We’re not revealing anything if we say that pregnancy represents a comprehensive revolution in the body (and life) of a woman. The months of gestation are months of radical changes to which one must adapt, from adjustments in home logistics to changing the wardrobe with maternity clothes. But the news of pregnancy also affects our skincare, and indeed among the major victims of the hormonal chaos that this state entails is our skin.
During pregnancy, everything we are used to is called into question in order to advocate for the wellbeing of both mother and baby. It happens with diet, sports activities and, of course, beauty routines, especially those that affect our skin, which requires special and even more personalized care in these months. Surely, if you find yourself in this situation, you have many questions about it. Therefore, we have spoken with Myriam Yébenes, CEO of Maribel Yébenes and a dermoesthetic expert for more than 25 years, to explain what happens to our skin during pregnancy and give us the keys to keep it well cared for.
First of all, the expert states that «there is no single ‘pregnancy skin’». While some women perceive their face as more luminous, others suffer from dryness, sensitivity, acne, increased oil production, dehydration, darkening of moles or the dreaded appearance of melasma. Regarding the body, the most common symptoms are, as Yébenes confirms, the darkening of the areolas, underarms or the midline of the abdomen, in addition to the appearance of stretch marks, spider veins, varicose veins, edema or itching.
What causes all these changes? «Primarily the intense hormonal activity inherent to gestation, the increase in blood volume, changes in immune response and the mechanical distension of tissues, in the case of stretch marks», she tells us. Facing concerns about how long these changes will last, the expert delivers a reassurance: «most of them are physiological alterations that tend to improve after childbirth». That said, in case of abnormalities or concern about any of the symptoms, the best course is always to consult a professional.
What to keep and what not to keep in the skincare routine during pregnancy
The first thing worth checking are the actives we use. The professional recommends «simplifying the routine and prioritizing hydrating, soothing and barrier-repairing actives». Hyaluronic acid, glycerin, ceramides, panthenol, niacinamide, vitamin C and azelaic acid are some of the options that best meet these requirements. On the other hand, pregnancy «is not the time to perform intense exfoliations nor to accumulate several acids in the same routine», so alpha-hydroxy acids, such as glycolic or lactic acid, or salicylic acid can be used punctually and in relatively low concentrations, and always under the supervision of a dermatologist and your obstetrician.
The big no-nos are retinoids in all forms, whether prescription or cosmetic use. In addition, Myriam Yébenes urges to «avoid hydroquinone and review any medical treatment for acne or hair loss, especially if it contains spironolactone, finasteride or certain antibiotics». «Another common mistake is to assume that a product is safe only because it is ‘natural’: some essential oils and concentrated extracts also do not have sufficient safety data during gestation», she concludes.
Alongside the actives, another major unknown in aesthetic care are the treatments. The expert’s stance is clear: «During pregnancy, the criterion must be very clear: when a treatment is purely elective, does not provide a medical benefit and there is not enough safety data, the reasonable thing is to postpone it. From Maribel Yébenes we would recommend suspending neuromodulators, fillers, biostimulators, threads, mesotherapies, injectable treatments, microneedling, lasers and IPL for aesthetic purposes, radiofrequency, focused ultrasounds, cryolipolysis, body remodeling devices, medium or deep peels and any procedure that causes significant inflammation. Soft and non-invasive care can be performed, provided they are adapted. In the case of body massages, it is essential to have the obstetrician’s authorization and to go to a professional trained in prenatal massage. During this stage, the goal is not to transform the face or body, but to preserve comfort, hydration and the health of the skin barrier».
But if there is a non-negotiable for pregnant skin, it is the sunscreen, which Myriam Yébenes calls the «main preventive treatment during pregnancy». Her recommendation is to use daily a broad-spectrum, water-resistant sunscreen with SPF 50, without forgetting that sunscreen does not replace shade. For particularly sensitive skin, her best allies are mineral filters with zinc oxide or titanium dioxide, while if the skin shows melasma or a tendency to spots, the best option is to choose color sunscreens with iron oxides.
Mujer embarazada
Melasma y estrías: las principales preocupaciones estéticas entre embarazadas
Among the most common skin changes during pregnancy are melasma and stretch marks. The expert defines melasma, also known as the ‘pregnancy mask’, as «an acquired pigmentation alteration that manifests as brown or grayish spots, usually symmetrical, in areas such as the forehead, cheeks, bridge of the nose or upper lip». This is because during pregnancy, hormonal changes increase melanocyte activity and make the skin respond more intensely to ultraviolet radiation and visible light, although factors such as genetics, phototype, or prior sun exposure history also come into play.
