Treating your skin concerns during pregnancy & breastfeeding

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Pregnancy and lactation are important times in a woman’s life, however, these milestones are also associated with many skin issues. Some women notice their skin glowing, while others are plagued with acne breakouts, sensitive skin and sallow complexion. In addition, pregnancy and breastfeeding is often a time of increased anxiety in regard to the safety of skincare and in-clinic treatments and the impact they may have on your growing baby.

Many women contact us regarding skin issues during pregnancy, due to the fact that our medical director is a mum of 3 and has a special interest in women’s health.  As such, we have done a lot of research to confirm what is effective and safe, and we are lucky enough to have our own in-house doctor available for a consultation should your skin issues become a problem.

It’s important to remember that there is no blanket approach in medicine - every person has different concerns and issues. We invite all our clients to come in have a consultation with either our dermal therapist, registered nurses or doctor in order to undertake a formal skin assessment and work on an individualised treatment plan.

What to Avoid

In terms of risks in pregnancy, it is important to avoid anything that could be toxic or teratogenic( anything that interferes with organ production) tiny growing babies.

In terms of home care - obvious things to avoid are Vitamin A (Retinol, Epiduo, Stevia, Tretinoin, Roaccutane), high dose of salicylic acid and hydroquinone. I advise stopping these compounds as soon as you are planning a pregnancy.

Please note that low doses of salicylic acid, lactic acid and glycolic peels are generally safe in pregnancy. The caution about salicylic acid is currently undergoing a lot of debate. For example, high-risk women are advised to take aspirin (a type of salicylic acid) in pregnancy to reduce miscarriage and pre-eclampsia (note ONLY if your Obstetrican thinks you are high risk - it is not advised for normal pregnancies!) So as ever, things are always changing, and we’ll keep you updated!

 

Is laser treatment safe?

In terms of laser and light therapies, there is contention amongst laser specialists about what is safe. When you think about it and assess the research, there are no evidence-based studies that confirm safety or risk. This is because it is unlikely we would ever get ethics approval to research pregnant women for non- essential treatments. However, from first principles, and after discussing this with experts and reviewing the literature, I feel that IPL and gentle Q switch laser (like skin toning) are probably safe in pregnancy and breastfeeding. However, due to the hormonal fluctuations involved in growing a human, there is an unpredictable risk of hyperpigmentation with heat therapy. So I would advise against using light and laser therapies for pregnant women or those in the postpartum period, but I do could consider them if breastfeeding is well established.

 

Mothersafe

All women who are planning a pregnancy, pregnant or breastfeeding need to know about Mothersafe,  a FREE telephone service for women run by clinical pharmacologists at the Royal Hospital for Women in  Randwick. This service offers women and health practitioners advice on exposure to drugs and insults during pregnancy and breastfeeding such as medications, infections, and occupational exposures. They can be contacted on 1800 647 848. Put it in your phone!

 

Home Care Advice

I am often asked about safe skincare in pregnancy, so I have summarised below. Again, please consider your individual issues and don’t just treat them from a resource! Of course, keep in mind your skin might change during pregnancy, just as your body does, so if any new concerns arise please pop in and discuss it with us. Note that I have used the Synergie products as examples, because that is what I use personally and in my clinic. However, you can use any good similar products, just check they are ACTIVE and that they don’t experiment on animals.

Sun cream

All pregnant women need to take special care to avoid too much sun exposure, as pregnancy hormones can increase the risk of melasma, a skin disorder that results in pigmentation deposits on the face, especially the forehead and cheeks. Melasma is extremely difficult to treat so be sun smart! I strongly advise using UberZinc, which is an effective and beautiful skin product that blocks out UVA and UVB waves and acts as a mild moisturiser. It is my favourite product and I don’t leave home without it. Uberzinc will last all day, but I usually reapply at lunchtime. If you develop melasma, please come and see us ad don’t lose hope. We have some amazing treatments that work!

