A blog post by Dr Sue Ho
Double Whammy – A Pregnant Aesthetic Doctor
Looking a little worried, but glad to have a very supportive husband.
“Why am I suddenly getting these spots on my face, Sue?” a friend asked some time back as she straddled her swollen belly, all bleary eyed and dishevelled. She’s hardly alone in her predicament. Countless mothers around the world suffer from the same, or far worse fate during and even after pregnancy.
I looked at her empathetically; an expression that, on hindsight, probably betrayed a little of my own fear. My husband and I were trying for a kid then. Fast-forward a year later, I was in the same predicament.
Moreover, the responsibility of helping patients take care of their skin problems certainly didn’t help; if I espouse the virtues of good skin care, shouldn’t I practice what I preach and LOOK the part? A double whammy situation indeed.
Thankfully, armed with the knowledge I acquired through years of medical studies, I handled things well and recently manoeuvred my way out of the sticky situation unscathed. More or less.
Now that I’ve experienced and overcome it myself, it’s time to share and spare other soon-to-be mothers from the dreaded “Mask of Pregnancy” – acne breakouts and the appearance of brown spots on the face and neck.
The Boon & Bane of Pregnancy
You may have heard of the term, the Pregnancy Glow. Not every person with child has it – an enviably shiny, dewy, and bright complexion. And if you do sport The Glow, count yourself lucky. The rest of us will have to bear with the unwanted effects of pregnancy on our skin, A.K.A., the Mask of Pregnancy.
A host of physiological changes take place during and after pregnancy – nausea, fatigue, and the swelling of the feet are but a few that come to mind. More importantly, the main reason for changes to your skin can largely be attributed to hormonal surges in the body.
When Your Glow Blows – Pregnancy Acne Woes
As the adage goes, too much of a good thing is a bad thing.
In the case of the Pregnancy Glow, a shiny and oily complexion can fast turn into a smorgasbord for acne-causing bacteria.
The increase activity in the skin’s oil glands, which gives you that shiny skin, typically goes into hyperdrive during the first and second trimesters. A buildup of sebum, dead skin cells, and dirt clogs up pores, providing a conducive environment for p-acne bacteria to take hold and multiply. The root of your pregnancy acne troubles? A spike in your body’s androgen hormones.
This means that appropriate oil control measures need to be taken to minimise acne formation. A facial cleanser such as a tea tree cleanser helps regulate sebum production and fight acne formation. Do note, however, to avoid the consumption of any edible tea tree products. Just stick to topicals, please.
You should also stay clear from any products containing salicylic acid as it can be unsafe for use while pregnant. Medications for acne, whether topical or oral should also be avoided. This is because many of these common medications (tretinoin and isotretinoin) are derived from vitamin A, which is unsafe in large concentrations during pregnancy.
During pregnancy, approximately a quarter of expecting women with pre-existing eczema see an improvement in their condition. For the rest of the third, those with a history of eczema or whose family members suffer from the sensitive skin condition may see a sudden flare up during pregnancy. Again, hormonal imbalances are to blame.
Symptoms appear as red itchy patches on the body. At times, these can worsen, with pus crusting over the areas. And while there is currently no clinically proven treatment to completely eliminate eczema, its symptoms can be managed with proper care.
These include moisturising often, avoiding hot showers, wearing loose-fitting clothes, staying out of prolonged exposure to the sun, drinking plenty of water, sleeping sufficiently and regularly, and moderating alcohol intake (though I doubt you should even imbibe at all when with child).
In more severe eczema flare-ups, topical steroids can be applied for relief, though it can only be used at the advise of your doctor.
Stretch Marks – Still A Long Stretch From Being Solved
With the inevitable weight gain during pregnancy, stretch marks can start creeping up. These unsightly, reddish-purple marks turn whitish over time and are most visible on the upper arms, thighs, and the abdominal area.
This is caused by poor skin elasticity, where the elastic fibres in the deeper part of the dermis are disrupted from the rapid skin stretching. I call these stretch marks, Pregnancy Battle Scars. Why?
Because stretch marks occur in the deeper parts of the skin, even very aggressive resurfacing lasers show limited results. Currently, the only way to truly remove stretch marks is with surgery. Topical medications containing retinoids or vitamin A derivatives combined with creams containing at least 10% AHA (lactic or glycolic acid) may be used post-breast feeding to lighten the redness in stretch marks.
“So will I get stretch marks?”, you ask. By and large, the chances of stretch marks showing up depend on your genetics. Lucky individuals with genetically stronger collagen and elastin fibres easily dodge the bullet.
The not-so-lucky amongst us will have to take every step to prevent stretch marks from taking hold. Some preventive care include weight control during pregnancy, and good hydration and nutrition as part of a healthy lifestyle. I really don’t have to say it, but this should be practiced way before in your planning stages.
DURING & AFTER PREGNANCY
Wrinkle Me Not
Another major hormone out of whack during and postpartum is the Human Growth Hormone (HGH). Responsible for new cell turnover, the reduction of HGH levels means wrinkles form easier.
The most popular anti-wrinkle solution, AKA Botulinum Toxin injections, can only be done after pregnancy and breastfeeding. One safer treatment that can help lighten fine lines is with Laser, which can be done after delivery and during breastfeeding.
Melasma – A Stubborn Pigmentation You’ll Not Want
Approximately 50% of pregnant women develop melasma; an unnerving statistic, for sure.
