When we think of skin changes in pregnancy, what immediately comes to mind are stretch marks or Striae Gravidarum . Stretch marks occur because of a breakdown of collagen, a substance that holds the skin together and is responsible for its stretching. Teen pregnant patients are more at risk for having stretch marks. Why is that important? Because, according to medical literature, stretch marks can increase the risk of having lacerations (or tears) during birth.
Another fairly common skin condition during pregnant is called Pruritus gravidarum or generalized itching during pregnancy without the presence of a rash. Approximately 14% of pregnant women are affected by this condition and it is associated with twin pregnancies, fertility treatments and diabetes. As stated in my previous blog, itching during pregnancy should not be ignored, especially in the third trimester because it could signify a condition called Cholestasis of Pregnancy that involves an increase in bile or liver enzymes. This condition is also associated with preterm labor.
Hormonal changes of pregnancy that involve estrogen or progesterone can produce skin lesions called spider angiomatas. Although spider angiomatas are associated with pregnancy, they can also be seen in men who are alcoholics.
If you are a pregnant woman who has palms that are red, especially at the fingertips than you have a condition called Palma Erythema. Palma Erythema occurs because of an increase in blood flow in the body and is a way of eliminating heat that comes from the fetus and disappears after the baby is born.
The most common rash that is associated with pregnancy is called PUPPPs (Pruritic Urticarial Papules and Plaques of Pregnancy). It usually develops in the third trimester and has a distinct look. It usually begins in the abdomen, involving the stretch marks and then spreads to the legs, buttocks and thighs. It is extremely itchy and is usually treated with topical steroids. Fortunately, it does not have a negative effect on the fetus.
The most serious skin disorder in pregnancy is called Pemphigoid Gestationis which is a rare, autoimmune disease. The rash begins around the belly button and then spreads to the trunk, buttocks and extremities. It is intensely itchy, can occur at any time of the pregnancy including the post partum period. It is often associated with premature labor, small babies and can recur in women who take birth control pills. It is usually treated with steroids.
Skin rashes during pregnancy should not be ignored or self-treated. At least three skin disorders that are associated with pregnancy can have an adverse effect on the fetus. Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.
*This blog post was originally published at Dr. Linda Burke-Galloway*