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The skin during pregnancy and breastfeeding
When you become pregnant, the body undergoes a major change and it is affected both externally and internally. This is largely due to the hormonal surge you get during pregnancy. During pregnancy, blood volume increases by between 30–50%, which usually has a positive effect on skin health. After enjoying the pregnancy glow, many women may experience postpartum skin problems. Most of these skin conditions occur due to hormonal changes. The levels of hormones such as progesterone and estrogen, which are responsible for maintaining a healthy pregnancy, suddenly decrease after childbirth, causing changes in the body, especially in the skin. In this article, we go through the most common changes that affect the skin during pregnancy and give our best tips on how to manage them.

Our best skin tips for you who are pregnant or breastfeeding, in short:

The most common skin complications during pregnancy and breastfeeding are stretch marks, changes in skin color (hyperpigmentation/melasma), hormonal acne, dry skin, broken veins or sensitive skin. These are our tips for you who have:

- Melasma: Sun protection is essential and really the most important thing to think about in melasma because the pigment cell is hypersensitive to sunlight.

- Hormonal acne: Drug treatment usually waits until breastfeeding is finished. To balance the skin with acne, you should use skin care that balances the sebaceous glands.

- Varicose veins: It is difficult to overcome varicose veins with skin care. To treat varicose veins, one often has to turn to heat/laser treatment or injection of astringent substances to remove the varicose veins.

- Dry skin during the breastfeeding period: The best way to treat postpartum dryness is to invest in a good moisturizer that contains three components: skin-specific fats, moisture binders and barrier-strengthening substances.

- Stretch marks Studies show that mainly massage and softening of the skin can reduce the appearance of stretch marks. Here it works with oil or cream to massage the area.

How do my hormones affect me and my skin?

During pregnancy, our female hormones are vital for the pregnancy to continue. Of the 6 most important hormones during a pregnancy - HSG, progesterone, oestrogen, prolactin, oxytocin and relaxin - there is by far the most research on oestrogen, progesterone and prolactin and the effect of these hormones on the skin.

Estrogen is a hormone produced early in pregnancy. Together with progesterone, it causes the lining of the uterus to grow and thicken so that the egg can attach and the pregnancy continues. Estrogen also helps with fetal development and the development of placenta function. It also affects your breasts, so if you feel that they are growing and tender, it is because the estrogen prepares them for breastfeeding already during the first trimester. Estrogen also makes you more sensitive to smell, taste and touch, which can be lovely but sometimes nauseating. The high estrogen levels during pregnancy also mean that you lose less hair than usual and that your nails grow faster.

Both progesterone and estrogen affect the firmness and elasticity of the skin. However, the negative effects of these hormones are that they make the pigment cell more sensitive to sunlight, which means that the risk of developing hyperpigmentation or melasma is high during pregnancy.

In the middle of pregnancy , the production of prolactin increases. Prolactin's main task is to form breast milk and to stimulate breast growth together with estrogen. But prolactin is not only milk producing, but also works in many other areas, such as our immune system, our mental health and metabolism. It is also the hormone that makes us humans, and mammals too for that matter, brood and feel the instinct to protect our children. Like oxytocin, prolactin helps with bonding with the newborn baby and is secreted during breastfeeding.

Many people notice a change in their skin, hair and nails during breastfeeding. If you have a skin condition, it can also often worsen during breastfeeding. This is largely due to the effect of prolactin on the skin. An accepted term in dermatology is now the prolactin-skin connection, which explains many skin changes during breastfeeding where the prolactin affects pretty much all of our skin cells including sebaceous glands and hair follicles as well as the immune system in the skin (1).

Figure 1. The hormones progesterone, estrogen and prolactin during pregnancy.

Most common skin changes during pregnancy and after childbirth

Melasma

Also known as ringworm, is a skin condition characterized by spots and dots similar to freckles. It occurs mainly on the sun-exposed parts of the face and often on the cheeks, chin, temples and nose. The condition is more common in women with medium to dark skin tones and is caused by increased melanin production due to a combination of hormonal and genetic factors as well as sun exposure. Pregnancy, use of birth control pills and sun exposure are the most common triggering factors.

