Black spots on skin during pregnancy

Skin Conditions During Pregnancy | ACOG

Many women notice changes to their skin, nails, and hair during pregnancy. Some of the most common changes include the following:
- Dark spots on the breasts, nipples, or inner thighs
- Melasma—brown patches on the face around the cheeks, nose, and forehead
- Linea nigra—a dark line that runs from the navel to the pubic hair
- Stretch marks
- Acne
- Spider veins
- Varicose veins
- Changes in nail and hair growth
Some are due to changes in hormone levels that happen during pregnancy. But for most skin changes health care professionals are not sure of the exact cause.
Dark spots and patches are caused by an increase in the body's melanin—a natural substance that gives color to the skin and hair. The patches are called melasma or "the mask of pregnancy."
To help prevent melasma from getting worse, wear sunscreen and a wide-brimmed hat every day when you are outside. The sun's UV rays can reach you even on cloudy days.
Dark spots and melasma usually fade on their own after you give birth. But some women may have dark patches that last for years. If melasma does not go away, you can talk with a dermatologist about treatment options. Dermatologists are specialists in skin conditions.
As your belly grows during pregnancy, your skin may become marked with reddish lines called stretch marks. These marks occur when the skin stretches quickly as the fetus grows. By the third trimester, many pregnant women have stretch marks on the abdomen, buttocks, breasts, or thighs. Sometimes the marks are faint. Sometimes they can be quite dark.
There are many products on the market that claim to prevent stretch marks. There is no proof that any of these treatments work. Using a heavy moisturizer may help keep your skin soft, but it will not help get rid of stretch marks. Most stretch marks fade after the baby is born, but they may never disappear completely.
Many women have acne during pregnancy. Some already have acne and notice that it gets worse during pregnancy. Other women who may always have had clear skin may develop acne while they are pregnant.
If you get acne during pregnancy, take these steps to treat your skin:
- Wash your face twice a day with a mild cleanser and lukewarm water.
- If you have oily hair, shampoo every day and try to keep your hair off your face.
- Avoid picking or squeezing acne sores to lessen possible scarring.
- Choose oil-free cosmetics.
Over-the-counter (OTC) products containing the following ingredients can be used during pregnancy:
If you want to use an OTC product that contains an ingredient not on this list, contact your obstetrician–gynecologist (ob-gyn).
Some prescription acne medications should not be used while you are pregnant:
- Hormonal therapy—Several medications that block specific hormones can be used to treat acne. Their use during pregnancy is not recommended due to the risk of birth defects.
- Isotretinoin—This drug is a form of vitamin A. It may cause severe birth defects in fetuses, including intellectual disabilities, life-threatening heart and brain defects, and other physical deformities.
- Oral tetracyclines—This antibiotic can cause discoloration of the fetus’s teeth if it is taken after the fourth month of pregnancy and can affect the growth of the fetus's bones as long as the medication is taken.
- Topical retinoids—These medications are a form of vitamin A and are in the same drug family as isotretinoin. Unlike isotretinoin, topical retinoids are applied to the skin, and the amount of medication absorbed by the body is low. But it is generally recommended that use of these medications be avoided during pregnancy. Some retinoids are available by prescription. Other retinoids can be found in some OTC products. Read labels carefully.
If you are concerned about which products to use to treat your acne, talk with your dermatologist and ob-gyn. Together you can decide which option is best for you.
Hormonal changes and the higher amounts of blood in your body during pregnancy can cause tiny red veins, known as spider veins, to appear on your face, neck, and arms.
Spider veins are most common during the first half of pregnancy. The redness should fade after the baby is born.
The weight and pressure of your uterus can decrease blood flow from your lower body and cause the veins in your legs to become swollen, sore, and blue. These are called varicose veins. Varicose veins can also appear on your vulva and in your vagina and rectum (usually called hemorrhoids). You are more likely to have varicose veins if someone else in your family has had them.
In most cases, varicose veins are a cosmetic problem that will go away after delivery.
You cannot prevent them, but there are some things you can do to ease the swelling and soreness and prevent varicose veins from getting worse:
- Be sure to move around from time to time if you must sit or stand for long periods.
- Do not sit with your legs crossed for long periods.
- Prop your legs up on a couch, chair, or footstool as often as you can.
- Exercise regularly—walk, swim, or ride an exercise bike.
- Wear support hose.
- Avoid constipation by eating foods high in fiber and drinking plenty of liquids.
If a tender, red spot appears on your leg, it should be checked by your health care professional.
The hormone changes in pregnancy may cause the hair on your head and body to grow or become thicker. Sometimes women grow hair in areas where they do not normally have hair, such as the face, chest, abdomen, and arms.
Your hair should return to normal within 6 months after giving birth. In the meantime, it is safe to use tweezing, waxing, and shaving to remove unwanted hair during pregnancy.
About 3 months after childbirth, most women begin to notice hair loss from the scalp. This happens because hormones are returning to normal levels, which allows the hair to return to its normal cycle of growing and falling out. In most cases, your hair should grow back completely within 3 to 6 months.
Some women find that their nails grow faster during pregnancy. Others notice that their nails split and break more easily. Like the changes to your hair, changes that affect your nails will ease after birth.