With pregnancy-induced hormonal fluctuations, your skin becomes hypersensitive, especially to the sun’s unforgiving rays. Elevated levels of estrogen and progesterone means your melanocytes, the melanin-producing cells in your skin, go into hyperdrive. During this time, it’ll be a lot easier for dark spots to appear on your skin.
The best way to prevent this is to avoid sun exposure whenever (and wherever) possible. This is because the sun’s ultraviolet rays stimulate your melanocytes, which can result in the dreadful hyperpigmentation condition, Melasma.
Realistically speaking however, to completely avoid the sun is impossible. To mitigate this, be diligent with applying sunscreen. This means applying at least 15 minutes before leaving home, and reapplying after every two to three hours when you’re out and about.
But what if you notice that hyperpigmentation such as melasma, has already invaded your skin? I’m afraid you’ll have to wait it out until your hormonal levels stabilise before getting any treatment.
If you’re in a hurry though, breastfeeding mothers can try Intense Pulsed Light (IPL) treatments at a low power. Always consult your OB on this.
After breastfeeding, there are a few treatment options you can consider, such as the Cosmelan System, or having Laser treatments that target hyperpigmentation.
The topical Triluma cream can be used at the same time to boost lightening of hyperpigmentation. It is a prescription-grade triple-action steroid cream containing the whitening agent hydroquinone; a potent ingredient that decreases the formation of melanin and reduces the appearance of dark patches.
Playing Laser Tag with Skin Tags
Skin tags are simply put, tiny pieces of hanging skin. These harmless lumps can appear anytime in our lives, and usually sprout on the face, eyelids, cheeks, neck, and even breasts.
Hormonal fluctuations during pregnancy and nursing can increase the chances of skin tag formation. And although inconclusive, some studies show that skin tags are hereditary.
But what about removing any existing skin tags? Treating skin tags is a relatively simple process, typically involving a straightforward laser treatment.
However, it is in the condition’s nature to recur anytime. This is especially true for someone prone to developing skin tags.
You and your doctor will literally have to play tag with these pesky bumps; repeated laser treatments will almost certainly be necessary. I advise to remove skin tags after breastfeeding, when your hormone levels have returned to norm.
Dullness After The Glow – A Brilliant Solution to The Rescue
For the fortunate Glowers, skin dullness after pregnancy is a common complaint. After all, having gotten used to glowing skin, the sudden loss of said radiance after delivery will be very apparent.
To maintain and for non-Glowers, achieve this glow, a gentle laser treatment such as the Clear + Brilliant Laser can be done on a monthly basis, after pregnancy and during breastfeeding.
I cannot say enough good things about Clear + Brilliant; it was my go-to treatment post-delivery. Why? Indulge me a little as I wax lyrical about Clear + Brilliant.
Compared with similar laser treatments, Clear + Brilliant requires little recovery time and distinguishes itself from the rest with its lower risk of complications.
Clear + Brilliant works by revitalising your skin from inside out. In a gist, it gently replaces damaged skin with healthier, younger-looking skin tissue. The result? Smoother, softer and youthful-looking skin. And the best part is that Clear + Brilliant reduces skin discolouration too!
Almost all of my patients who’ve had Clear + Brilliant treatments say that their skin look younger and feel smoother.
What’s more, their skin achieved a noticeable glow after a series of three to five Clear + Brilliant treatments. This glow owes to the fact that Clear + Brilliant significantly helps refresh skin tone and texture. Within as little as a week, patients notice brighter, softer and more youthful skin texture. With multiple treatments skin discoloration, and fine lines fade and soften.
Clear + Brilliant is the first treatment that I would personally recommend postpartum. But if you’re feeling a little more adventurous and can tolerate a longer downtime, then the Restylane Skinboosters is another great option when your hormones are back in line.
Aesthetic procedures are definitely helpful in mitigating or resolving intra- and post-pregnancy skin issues. But it’s also important to practice sound skin care outside of the doctor’s office; regular facials are vital to preventing unwanted skin conditions as well as prolonging the results of any aesthetic procedures you’ve had.
Sleeping and eating well (i.e., increasing fruit and vegetable intake) and drinking plenty of water is also necessary to keeping your skin healthy and well hydrated. Plus, cutting down your consumption of oily and processed food will help reduce sebum production. And even if you’re not doing it for vanity, these healthy habits will improve your overall well being!
Having said all these if there’s one takeaway you should do well to remember, this is it:
ALWAYS REMEMBER YOUR SUNSCREEN!
Having honed her medical and surgical skills in Ireland and across the straits, Dr Sue has, since 2006, worked in Singapore’s public hospitals, including Singapore General Hospital, Tan Tock Seng Hospital, and National University Hospital.
Sue’s passion for aesthetics was sparked by a fateful encounter with Dr Kelvin Chua, founder and medical director of SL Clinic. With rigorous training, Sue is committed to enhancing the natural beauty of each patient, through a personalised and holistic program of treatment and care.
BOTOX treatments, filler augmentation and skin rejuvenation are some of the minimally invasive procedures Sue is interested in. She is also an advocate for active living, often giving patients tips and insights to leading a healthier, more wholesome lifestyle.
Recently married to a Frenchman and having just become mother to a lovely daughter, Sue makes a conscientious effort in keeping a work-life balance.
Sue believes in raising her daughter in a positive and loving environment. Between two jobs and charity work, Sue still manages to find time for her family by going on excursions to the great outdoors. With the appropriate sun protection, no less.
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