Skin in pregnancy: acne, dark patches, rashes and what to avoid

Some people get the famous pregnancy glow and others get acne, dark patches or itchy rashes. Here’s what’s common, what to avoid, and what needs checking.

Skin changes that are common

The NHS says hormonal changes in pregnancy may make your nipples and the area around them go darker. Skin may darken in patches or all over, and birthmarks, moles and freckles may darken too. These changes usually fade after the birth. The NHS advises sun protection. For stretch marks, see stretch marks.

Acne

The NHS says topical retinoids (such as tretinoin and adapalene) aren’t suitable in pregnancy because there’s a risk they might cause birth defects. For antibiotics, the NHS says pregnant women are usually advised to take erythromycin. The NHS says it’s not thought to be safe to take co-cyprindiol if you’re pregnant. Isotretinoin tablets must not be taken in pregnancy. If you’re taking it and think you might be pregnant, tell your doctor straight away. Don’t stop or start any acne medicine without speaking to your GP, midwife or pharmacist. If you took a retinoid before you knew you were pregnant, tell your GP or midwife.

For skincare products such as retinol creams, ask a pharmacist or your midwife before using them. See also hair dye, nails and beauty treatments in pregnancy.

Itching and rashes

The NHS says to see a GP if the itching affects your daily life, doesn’t improve after treatment from a pharmacist, you have eczema that is getting worse, or you develop a new rash, lump or swelling. Very itchy skin, itchy palms or soles, or itching that is worse at night needs urgent advice. See itching in pregnancy and obstetric cholestasis.

Some rashes are specific to pregnancy. Polymorphic eruption of pregnancy (also called PUPPP) is an itchy rash that usually starts on the tummy, often in stretch marks, in the third trimester. The British Association of Dermatologists says it does not affect the baby and can be treated with emollients, steroid creams and pregnancy-suitable antihistamines. Pemphigoid gestationis is rare. It causes itching and a rash that often starts around the belly button and can develop into blisters, and needs a dermatologist and extra monitoring. Tell your midwife or GP about any new rash, and see a dermatologist if you get blisters.

If you have eczema, you can keep using your usual emollient. Eczema UK says topical steroids are safe to use in short bursts of up to two weeks in pregnancy, but check with your GP or pharmacist.

Questions people ask

Is the pregnancy glow real?

Skin changes vary hugely. Some people notice their skin looks different, and not everyone gets it. Neither is a sign of a problem.

Will dark patches go away?

The NHS says these skin changes usually fade after the birth.

Can I use my usual moisturiser?

Plain, unperfumed moisturisers are what the NHS suggests for itchy skin. For specific products, ask a pharmacist.