Some uncommon health conditions can arise during pregnancy and cause skin changes. These include the following:
- Pruritic urticarial papules and plaques of pregnancy (PUPPP)
- Prurigo of pregnancy
- Pemphigoid gestationis
- Intrahepatic cholestasis of pregnancy (ICP)
In PUPPP, small, red bumps and hives appear on the skin later in pregnancy. The bumps can form large patches that can be very itchy. These bumps usually first appear on the abdomen and can spread to the thighs, buttocks, and breasts.
It is not clear what causes PUPPP. It usually goes away after you give birth. In the meantime, your health care professional may prescribe anti-itch medication to help with the itching.
With prurigo of pregnancy, tiny, itchy bumps that look like insect bites can appear almost anywhere on the skin. This condition can happen anytime during pregnancy. It usually starts with a few bumps that increase in number each day. It is thought to be caused by changes in the immune system that occur during pregnancy.
Prurigo can last for several months and may even continue for some time after the baby is born. It is usually treated with anti-itch medication applied to the skin and other medications, such as antihistamines and corticosteroids.
Pemphigoid gestationis is a rare skin condition that usually starts during the second and third trimesters of pregnancy or sometimes right after childbirth. With this condition, blisters appear on the abdomen, and in severe cases, the blisters can cover a wide area of the body. It is thought to be an autoimmune disorder. Sometimes the condition returns during future pregnancies.
There is a slightly increased risk of pregnancy problems with this condition, including preterm birth and a smaller-than-average baby. There is also a small chance that your baby will have similar blisters at the time of birth. These blisters are usually mild and go away within a few weeks.
If your health care professional diagnoses pemphigoid gestationis after checking your blisters, you and your fetus should be monitored closely during the last part of pregnancy. Your health care professional may also give you medications to control the outbreak of blisters and help relieve your discomfort.
ICP is the most common liver condition that happens during pregnancy. Bile is a substance that is made in the liver. Bile travels from the liver to the small intestine, where it is used to break down fats in food. In ICP, this flow of bile is blocked and the components of bile are deposited in the skin.
The main symptom of ICP is severe itching in the absence of a rash. Itching commonly occurs on the palms of the hands and soles of the feet, but it can also spread to the trunk of the body. It is typically worse at night.
Symptoms usually start during the third trimester of pregnancy and often go away a few days after childbirth. But ICP can happen again in future pregnancies.
If your health care professional diagnoses ICP after doing blood tests, you and your fetus should be monitored closely during the third trimester. Close monitoring is needed because ICP may increase the risk of preterm birth and other problems, including, in rare cases, stillbirth. In some cases, your ob-gyn may recommend an early delivery to help reduce the risk of stillbirth. You may also be given medication to help control severe itching.
Women who already have certain skin diseases, such as atopic dermatitis and psoriasis, may see their conditions worsen or improve while they are pregnant. The changes are different for every woman and every pregnancy.
If you have any type of skin disease, let your ob-gyn know of any changes in signs or symptoms during your pregnancy. You should also review any medications that you take to treat your condition with your ob-gyn to make sure they are safe to use during pregnancy.
For conditions that cause itchy skin, using an over-the-counter anti-itch cream may help provide relief. You also can try the following tips:
- Wash with mild, fragrance-free soaps.
- Add uncooked oatmeal or baking soda to your bath.
- Place a cool, wet cloth on the area to ease the burn.
- Use a heavy moisturizer on your skin twice a day.
Antibiotic: A drug that treats certain types of infections.
Autoimmune Disorder: A condition in which the body attacks its own tissues.
Bile: A substance made by the liver that helps digest fats.
Hormone: A substance made in the body that controls the function of cells or organs.
Immune System: The body’s natural defense system against viruses and bacteria that cause disease.
Linea Nigra: A line running from the belly button to pubic hair that darkens during pregnancy.
Melasma: A common skin problem that causes brown to gray-brown patches on the face. Also known as the “mask of pregnancy.”
Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women's health.
Preterm: Less than 37 weeks of pregnancy.
Rectum: The last part of the digestive tract.
Stillbirth: Birth of a dead fetus.
Trimester: A 3-month time in pregnancy. It can be first, second, or third.
Uterus: A muscular organ in the female pelvis. During pregnancy this organ holds and nourishes the fetus.
Vagina: A tube-like structure surrounded by muscles. The vagina leads from the uterus to the outside of the body.
Vulva: The external female genital area.

