Skin rashes in pregnancy

Written by Dr Jyoti Ramani,



During pregnancy, skin changes are common. Many of these skin changes are normal in pregnancy and should not be mistaken for a rash or skin disorder.

What are normal skin changes during pregnancy?

The most common skin changes in pregnancy are:

melasma: brown, clearly defined patches on the face, typically on the cheekbones and forehead.

darkening of the nipples and external genitals (pubic area).

darkening of existing moles.

linea nigra: a dark line that appears on the abdomen, running straight down from the umbilicus (belly button).

striae gravidarum (stretch marks of pregnancy): red lines or bands that can appear on the abdomen during pregnancy, or the breasts after breastfeeding, which later become white, smooth, shiny and flattened.

veins on the skin can become more obvious.

varicose (swollen) veins can appear on the legs.

an increase in the number of skin tags (small, harmless skin outgrowths that occur especially on the neck, but can be found on any part of body).

acne can worsen.

Why do skin changes occur during pregnancy?

Pregnancy causes changes in blood hormone levels, mainly an increase in oestrogen levels and melanocyte-stimulating hormone (MSH). Melanocytes are the cells within the skin whose concentration determines the degree of pigmentation of the skin.

Darkening (hyperpigmentation) occurs following the increase in MSH. The changes in veins are due to the increase in oestrogens. Striae gravidarum occur when elastic tissue stretches as the abdomen and breasts enlarge.

Are these skin changes permanent or harmful?

Most of these changes disappear within a few months after the baby is born, but tend to reappear in subsequent pregnancies. Striae gravidarum do not disappear completely, but in time they become less noticeable.

Except for affecting the mother's appearance (cosmetic effects), these skin changes do not harm mother or baby in any way.

What are abnormal skin conditions in pregnancy?

Skin disorders that occur during pregnancy can be:

rashes specific to pregnancy, called specific dermatoses (skin disorders) of pregnancy.

non-specific rashes that could occur at any time.

itching without rash.

These disorders can cause harm to mother and baby, so seek medical advice if you spot any skin changes that seem abnormal. Itching without rash can be normal or abnormal in pregnancy. Advice should be sought if itching occurs after the first trimester (three months) of pregnancy, or if it keeps getting worse.

Specific dermatoses of pregnancy

Rashes that only occur in pregnancy are:

PUPPP - (pruritic urticarial papules and plaques of pregnancy)

herpes gestationis

impetigo herpetiformis

papular dermatitis of pregnancy

prurigo gestationis.

Non-specific rashes during pregnancy

Any skin disorder can appear during pregnancy. Causes of rashes include allergies, medicines, insect bites, skin infections, viral infections, parasites, tumours, and a group of diseases that affect the whole body known as connective-tissue disorders.

These rashes can affect any person at any time, not specifically pregnant mothers. However, pregnancy can change the appearance and consequences of these rashes, and the condition causing the rash may also have harmful effects on the pregnancy.

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