyperpigmentation (melasma) may appear on the face, and usually disappears spontaneously after birth.
This is intensified by exposure to UV light (i.e. to direct sunlight), and using sun block can minimize it. Additionally, pigmentation of the nipples and the areola, the area around the navel, the armpits, and the genital and anal regions is intensified. In general, sensitivity to light is increased in pregnancy.
■ Striae. During the second half of pregnancy, striae distensae appear relatively often on the stomach, the hips, the thighs and the breasts. As body size increases, these become wider and more plentiful. The skin in the area around the striae is thin, flabby, and inelastic. There is no known physical measure or drug that is effective as prophylaxis.
■ Fibroma. Soft fibromata appear more frequently during pregnancy, especially in the neck and axillary regions.
■ Blood vessel changes. Blood circulation in the skin is increased; it feels warm, and the vasomotor excitability of the vessels in the face increases. This can lead to quick blushing and blanching, and to increased dermatographism. In addition, the veins in the breast and stomach skin are much more visible, and varicosities in the legs and the vulva, as well as hemorrhoids, may appear.
■ Skin glands, hair and nails. Especially in early pregnancy, the secretion of the sebaceous glands can increase significantly. Acne frequently improves. On the other hand, an acute pregnancy acne (acne gravidarum) can occur during the third month. This disappears during the postpartum period. The growth of hair on the head and of nails is generally enhanced during pregnancy. After birth, hair loss often seems quite threatening; however, this syn-chronal transition from anagen to telogen hair is fully physiologic, and usually returns to normal over the next few months postpartum. It does not require therapy.
Topically applied substances are absorbed in greater quantities during pregnancy. This applies especially to skin that has been altered by infection, and to sore areas; this can lead to increased exposure to the system and thus to the fetus.
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