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FAQ169

Last updated: July 2022

Last reviewed: December 2021

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

Skin darkening during pregnancy (melasma or chloasma)

Pregnancy
Your Body

By Eva Dasher

September 25, 2020

It's common to develop blotchy spots of darker skin when you're pregnant, a condition called melasma or chloasma. Women with darker complexions are more likely to have melasma than women with lighter skin. Changes in skin pigmentation due to melasma usually disappear on their own after delivery.

Photo credit: Thinkstock

Is it normal to have melasma during pregnancy?
What causes melasma?
Is my linea nigra related to melasma?
How can I prevent melasma from getting worse during pregnancy?
Will I still have melasma after my pregnancy?
Are darkened spots on skin during pregnancy ever a sign of illness?

Is it normal to have melasma during pregnancy?

Yes, it's common to develop blotchy spots of darker skin when you're pregnant, a condition called melasma or chloasma. Melasma is also sometimes referred to as the mask of pregnancy because the splotches typically show up around your upper lip, nose, cheekbones, and forehead in the shape of a mask.

You may also develop dark patches on your cheeks, along your jawline, or on your forearms and other parts of your body that are exposed to the sun. What's more, skin that's already more pigmented – such as your nipples, freckles, scars, and the skin of your genitals – may become even darker during pregnancy. This also tends to happen in areas where friction is common, such as your underarms and inner thighs.

What causes melasma?

Melasma may be triggered by hormonal changes during pregnancy, which stimulate a temporary increase in the amount of melanin your body produces. Melanin is the natural substance that gives color to hair, skin, and eyes.

Sun exposure plays a role too. Women with darker complexions are more likely to have melasma than women with lighter skin.

You're also more likely to develop melasma if it runs in your family.

Is my linea nigra related to melasma?

The same increased production of melanin that causes the facial splotches of melasma also causes the linea nigra, or dark line that you may notice running down your belly.

The linea nigra will probably fade back to its pre-pregnancy color several months after you deliver your baby, but may not completely disappear.

How can I prevent melasma from getting worse during pregnancy?

All changes in skin pigmentation due to melasma usually disappear on their own after delivery, but you can do a few things to safely minimize darkened spots on your skin during pregnancy:

