SKIN DISEASES IN PREGNANCY
What are normal skin changes that occur during
pregnancy?
Due to hormonal changes during pregnancy, the skin around the nipple
and genital becomes dark and a dark line develop in the middle of the
abdomen (called Linea Nigra). There may be purplish to pink
streaks of stretch marks as the abdomen enlarges when the baby grows in
the womb because of the stretching of the skin. These are called Striae.
These are all physiological skin changes that occur during pregnancy.
Some women also develop pigmentation on the face (melasma).
Are these changes permanent; and can they be
treated?
The physiological skin changes tend to remain for sometime after
delivery; but they usually fade, often not completely, with time.
Pigmentation can be lightened with bleaching cream; but the stretch
marks usually lighten in color but rarely disappear. Creams advertised
to prevent stretch marks generally do not work. Most skin diseases
during pregnancy are harmless to the baby. However, Rubella (German
measles), Syphilis and Genital Herpes Simplex Infection can be harmful
to the baby in the womb.
a) Rubella (German measles)
This infection is caused by a virus which is spread by coughing and
sneezing. Shortly after infection with the rubella virus, a non-itchy
rash appears all over the body which lasts for 2-3 days. If infection
occurs during the first 4 months of pregnancy, the baby may develop
birth defects or may even die within the uterus. All females should be
vaccinated against Rubella during childhood; but no females should be
vaccinated during pregnancy.
b) Syphilis
Syphilis is a sexually transmitted disease. In the early stage of
syphilis, painless ulcers appear in the genitals which heal
spontaneously within 3 weeks even without treatment. Rashes appear on
the skin, palms, soles and mouth 6-8 weeks later. If infection occurs
during pregnancy, the baby may be born with heart-, bone- and
brain-defects. All women are routinely tested for syphilis during their
regular check-up for pregnancy in Singapore.
c) Genital herpes
Herpes simplex infection is caused by a virus. Infection of the
genitals is usually acquired by sexual contact. It is often a
recurrent disease. It presents as painful blisters and sores on the
genitals and the virus may be present in the vagina even without
symptoms. During delivery, the baby may become infected by the
virus and cause infection on the skin, in the brains and liver.
Infection of the newborn can be prevented by ensuring that the
mother's infection is under controlled during delivery; a Caesarian
section may be necessary.
What skin diseases are specifically seen during pregnancy
The following skin diseases occur only during pregnancy and they
usually clear after delivery:
I Polymorphous Eruption of Pregnancy
One in 300 pregnant women develop this itchy skin disease. The rash
usually starts on the stretch marks on the abdomen which spread to
affect the rest of the body. The skin disease is not harmful to the baby
in the womb and always disappears 6 weeks after delivery. Rarely, it
starts after delivery of the baby but would clear after 6
weeks.
II Herpes Gestationis
This skin disorder appears as tiny blisters which usually start on
the umbilicus. It is very rare. Except for occasional premature birth,
there is no serious risk to the baby in the womb. It tends to recur
during subsequent pregnancies.
III Erythema Multiforme of Pregnancy
This rash has a classical "target" appearance and often affects the
body and arms. It is not itchy and may clear even before delivery and
always after that. There are many other causes of Erythema multiforme
(eg infection and drug reaction) which a doctor needs to differentiate
from.
Hairfall during and after pregnancy
Significant hairfall can occur shortly after delivery. This condition
is called Telogen Effluvium. Complete recovery will take place 3 to 6
months after delivery without any treatment.
Are there any special prercaution I must take when
I have a skin problem during pregnancy?
Most skin diseases can be treated in the same way as in non-pregnant
women. Doctors will avoid drugs that are known to be unsafe to the baby
in the womb. It is important to always inform your doctor whenever you
are pregnant. Always consult a doctor if you develop any skin rash
during pregnancy. Do not self-medicate. Avoid traditional medication as
they may affect the unborn child in the womb.
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