Vitamin C serum

For similar reasons, I advocate all pregnant and breastfeeding women use a Vitamin C serum in the morning after cleansing. This is safe to use in pregnancy and lactation. Vitamin C  reduces pigmentation, brightens the complexion and prevents  DNA damage. Remember that all Vitamin C preparations are not created equally. Vitamin C is essentially an unstable compound, so many Vitamin C serums lose potency and inactivate quickly. A lot of research and time needs to go into finding a stable product. I recommend Suprema C serum by Synergie Skin, which I also prescribe to treat general pigment disorders such as post-inflammatory pigmentation, dark circles under the eyes and solar damage. Oral vitamin C has recently been linked with a reduced risk of pre-eclampsia (end stages of high blood pressure in pregnancy) so ensure you eat 2 pieces of fruit a day or alternatively consider taking take an oral Vitamin C supplement.

Vitamin B serum

Vitamin B is an important topical compound to keep skin hydrated, reduce redness and pigmentation and improve skin immunity. Daily use of Vitamin B (used as a serum overnight under a moisturiser) will enhance skin clarity and luminosity. As a practitioner, I can prescribe a stronger one than you can find from a beautician, so I would start with Priority B serum from Synergie Skin. For many of my clients with rosacea, which is commonly exacerbated by the hormonal changes associated within pregnancy and breastfeeding, Vitamin B is a vital part of their daily skin regime to reduce redness and dry skin.

 Moisturiser

A good moisturiser is an essential component of your daily skincare routine as this helps to support a healthy skin barrier. However, using the incorrect moisturiser can cause breakouts or increased sun sensitivity.

  • For those of you with red, or sensitive skin my go-to is Dermacalm  

  • For dry skin, I love Masquerase - leave on overnight (it’s actually a skin masque, just leave it on a bit longer a a few times a week and you will feel the difference.

  • For very dry, sun-damaged skin (like mine - thanks menopause) I have found HydroLock invaluable and I use it every second night over my serums.

  • For those with oily, acne-prone skin Uberzinc can be used at night. Alternatively, Synergie Hydrogel is an oil-free moisturiser, that is suitable for excessively oily or congested skin. 

Stretch Marks

I thought I would just add in a small comment about stretch marks, as this is a common issue I treat postpartum. YES, there is some preliminary evidence that you can reduce stretch marks with silicone gel. The main evidence is the product Stratimark Stretch mark gel, which you will soon be able to purchase from our clinic and online store. I am currently recruiting for women a small GP led research study on the role of silicone gel and stretch marks - if you are interested in taking please email us on info@thriveskinclinic.com.au

Treating stretch marks

In terms of treatment of striae (stretch marks) postpartum - I use a combination of home care (silicone gel), IPL and either micro-needling or resurfacing laser. This multimodal approach works better when the scars are still red (called striae rubra), so if you have stretch marks, book in as early as you can. If you are breastfeeding, we avoid using local anesthetic. If you are not breastfeeding, we are able to use local and hence hit the dermal with higher settings. It’s important to have appropriate expectations about scar manageme. In general, my advice is: we will aim to give a nicer looking scar! However, there is no doctor on earth who can achieve the return of normal skin. That said, we are getting some great results with our multimodal treatment patients - Take a look at our before and afters!

 

Vaginal health

Just a final note about that very important part of your anatomy.! Our vulva and vaginas are often overlooked however they are VERY important skin and mucosal surfaces and need to be treated with TLC. Please never use soap on your vulva or inside the vagina! During breastfeeding and menopause it is very common to get irritated, dry and painful vulval and vaginal skin. My first piece of advice here is to use a good vaginal moisturiser like Olive and Bee cream which can also be used as a lubricant. It is one of the only NATURAL and TGA approved products in Australia and is also great for women who are on hormonal treatments for breast cancer. Stay tuned on this issue, as I am very passionate about the vulva and vaginal health. I will be introducing some more educational blogs and clinic treatments for these over the next year.

 The end

I got so excited about this blog that I have run out of space to talk about in-clinic treatments. SO I will do this as a separate blog sometime soon. If you have any specific issues you would like me to discuss, comment below or send us a question to our instagram and I will try to answer it as part of a monthly Q&A session. I will also post a link to Terri Vinson’s blog on safe makeup and skin products in pregnancy