Use sun protection. This is crucial because exposure to the sun's ultraviolet (UV) rays triggers melasma and intensifies pigment changes. Use a broad-spectrum sunblock (a formula that protects against both UVA and UVB rays) with SPF 30 or higher every day, even when it's not sunny, and reapply often during the day if you're outside. This is true even if you have dark skin. Although dark skin has more melanin (pigment) than lighter skin and doesn't sunburn as quickly, it's not enough to protect you from harmful UV radiation.
Even if you don't plan to leave the house or spend much time outside, it's a good idea to apply sun protection as part of your morning routine. The American Academy of Dermatology cautions that your skin is exposed to a significant amount of UV light whenever you walk down the street, ride in a car, or even sit inside near a window.
When you're outside, wear a wide-brimmed hat as well as a long-sleeved shirt if you have pigmentation changes on your arms. Limit the time you spend in the sun, especially between 10 a.m. and 2 p.m. And definitely avoid tanning salons.
Don't wax. Using wax to remove hair can cause skin inflammation that worsens melasma, especially in areas of your body that are affected by pigmentation changes.
Use hypoallergenic skin care products. Cleansers and face creams that irritate your skin may make melasma worse.
Apply concealer. If the darkened spots bother you, cover them up by using makeup for now. Concealer with white and yellow undertones often helps, but consult the makeup salespeople at your local store to find the right product for your skin type. You can also seek the advice of a board-certified dermatologist. Don't use skin-bleaching products while you're pregnant, and talk to your doctor before starting them if you are breastfeeding.

Will I still have melasma after my pregnancy?

Melasma usually fades without treatment after you have your baby. The darkened spots probably will fade within a year after delivery, and your skin should return to its normal shade, although sometimes the changes never completely disappear.

For some women, contraceptives containing estrogen (such as the Pill, the patch, and the vaginal ring) can also contribute to melasma. If the skin changes are bothersome, consider another birth control option.

If your skin is still blotchy a few months after giving birth and it's bothering you, talk to your healthcare provider or a dermatologist about treatment options for melasma. She may suggest using a bleaching cream that contains hydroquinone (and possibly sunscreen), a topical medication that contains tretinoin (Retin-A), or a chemical peel such as azelaic acid.

If you're breastfeeding or plan to get pregnant again soon, let your provider know and check with her before using any over-the-counter treatments.

Don't expect instant results – it may take many months to see improvement. If other treatments haven't helped, a dermatologist can lighten dark spots with laser treatments, but that's not the first option.

In any case, continue to protect your skin from the sun by using sunscreen every day, wearing protective clothing, and staying out of the sun during peak hours.

Are darkened spots on skin during pregnancy ever a sign of illness?

Certain types of skin discoloration can be a symptom of skin cancer or other medical problems.

Call your provider if you have changes in skin pigmentation as well as pain, tenderness, redness, or bleeding, or if you notice any changes in the color, shape, or size of a mole.

You may be referred to a dermatologist for a diagnosis and appropriate treatment.

Wondering what skin care products are safe and which to avoid while pregnant? Check out our article on safe skin care during pregnancy.

Learn more:

Acne during pregnancy
Hair and nail changes during pregnancy
Varicose veins during pregnancy

Sources

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies.

AAD. Undated. Melasma. American Academy of Dermatology. https://www.aad.org/public/diseases/a-z/melasma-overview [Accessed September 2020]

UpToDate. 2019. Maternal adaptations to pregnancy: Skin, hair, nails, and mucous membranes https://www.uptodate.com/contents/the-skin-hair-nails-and-mucous-membranes-during-pregnancy [Accessed September 2020]

UpToDate. 2020. Melasma: Management https://www.uptodate.com/contents/melasma-management [Accessed September 2020]

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Dermatoses of pregnancy

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Pregnancy is a wonderful time for any woman, especially when it is a planned and desired event in the life of a couple. Unfortunately, due to various circumstances, pregnancy does not always occur naturally - in such cases, modern medicine offers various procedures for assisted reproductive technologies. This makes the woman's attitude to such a natural process even more reverent. And here, often, our skin can present surprises. A number of skin conditions can worsen during pregnancy. However, traditionally prescribed drugs have limitations for use in such a situation. And here it is important that the specialist has experience in treating such situations.

Our Clinic is unique in some way, since many years of experience in managing women with skin diseases during pregnancy is not only the head doctor, who has been a consultant at the D.O. Ott, but also other specialists who are employees of the Department of Skin Diseases of the First Medical University. Academician I.P. Pavlov.

Now let's try to explain the causes and identify the most common skin diseases during pregnancy.

During pregnancy, the main cause of skin lesions is considered to be changes in the immune system of the pregnant woman. Pathological processes can be manifested by an exacerbation of chronic skin diseases or the appearance of specific pregnancy-associated dermatosis, the so-called "pregnancy dermatosis".