Although melasma does not cause pain or itching and may resolve on its own, it can cause cosmetic concern for patients.

Tips for melasma:

Sun protection is A and O and really the most important thing to think about with melasma because the pigment cell is hypersensitive to sunlight. You can also treat melasma with ingredients such as retinol, tretinoin (after breastfeeding is finished), azelaic acid, N-acetyl glucosamine or/ in combination with niacinamide and vitamin C.

You can find these substances in our products Sun Emulsion SPF 50+ and Night Active Retinol.

Hormonal acne

Postpartum acne can appear in many forms, white or black blackheads, pustules and painful cysts. Many women develop acne during their pregnancy which disappears after delivery. But for some women, it continues even into the postpartum period. Developing acne during pregnancy is normal and is mainly caused by an increase in progesterone levels. After pregnancy, progesterone levels return to normal and acne disappears. But it can take longer for some women to normalize their hormone levels, which means they may have acne even after giving birth.

Tips for hormonal acne:

Drug treatment usually waits until breastfeeding is finished. To balance the skin with acne, you should use skin care that balances the sebaceous glands. Look for ingredients like zinc, niacinamide (vitamin B3), vitamin A, azaleic acid, and PHA acids (such as lactobionic acid).

You can find these substances in our products Night Active Control , Light Emulsion and Rich Emulsion .

Can you use retinol during pregnancy and breastfeeding?

High doses of vitamin A should be avoided during pregnancy, due to the damaging effect of vitamin A acid on the fetus. For example, pregnant women are advised against eating liver, which contains high levels of vitamin A (retinol). However, foods with lower levels of vitamin A do well, such as dairy products and eggs.

So what about skin care containing retinol? If we count on a concentration of 0.1% retinol in a skin care product, it is incredibly little vitamin A that we can possibly get through the skin. Calculation example. 0.1%, (2 mg/cm2), application to the face which is about 40cm2 and a maximum of 10% absorption through the skin gives 0.008 mg of Retinol which is absorbed with each application.

The corresponding 0.008 mg retinol equivalent is found in about 30 grams of carrots.

Carrots contain about 10mg/g beta-carotene. There is approx. 30% absorption of beta-carotene from the intestine, 12 mg of beta-carotene corresponds to 1 mg of retinol. From this it follows that 0.008 mg of retinol corresponds to the amount of beta-carotene that we get if we eat about 32 grams of carrots (0.008/0.01/0.3*12), which is a very small carrot.

When retinol is used topically (approx. 0.1%), there is therefore very little systemic absorption of retinol via the skin.

You will find these substances in our products Night Active Control and Night Active Retinol .

Varicose veins

Also known as spider veins, is a postpartum skin condition characterized by abnormally swollen veins. Varicose veins are associated with increased estrogen levels and often appear in the third trimester of pregnancy. They can sometimes persist for several months up to a year after childbirth. The increased blood volume in the body during pregnancy creates pressure in the blood vessels, causing the blood to back up in the veins. This can cause the veins in the lower extremities to become enlarged and look like swollen and tangled veins.

Tips for varicose veins:

 Unfortunately, it is difficult to get rid of varicose veins with skin care. To treat varicose veins, one often has to turn to heat/laser treatment or injection of astringent substances to remove the varicose veins.

Dry skin

Especially after childbirth, hormonal changes due to breastfeeding can affect the texture of the skin and cause dryness. Lower levels of estrogen during the breastfeeding period affect the production of hyaluronic acid, collagen and elastin in the body.

The low levels contribute to increased transepidermal water loss which can lead to dehydration and make the skin flaky and dry.

Tips for dry skin during breastfeeding:

The best way to treat postpartum dryness is to invest in a good moisturizer that contains three components: skin-specific fats (ceramides, cholesterol, squalane), and moisture binders (e.g. urea, glycerin/erytriol, ectoin) and barrier-strengthening substances (niacinamide). A good moisturizer helps protect the skin barrier, prevent transepidermal water loss and retain moisture in the skin.

You will find these substances in our products Light Emulsion , Rich Emulsion , Rich Intense and Probiotic Concentrate .

