Topic Overview

Stretch marks

Stretch marks (striae gravidarum) are lines on the skin that may appear late in pregnancy. They look like slightly indented pink, red, dark, or white streaks, depending on your skin colour. Stretch marks are most common on the belly, but they can also develop on the breasts and thighs.

The cause of stretch marks is not well understood. They have been linked to increasing pregnancy hormones and stretching of the tissue under the skin. Heredity is thought to play a role in the development of stretch marks; if your mother had them, you are likely to have them as well. Weight gain during pregnancy does not seem to play a role in the development of stretch marks. Some women who gain little weight during pregnancy develop stretch marks.

Creams or oils (such as vitamin E oil) or other treatments have not been shown to prevent stretch marks. They do, however, help with skin dryness and may reduce itching.

Although stretch marks never go away, they fade to a lighter colour, becoming less obvious after pregnancy.

Itchy skin

Dry, stretching skin tends to be itchy. Your growing belly is likely to be the most itchy part of your body as your pregnancy progresses. To manage itchy skin, avoid hot showers and baths. After bathing, pat excess water off your skin and apply moisturizer before it has fully dried. Applying moisturizer that you keep in the refrigerator may further reduce itching. Try eliminating drying soaps, skin products with alcohol, and heavily chlorinated water from your daily routine. These may contribute to skin dryness. If you live in a dry climate, use a humidifier at home. For a severe, persistent itch, contact your health professional.

Other skin changes during pregnancy

• The areola, or area around your nipples, may darken in the second trimester of pregnancy.
• A dark line on the skin between your navel and your pubic area (linea nigra) may appear. Linea nigra fades after pregnancy.
• Dark patches may develop on your face. This is known as the "mask of pregnancy," or chloasma, and it usually fades after delivery.

These skin pigment changes are not totally understood. It is thought that high levels of pregnancy hormones cause the pigment-producing cells in the skin (melanocytes) to make more pigment.^{footnote 1} To help keep these skin changes from being too obvious, use sunscreen and avoid sun exposure.

Some women develop redness on the palms of the hands (palmar erythema) during pregnancy. Sometimes the red areas are also itchy. Palmar erythema is thought to be caused by increased levels of estrogen during pregnancy. The problem is not serious and usually disappears shortly after delivery.

Tiny, red elevated areas (vascular spiders, or angiomas) on the face, neck, chest, and arms affect some women during pregnancy. Like palmar erythema, angiomas are not serious and usually go away after pregnancy.

Other normal skin changes that occur during pregnancy include blotchy skin and acne. Acne may either increase or clear up during pregnancy.

Some women develop a red, raised rash that itches. This is called pruritic urticarial papules and plaques of pregnancy (PUPPP). It most often occurs in a first pregnancy. The rash may first appear on stretch marks on the stomach. Then it may spread to the thighs, rear end (buttocks), and arms. PUPPP is not a serious condition and does not cause problems for your baby. But it can be very upsetting for you. Controlling your symptoms is the main focus of treatment. PUPPP usually goes away on its own shortly after your baby's birth. The condition is usually treated with anti-itch creams. If the itching is very bad, you may be given corticosteroid pills.