Changes on the skin are very diverse both in manifestations and in the mechanisms of development. Conventionally, they can be divided into 3 groups:

I. Pregnancy stigmas:

Chloasma is the most famous of them. As a development mechanism, various functional endocrine-metabolic changes during pregnancy are assumed. It appears as brownish spots of indefinite outlines, often symmetrical, on the skin of the cheeks, forehead, chin, neck without subjective sensations. Chloasma can occur at different gestational ages, intensifying as it develops and disappearing without a trace shortly after childbirth. But with subsequent pregnancies, chloasma occurs again. Exposure to sunlight enhances the severity of spots.

Pregnancy melanosis - skin changes in the form of hyperpigmentation in the nipples, genitals, white line of the abdomen, also without subjective sensations or inflammation. After childbirth, these disorders disappear. Chloasma and melanosis usually do not require special treatment and spontaneously regress after delivery.

II. Skin diseases that are relatively often registered during pregnancy:

This group includes a variety of skin changes and diseases that often accompany pregnancy, as well as some common dermatoses, the course of which usually worsens during gestation. The main mechanism is a change in hormonal ratios in the body of a pregnant woman. This, in turn, affects the functionality of the immune and nervous systems, the state of the gastrointestinal tract, kidneys, cardiovascular activity, water-salt metabolism, etc.

This group includes: hyperhidrosis

hypertrichosis
palmoplantar telangiectasias
erythema of the palms
alopecia - hair loss
onychodystrophy - changes in the nail plates

Most of these and other conditions, as a rule, disappear after childbirth. Their treatment, if necessary, is symptomatic.

The course and severity of symptoms of other skin diseases also change during pregnancy. These primarily include eczema, atopic dermatitis, psoriasis, lichen planus, acne, Dühring's herpetiformis. During pregnancy, they often worsen, and exacerbations are usually more pronounced, more severe than before gestation. Sometimes, on the contrary, during pregnancy, a remission occurs, which continues until childbirth, after which another exacerbation occurs. Correction of exacerbations of these dermatoses during pregnancy is very difficult. Many medicines used under normal conditions affect the development of the fetus. Therefore, external symptomatic therapy becomes the leading method.

III. Actually dermatoses of pregnant women

The four skin diseases characteristic of pregnancy, gestational pemphigoid, polymorphic dermatosis of pregnancy, atopic dermatitis of pregnancy, and cholestasis of pregnancy can be distinguished by clinical presentation, histopathology, risk of fetal complications. Only gestational pemphigoid and intrahepatic cholestasis of pregnancy are associated with significant risk to the fetus. Because all of these dermatoses are characterized by pruritus, careful evaluation of any pruritic pregnancies is necessary.

Pregnancy pemphigoid , formerly known as herpes gestationis, is the rarest of the skin disorders of pregnancy and is an autoimmune disease. Clinically, it manifests itself in the form of papules and plaques, transforming into vesiculobullous elements, localized in the umbilical region with spread to the chest, back and limbs. Pemphigoid usually resolves spontaneously within a few months after delivery. As a rule, there is a recurrence of dermatosis during subsequent pregnancies with an earlier onset of dermatosis and greater severity compared to the previous pregnancy. Treatment should be aimed at reducing itching and blistering. In mild cases, topical corticosteroids and antihistamines are effective. In severe pemphigoid, it is advisable to use systemic corticosteroids.

Polymorphic dermatosis of pregnancy (PEP) is a benign, pruritic inflammatory disease. It usually occurs at the end of the third trimester or immediately after delivery in the first pregnancy. Urticarial papules and plaques appear first on the abdomen and, unlike gestational pemphigoid, do not affect the umbilical region. The rash usually spreads to the thighs and buttocks, and can rarely be widespread. Eruptions with clear boundaries regress spontaneously within 4-6 weeks without treatment. Treatment for PEP is based on symptomatic relief with topical corticosteroids and antihistamines. If the rash becomes generalized, a short course of systemic corticosteroids may be used.