Striae gravidarum – Stretch marks

Dear child has many names, stretch marks, stretch marks or striae gravidarum. This is common and affects about 90% of all women during pregnancy.

Studies show that mainly massage and softening of the skin can reduce the appearance of stretch marks. Here it works with oil or cream to massage the area.

Rich Body Cream, which is formulated completely without additives, is excellent to use in connection with the massage. If you want even more oil, we recommend taking a few drops of Probiotic Concentrate and mixing it in. This contains live lactic acid bacteria (L. reuteri) that come from human breast milk. These are the same bacteria used in Semper's drops that you may give your child to build up a balanced intestinal flora.

Here you will find Rich Body Cream and Probiotic Concentrate .

The list to avoid during pregnancy and breastfeeding

Since pregnancy is completely controlled by this fine-tuning orchestra of hormones, it is of course important not to disturb the hormonal balance. Therefore, one should be especially careful with the intake of hormone-disrupting substances .

What do endocrine disruptors mean?

According to the Swedish Chemicals Inspectorate, the word has the following explanation: Many important processes in the body are controlled by hormones that act at very low levels in the body. Hormone-disrupting substances are substances that are foreign to the body and can disrupt the body's own hormone system. The substances can, for example, contribute to the development of cancer or affect metabolism, the ability to have children and possibly the child's development.

Unfortunately, today's system that evaluates the risks of chemicals is not sufficient to detect how the child's development is affected when the woman is exposed to various chemical mixtures during pregnancy. This is shown by a new study (SELMA study) published in the respected journal Science 2.

Facts about the SELMA study:

The SELMA study is run at Karlstad University and follows approximately 2,300 mother-child pairs from early pregnancy through childbirth and up to the child's school age. The aim is to investigate the significance of exposure to hormone-disrupting chemicals during the early fetal period for the child's health and development later in life. Among other things, the study has shown connections between mixtures of different chemicals and the child's gender development, respiratory problems, cognitive development, growth and chronic diseases later in life.

List of known hormone-disrupting substances that are particularly important to avoid during pregnancy

All hormone-disrupting substances should be avoided during pregnancy. In the past, they have focused on environmental toxins that risk being stored in certain types of fish, i.e. dioxins, PCBs and mercury.

Nowadays, we know that even certain substances in packaging materials also have hormone-disrupting properties, such as some plasticizers in plastics (phthalates) and bisphenol A, which can be found in varnish used on the inside of cans.

Some parabens in skin care products and cosmetics are also on the list of endocrine disruptors. Some sunscreen products also contain UV filters with known endocrine-disrupting effects (see table below).

How much of what you apply gets into the body?

The concentration of substances that penetrate the skin and further out into the body depends on the nature of the molecule and also on the size of the molecule.

Both, for example, parabens and certain UV filters can be measured in the urine as a measure of absorption from the skin to the body, where all have a molecular weight that is below 300 Daltons.

If you want to know more about which chemicals you should avoid as a pregnant woman, we recommend that you read the Nature Conservation Association's list of dangerous chemicals to avoid while pregnant. You can find the list here.

Skinome's products are safe to use during pregnancy and breastfeeding*

The absorption and addition of retinol to the body from Night Active Control and Night Active Retinol is small, the maximum amount you get corresponds to the amount of beta-carotene (which is converted into retinol in the body) that you get by eating a small carrot (about 30 gram carrot). We therefore do not generally advise against using our products even if you are pregnant or breastfeeding.

*However, when using medicines with high levels of vitamin A or if you get higher levels of vitamin A from other sources, you should consult your doctor about the use of our products that contain retinol (Night Active Retinol and Night Active Control)

You will find all our products here.

References

  1. Kerstin Foitzik, Ewan A Langan, RP Prolactin and the skin: a dermatological perspective on an ancient pleiotropic peptide hormone. J Invest Dermatol (2009).
  2. Svensson K, Tanner E, Gennings C, Lindh C, Kiviranta H, Wikström S, BC Prenatal exposures to mixtures of endocrine disrupting chemicals and children's weight trajectory up to age 5.5 in the SELMA study. Sci Rep. 2021 May 26;11(1)11036. doi 10.1038/s41598-021-89846-5.
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