women
In addition to affecting what happens to you internally, hormonal changes in pregnancy can also affect your external appearance.

Many women look and feel better than ever during pregnancy, while those less fortunate report that there is a downturn in their appearance. However pregnancy affects you, the changes will be temporary and you’ll be back to your normal self soon after the birth.

Skin

You may find that your skin looks better in pregnancy due to hormonal changes, mild fluid retention, and increased blood flow. These can all result in smoother skin and are responsible for the famous “pregnancy glow.” On the other hand, you may find that your skin gets drier and more pimply and you may need to take extra care of it during pregnancy.

Skin also tends to darken during pregnancy, although the cause for this is unknown. One possible explanation is the increased levels of estrogen and melanocyte-stimulating hormone, which stimulate skin pigmentation.

Stretch marks (striae gravidarum)

Many women develop stretch marks during pregnancy, which can occur on bellies, breasts, hips, or legs. These initially appear as pink or purple lines and may be quite itchy. After pregnancy they fade into pale wrinkles. Nobody knows for sure why these occur, but they probably result from a combination of pregnancy hormones and your skin stretching. You’re more likely to get stretch marks if you’re very young, if you gain a lot of weight in pregnancy, or if you have a very big baby. There is less agreement about the role of other factors such as a family history, being very overweight before pregnancy or belonging to a particular ethnic group.

Many creams, lotions, and oils have been marketed for the prevention or treatment of stretch marks but none has been proven to work. Studies have shown that some creams containing ingredients such as vitamin E, elastin, collagen-elastin hydrolysates, and menthol can reduce the development of stretch marks; but other trials have shown that creams containing vitamin E had no effect. If you want to use a commercially recommended cream, lotion, or oil, they are safe to use and may help prevent stretch marks, but unfortunately there is no guarantee.

Applying moisturizing creams to relieve dry, itchy skin, or ones recommended to reduce stretch marks, is safe during pregnancy.

Chloasma

This describes the increased pigmentation of the cheeks, nose, and chin that affects around 50–70 percent of pregnant women. Using a protective sunscreen and avoiding the use of any photosensitizing skin-care products may reduce chloasma. A recent study found that using a highly protective sunscreen (SPF 50 and UVA-PF 28) prevented most pregnant women from developing chloasma.

Hair and nails

Hair stays longer in the growth phase during pregnancy, meaning that your scalp hair is likely to grow and thicken. Not so welcome is the fact that facial and body hair may also increase. After the birth, many women find that they suddenly lose a lot of hair as the growth phase stops. You should find that your hair is back to normal within six months.

Fingernails may also change, often becoming stronger, although some find that they become softer and brittle. Nails may develop white spots or transverse grooves, but these are rarely anything to worry about and don’t mean that you’re lacking in vitamins.

Teeth

Pregnant women are more prone to tooth decay (dental caries), bleeding gums, and chronic gum infection (periodontal disease). Poor dental health not only affects you, but can also have an impact on your baby. Studies have linked infection of the gums in pregnant women to premature birth, and if a woman has ongoing tooth decay after the birth, her baby may acquire bacteria directly from her saliva, leading to tooth decay in the child later on. It’s therefore important that you take care of your teeth during pregnancy and visit your dentist and dental hygienist regularly.

To keep your mouth healthy during pregnancy, brush twice a day with fluoride toothpaste and floss every day. Routine dental treatment and some local anesthetics are safe in pregnancy, although it’s better to postpone elective dental treatments until after pregnancy or take care of them before pregnancy. Many women worry about having their teeth x-rayed in pregnancy. The radiation exposure from dental X-rays is minimal and the risk to your baby probably negligible. However, dentists will take every precaution to minimize your radiation exposure, covering you with a leaded apron before the X-rays.

Taking good care of your teeth and gums is important during pregnancy, when you’re more susceptible to dental problems.

Q: I am 18 weeks’ pregnant and due to go on a beach vacation. My facial and body hair has grown and become very unsightly. How can I safely remove it?
A: You can safely tweeze, wax, and shave new stray hair. Skin bleaching and hair removal creams are probably safe during pregnancy, but there has been insufficient research to clear them since they can be absorbed through the skin and their effects on the baby are unknown. Permanent hair-removal techniques, such as laser and electrolysis, are thought to be safe in pregnancy. Both techniques penetrate the skin no deeper than a few millimeters. Consult your doctor to see if this is okay.
Q: I’ve been using topical cream to treat acne and I’ve just found out that I’m pregnant. Will it harm my baby?
A: Tretinoin belongs to a group of medications called retinoids that contain vitamin A and may be associated with birth defects. Studies have looked at the effects of this cream in pregnancy and have found that babies whose mothers used it, even in the first trimester, had no increase in birth defects. However doctors recommend avoiding tretinoin cream in pregnancy. Another similar medication, isotretinoin, which is taken orally, may increase the risk of birth defects and is therefore contraindicated in pregnancy.
Q: I’m in the first trimester and will be going to my sister’s wedding. Can I have highlights put in my hair?
A: Although the research into the safety of hair dyes if used in the first trimester may seem conflicting, the amount of chemicals used is small and it’s unlikely that hair dyes cause harm. Also, if your hairdresser uses foil, the dye is kept off your skin.
Q: I’ve heard that nail polish needs to be removed if you have a cesarean. Why is this?
A: Previously, women were encouraged to remove nail polish before surgery. One of the reasons was that the “pulse oximeter,” a device attached to your finger to measure the oxygen in your blood during surgery, may give lower readings if placed over nail polish. However the device works as intended with nail polish or long nails if it’s mounted sideways on a finger. Therefore there’s no need to remove your polish.

What’s safe and what’s not

Beauty treatments and cosmetics

The following advises which products and treatments are safe in pregnancy.

  • Hair and nail products

    Shampoos, conditioners, manicures, and pedicures are safe. Minute amounts of hair dye may be absorbed through the skin, but there’s no evidence that this affects the baby. Chemical hair straighteners and curlers are also thought to be safe.

  • Piercing

    Facial piercing or piercing the belly button, nipples, or genitalia isn’t advised since you’re at a higher risk of infection. If you have a navel piercing already, you can change a metallic ring for a flexible plastic retainer made from PTFE (polytetrafluoroethylene). Nipple rings can affect breast-feeding, so remove a ring before birth so the skin can heal. Vaginal or vulval piercings are best removed to avoid damage at birth.

  • Tanning

    Tanning beds aren’t advised because of harmful UV rays. Tanning beds can cause your body to overheat, which can harm your baby, and UV rays may break down folic acid. Tanning lotions are safe.

  • Body wraps/Hot tubs

    These raise body temperature, which is unsafe for you and your baby. Heat exposure from a hot tub in the first three months can increase the risk of a baby developing spina bifida.

  • Facials

    The cosmetics used for facials are thought to be safe.

  • Botox

    The Food and Drug Administration recommends that women who are pregnant or breast-feeding should not use Botox. Although it’s used for cosmetic reasons, it is a drug and should be considered as such. Doctors also advise avoiding Botox during pregnancy.

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