Atopic dermatitis of pregnancy (AEP) is the most common skin disorder in pregnancy. AEP is a benign disease characterized by an pruritic eczematous or papular rash. Two-thirds of AEP cases are characterized by eczematous skin changes localized to atopic areas of the body such as the neck and flexor surfaces of the extremities. The remaining cases are characterized by a papular rash in the abdomen and extremities. Lesions usually respond well to treatment and resolve spontaneously after delivery. However, AEP is more likely to recur in subsequent pregnancies. Dermatosis does not significantly affect the fetus, but there is an increased risk of developing atopic dermatitis in an infant.

Intrahepatic cholestasis of pregnancy (ICP) - characterized by acute itching that often begins on the palms and soles and then generalizes. The skin has mostly secondary lesions such as excoriations but may also have papules. In 10%, jaundice develops due to concomitant extrahepatic cholestasis. After giving birth, itching goes away within a few weeks. There is a risk of recurrence in subsequent pregnancies. Diagnosis of ICP is important because there is a risk of complications for both mother and fetus.

Treatment is aimed at normalizing the level of bile acids in the blood serum in order to reduce the risk to the fetus and to control symptoms in the mother. Treatment with ursodeoxycholic acid (UDCA) is recommended. Other drugs that reduce itching may be used, such as antihistamines, dexamethasone. Treatment of pregnant women with dermatoses is very difficult, especially in the first trimester of pregnancy. If dermatosis is detected in a pregnant woman, it is necessary to jointly manage it by a dermatologist, an obstetrician-gynecologist. Treatment of dermatoses in pregnant women requires a differentiated approach to therapy, taking into account the duration of pregnancy, exacerbation of the disease and the prevalence of the process.

The clinic has sufficient laboratory facilities and all the necessary equipment for the diagnosis and treatment of conditions such as pregnancy dermatosis.

How to remove blackheads and enlarged pores? SkinLazerMed

Black dots on the face are “plugs” that are formed due to the accumulation of dead epidermal cells, dust particles and sebum in the pores. Such plugs clog the exits of the sebaceous glands. Melanin is the pigment that gives comedones their black color.

How to get rid of blackheads and enlarged pores?

Even the right home care cannot clean the skin of the face efficiently and effectively. How to take care of the cleanliness and health of your skin in the beauty parlor? We will tell you about the procedures that will take care of your skin: normalize the work of internal processes and significantly improve the appearance of the skin of the face!

1. Facial cleansing

Facial cleansing is one of the best deep skin cleansing procedures. There are several types of cleansing, which are similar to each other, but are prescribed individually, depending on the contraindications, wishes and individual characteristics of the patient.

Ultrasonic cleaning is one of the most gentle types of cleansing that does not cause any trauma to the skin. Cleansing takes place with a special apparatus with a metal nozzle in the form of a "shovel". Under the influence of ultrasonic vibrations, the skin is cleansed, the ducts of the sebaceous glands open, the blood supply and metabolic processes in the cells improve. The procedure is absolutely painless and comfortable for the patient.

Mechanical cleaning is a procedure aimed at deep cleansing of the face. During the procedure, both open and closed comedones are removed. This procedure is slightly traumatic and may cause some discomfort during the session. A doctor xmetologist performs a deep cleansing of the skin using a specialized tool - Vidal's loop or Uno's spoon. Contraindications to mechanical cleaning are rosacea, dilated capillaries, thin, dry skin, inflammation, skin diseases.

Combined facial cleansing is the most popular type of facial cleansing. The procedure combines two types of procedures : ultrasonic and mechanical cleaning. Is the most effective method for cleansing the skin of the face. This procedure is contraindicated for any inflammatory rashes, dermatitis and herpes, fever, during critical days.

Atraumatic facial cleansing is the most gentle type of skin cleansing. During the procedure, fruit acids act on the surface of the skin. This method is the softest and most gentle among those known.

Leave a request for the procedure right now!

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The administrator will call you back and select a convenient appointment time . Gas-liquid peeling is a painless procedure that deeply cleanses the skin, improves microrelief, eliminates puffiness, and normalizes lymph flow and blood flow.

The cosmetologist cleans the skin of the face using a special nozzle through which compressed air and moisturizing/nutritious substances are supplied. All dust particles and dead skin cells are pushed out of the pores. During the session, a multi-level facial massage is performed. The effect is noticeable immediately after the procedure: the pores are cleansed, and the skin has acquired a healthy, toned and radiant appearance!