Yébenes explains that it cannot always be fully avoided, but it can reduce the risk of appearance or darkening: «The fundamental measure is daily and consistent photoprotection, preferably with color and iron oxides, along with hat, shade and reducing direct exposure. It is also important to avoid irritation, because inflamed skin can produce more pigment. During gestation actives such as azelaic acid, vitamin C or niacinamide can be considered, always with an appropriate formulation and a progressive introduction. Retinoids and hydroquinone should be avoided, and more intensive treatments, such as certain lasers, peels or depigmenting protocols, should be postponed».
Regarding this, the expert warns that although in some women melasma disappears after delivery, in others it can remain for years or reappear with each sun exposure. Her recommendation: «It is not advisable to approach it as a stain that must ‘erase’ quickly. It needs consistency, diagnosis and a careful combination of protection, home treatment and, when possible, personalized professional procedures».
In the case of stretch marks, the dermoesthetics expert is emphatic: «There is no cream that can honestly guarantee that a woman will not develop stretch marks». Indeed, stretch marks, as she defines them, are a type of scar that appears when the skin stretches rapidly and the collagen and elastin fibers are altered; factors such as genetics, the speed of weight gain, or hormonal changes, among others, influence their appearance. Guidelines such as maintaining weight gain within obstetrician recommendations, daily skin hydration or actives like hyaluronic acid and Asiatic centella help keep the skin barrier healthy and improve skin flexibility, but there are no products that certify total prevention against stretch marks.
Myriam Yébenes insists that once stretch marks have appeared, they can be faded but never completely eliminated. «Recent stretch marks, still reddish or purplish, tend to respond better than older white ones. After pregnancy, and also considering breastfeeding, treatments such as fractional laser, microneedling, radiofrequency, or combinations of techniques that stimulate collagen remodeling can be considered. Retinoids can improve some recent stretch marks, but they are contraindicated during pregnancy and should not be introduced during breastfeeding without medical indication», she advises.
What about hair and nails during pregnancy?
Not only the skin, hair and nails are also victims of the hormonal and metabolic changes the mother’s body experiences during gestation. It is common for many women to notice that during these months their hair looks thicker, more abundant and shiny, and that after delivery it enters a shedding phase known as «postpartum telogen effluvium» which responds to the drop in estrogen that occurs in this situation.
Therefore, the expert emphasizes that during pregnancy and postpartum there should be a respectful hair care routine: «use gentle shampoos, apply conditioner from mid-length to ends, reduce the use of heat tools and avoid overly tight hairstyles». «It is not advisable to start hair supplements or anti-hair loss treatments on your own», she continues, and notes that it is wise to consult a dermatologist if there are «patches of hair loss, scalp inflammation, very intense shedding or if the volume does not recover approximately after childbirth».
In the case of nails, it is also common to notice they grow faster, but as Myriam Yébenes points out, they can also become fragile, brittle or show ridges and flaking. The expert recommends that, to optimize nail care, we turn to regular hand and cuticle hydration, wear gloves when handling cleaning products and avoid overly aggressive manicures.
The routine recommended by the expert for pregnant women
With all this information in hand, the question remains: what is the best skincare routine during pregnancy? The dermoesthetic expert details it step by step: «In the morning we would recommend a gentle cleanse, followed by a well-tolerated antioxidant, such as vitamin C or niacinamide, a moisturizer suited to the skin type and an SPF 50 broad-spectrum sunscreen (she recommends Beyond Sun Protection SPF 50, which in addition to protecting also includes niacinamide and vitamin E to reinforce the skin barrier). If melasma or a predisposition to dark spots is present, it would be preferable that the sunscreen has color and iron oxides. At night, it would be enough to cleanse again, use azelaic acid if acne or pigmentation exists and has been recommended by a professional, and finish with a hydrating and reparative formula».
«For the body we advise lukewarm showers, cleansers that do not disrupt the skin barrier and the daily application of a body cream or emulsion on slightly damp skin. Focus can be placed on the abdomen, breasts, hips, thighs and buttocks, not with the promise of completely preventing stretch marks, but to keep the skin flexible, comfortable and properly hydrated», she adds.
Finally, the expert leaves us with a series of guidelines worth keeping in mind: «The most common error is overcomplicating the routine, but it is also common to apply an insufficient amount of sunscreen or to reserve it only for days at the beach. During pregnancy, a simple, consistent and personalized routine is usually much smarter than trying to fix every change with intensive treatments. The skin does not need to stop taking care of itself, but it should be cared for differently».
