What is pregnancy Acne?
Pregnancy is a happy period in a woman’s life, taking into account her purpose and the joy of bringing a child into the world. At the same time, the expectant mother must know that she will also face some changes both in terms of her psyche and her body, and one of the challenges her body will have to face will be acne that may appear during the pregnancy.
Pregnancy acne is a pathology of an inflammatory nature of the pilosebaceous unit with excessive accumulation of sebum at this level that can appear in a large proportion of expectant mothers, especially in the first trimester of pregnancy.
It is frequently found in pregnant women, including those who have never faced forms of acne in the past , it can be considered disturbing from an aesthetic point of view, but it should be known that it has chances of diminishing during pregnancy, after birth the skin will return to normal with appropriate treatment and do not put the life of the mother or the child in danger.
Acne Signs and symptoms
It is known that over the course of a month, female hormones experience cyclical variations that will cause changes in the body for the preparation, installation and maintenance of pregnancy, the more so the level of these hormones changes during pregnancy.
In addition to the beneficial effect in supporting pregnancy, these hormones can also cause unpleasant dermatological changes with the accumulation of excess sebum and the appearance of acne. Thus, the sebaceous glands, whose activity is mediated by androgens whose level increases during pregnancy, will increase their production of sebum, its keratinization will obstruct the elimination to the outside of the hair follicle and the comedone will form. This will further constitute a proliferation environment for a bacterium called Propionibacterium acnes, which results in inflammation.
If these comedones open to the outside of the skin, they will appear as black dots, and if they are closed, they will be white or skin-colored. At the dermal level, inflammatory lesions appear such as follicular papules that can be painful with digital pressure, and nodules that may leave scars or may be resistant to treatment. Itching occurs rarely and may be due to compounds with a similar effect to histamine released by P.acnes.
The preferred location is the face, but it can also appear on the anterior chest or back. It should also be mentioned the psychosocial impact that occurs with this pathology, the onset of a depressive state related to it or the anxiety regarding its resolution.
Acne Cause
The causes of pregnancy acne are mainly hormonal, the increased level of androgens, progesterone, insulin, growth hormone, and prolactin being some of the most well-known ones involved in its development and evolution by increasing the secretion of natural oils from the skin, followed by the clogging of pores, the accumulation of bacteria and the appearance of inflammation.
The genetic predisposition through the presence of a seborrheic complexion, the existence of acne problems in the antecedents can equally contribute to the development of this pathology. At the same time, it is demonstrated in clinical studies that acne can start with pregnancy in women who have not had problems of this kind in the past.
Fluid retention frequently encountered during pregnancy leads to the storage of toxins, a fact that contributes to the exacerbation of acne episodes.
Factors that can favor or aggravate the occurrence of pregnancy acne
The new physical and mental changes to which the pregnant woman’s body must adapt inevitably lead to a level of stress, a fact that contributes to the aggravation of acne. An additional risk factor for the development or worsening of acne during pregnancy is women with hyperandrogenism, irregular menstruation, endocrine pathologies such as polycystic ovary syndrome or a complexion with acne in the antecedents.
Also, with the appearance of cravings during pregnancy, the increased caloric requirement, the consumption of chocolate, carbohydrates and processed foods are risk factors and aggravations. Environmental factors, heat, humidity, but also sweat ultimately have the same effect as those above.
Acne Diagnostic
To begin with, an evaluation of acne is made from a clinical point of view, of the number of lesions and their type, if it is about comedones, cysts, nodules, if it presents inflammation or not, the antecedents of acne in adolescence or adulthood, important aspects for determining its severity. Thus, in mild/grade I acne, there are less than 30 comedones, less than 10 papules and there are no post-lesional lesions. Moderate/grade II acne involves the predominance of papules (more than 10), less than 3 nodules, with or without the appearance of scars. In severe/grade III acne, nodules, cysts and the development of post-lesional scars predominate.
Subsequent tests include a microbiological examination for P. Acnes and Staphylococcus aureus that may be present at the level of the lesions, an examination performed prior to the initiation of antibiotic therapy.
Endocrine testing considers the evaluation of hormonal levels that may be responsible for the appearance of acne and at the same time excludes another pathology with similar manifestations such as polycystic ovary or hyperandrogenism. The level of androgens, progesterone, prolactin, insulin, thyroid hormones, free and total testosterone, luteinizing and follicle-stimulating hormone is evaluated.
Acne Treatment
Since we are talking about a pregnancy, the first important aspect that must be taken into account is avoiding the basic risk of congenital malformations in the fetus and disruption of the natural evolution of the pregnancy. To evaluate this basic risk, different risk classes established by the FDA (Food and Drug Administration), Rote Liste, are used.
Azelaic acid and benzoyl peroxide are recommended as a first step. Associated with them, local and systemic antibiotics are used. Macrolides are the choice. Tetracyclines are only indicated for a limited period at the beginning of pregnancy due to their teratogenic effect with the impairment of bone development of the fetus and teeth, and cephalosporins have not demonstrated significant therapeutic effects. The FDA recommends the use of zinc sulfate, and in the case of inflammatory acne, systemic corticosteroid therapy is used for a short time in the first trimester of pregnancy.
Most of the studies carried out mention the prohibition of Isotretinoin and topical retinoids derived from vitamin A used topically because they have been correlated with fetal malformations, impending abortion and pregnancy complications.
Adjuvant therapy and possible natural treatments that could help
Citrus juice, aloe vera, sodium bicarbonate for cleaning the skin, honey, a diet based on fresh fruits and vegetables, whole grains and avoiding fast food are beneficial.
Acne Prevention
Correct skin hygiene to remove impurities, exfoliated cells and excess sebum is an important aspect, but the future mother will have to avoid cosmetic products and cleaning solutions with oils, opt for moisturizing creams. Sweat must be removed as quickly as possible, touching the face is best avoided and much more importantly, mechanical removal of pimples, squeezing of blackheads or any other aggression of these lesions is avoided because this process will lead to the dissemination of bacteria, the expansion of acne and subsequent scarring.
Frequent exposure to UV rays is avoided and sun protection factors are used. Hydration of the body is again important, as is avoiding the consumption of super-processed foods with a high glycemic index.
Last but not least, stress is another factor that aggravates acne that can be avoided through relaxation techniques, meditation or other activities that create a feeling of well-being.
Final Words
Acne during pregnancy is an inflammatory skin condition that occurs in most pregnant women, especially at the beginning of pregnancy, whether they have faced acne in the past. In addition to the aesthetic aspect, this can have a psycho-social impact, causing anxiety and depression for the expectant mother.
Its etiology is mainly hormonal, but the factors that favor its occurrence and worsening are the predisposition to a seborrheic complexion, a history of acne, the high consumption of refined sweets and foods with a high glycemic index.
Fortunately, it remits during pregnancy following an appropriate treatment chosen in such a way as not to put the life of the fetus and the evolution of the pregnancy at risk, which is why a dermatological consultation is necessary, the medication used being administered on the doctor’s recommendation.