What are some of the most common skin concerns that new moms face in the first few months after delivery, and how can they be addressed?
Sometimes called the mask of pregnancy, melasma is caused by a combination of heredity, sun and hormones. Typically, melanoma slowly improves after delivery.
The best ways to help prevent it is to avoid the sun whenever possible and to use a broad-spectrum, water-resistant sunscreen with an SPF of 50. Taking vitamin D3 is important for those strictly avoiding sun exposure.
Treatment for melanoma includes using brightening products and retinoids after delivery. Prescription options rely on tretinoin and hydroquinone, which can be harsh and unpleasant but do provide results over time. Newer non-prescription options that contain nanoencapuslated retinol, which is less harsh than its traditional counterparts, frequently provide benefits comparable to prescription therapy and are better tolerated.
Blood vessel enlargement occurs during pregnancy as a result of increased estrogen levels. Known as telangiectasia and spider hemangioma, they appear frequently on the cheeks, nose, chin and forehead, and typically tend to fade after delivery. Those that don’t fade may respond well to non-scarring vascular laser treatment.
A common occurrence, stretch marks represent internal tearing of the dermis due to its inability to accommodate tension from rapid skin stretching. Genetics may predispose some new moms to stretch marks.
Many prescription and non-prescription remedies have been suggested, but none have been proven in scientific studies. Stretch marks invariably fade within 6 to 24 months of formation, but not completely. Watchful waiting really is the best approach.
Moles tend to rise up and become lighter as the years go by. Pregnancy, however, can speed up this natural process, which is in part due to increased hormone levels. Raised moles also can be more prone to irritation from clothing, seatbelts and more. Shave removal can be performed with good results delivered by a precise refined surgical technique.
Note that melanoma also occurs at a slightly higher frequency during pregnancy. You should have your dermatologist evaluate any dark, irregular and changing moles you notice during or right after pregnancy.
What are some skin conditions a new mom might see on her newborn, and how should she respond?
Appearing as tiny white bumps, milia are actually small, keratin-filled superficial epidermal cysts. They are very common, require no treatment and usually resolve spontaneously by exfoliation during the first two months of life.
To minimize incidents of diaper rash — which are very common — change your baby’s diapers promptly and frequently so as to avoid irritation from urine, etc. use a gentle liquid cleanser with lukewarm water, and follow up with a heavy, soothing protecting emollient product.
Infant acne is caused by the mother’s hormones. Infants are exposed to these hormones in utero via the umbilical blood and after delivery via the mother’s milk. Infant acne usually resolves during the first year even if breastfeeding is extended. Treatment is generally not required.
Cradle cap usually resolves during the first year of life. Softening scales with mineral or seed oils (olive, almond or peanut) an hour prior to shampooing with baby shampoo will help minimize this condition. A small amount of moisturizer/oil after shampooing can also help. More severe cases of cradle cap may require mild prescription products, particularly if the scalp remains noticeably inflamed.
Atopic dermatitis (eczema) is fairly common in infants and is best thought of as an inherited tendency to dry and sensitive skin during childhood (and sometimes beyond). Dermatologic treatment for infants with an ongoing itchy, dry, red, scaly rash is often helpful, consisting of mild topical cortisone products, applying moisturizers frequently and avoiding irritants and scratching.
Craig Kraffert, MD, is a board-certified dermatologist, President of Amarte, and founder of both DermStore.com and ReddingDerm, a five-clinic dermatology practice in northern California and Oregon specializing in aesthetic and clinical dermatology.