Stay Beautiful Safely

Keeping Skin, Hair and Nails
Looking Great During Pregnancy By Nicole Gray

State-of-the art dermatology and plastic surgery allow us to seek treatments that offer instant gratification when we’re not pregnant, but that doesn’t always hold true when we’re carrying another life inside of us.

Some fortunate women feel incredibly beautiful when they are pregnant, though many others feel awkward and unattractive. The reality is that pregnancy makes us look different. Pregnancy is characterized first and foremost by weight gain, but in addition, drastic hormonal fluctuations lead to physical changes in skin and hair that may affect appearance. On top of these changes, certain beauty routines, such as getting Botox® (botulinum toxin type A) injections or using topical Retin-A, are forbidden during pregnancy.

Skin Care
According to Dr. Jeanine Downie, a dermatologist and the director of Image Dermatology in Montclair, N.J., the three main dermatological problems during pregnancy are acne, eczema and melasma. “Plus, skin conditions that have been under control may flare,” she says. Fortunately, acne, eczema and melasma can be addressed during pregnancy, but the options are limited.

For clients with acne, Dr. Downie recommends glycolic or salicyclic acid peels as frequently as once a month. Both improve skin texture and tone, help with very fine lines and are considered safe during pregnancy. Acne is a common concern, but pregnant women should always approach a dermatologist or plastic surgeon for treatment, because the vast majority of prescription and over-the-counter acne medications are contraindicated during pregnancy. Dr. Downie is adamant in not allowing her pregnant patients to use products with tretinoin, which is the active ingredient in Retin-A and Renova. In pre-clinical studies in mice, there was some evidence of fetal toxicity and birth defects in animals treated with tretinoins.

In addition, Dr. Downie advises that pregnant women should not use prescription drugs, Differin (adapalene) or Tarazac, or over-the-counter drugs, Benzoyl peroxide or ProActive. Certain topical steroid creams, such as Clindagel (clindamycin) or Erygel (arithromycin), are safe for acne and eczema, but again only with the guidance of a qualified physician.

One of the most distressing dermatological concerns for pregnant women is melasma, which is often called the “mask of pregnancy” and is characterized by brown pigmentation on the cheeks, around the eyes, on the forehead and above the lips. To minimize melasma, Dr. Downie encourages her patients to continuously wear full-coverage sunblock with SPF 30 or higher; however, she reserves treatment with hydroquinone, a skin lightener, until after breastfeeding is complete. She also finds that chemical peels can help even out dark patches in her pregnant patients.

Hair Care
Dr. Downie bases her advice on both common sense and science. “We live in a society that is focused on appearance,” she says. “A lot of women are really concerned about their expanding waistlines, so they focus instead on their hair and nails. That’s understandable, but remember that exercise and proper hydration are a great foundation for beauty.”

Still, problem hair can crop up during pregnancy. “Hair will shed during and after pregnancy, but you should be careful which hair care products you use," says Dr. Downie. "You should not use Rogaine (minoxidil). Instead, use deep penetrating protein-based shampoos, conditioners and reconstructors.”

And, of course, there’s the contentious issue of using hair dye. Dr. Downie suggests that women weigh the risks on their own, and she provides the following paradigm: “The AMA recommendation is to not dye your hair during pregnancy. If you dye your hair three times while you’re pregnant, that’s the equivalent of smoking one to four cigarettes.”

Many women cover their gray by re-touching with hair color crayons, which you can buy at any drugstore. In fact, if you do opt for a completely non-chemical approach to hair care while pregnant, there are numerous options. Michael Mata, CEO and president of Biolustre Inc. recommends BioLustre, a patent-pending hair repair treatment, to pregnant women based on its hazard rating of 0 and its ability to counteract the thinning process. According to Mata, "Hair tends to thin not only because of hormonal changes, but also because of vitamin depletion to the follicles. Biolustre is the safe way to go for healthy, shiny, fuller hair before, during and after pregnancy.”

Nail Care
Admittedly, a woman’s beauty routine might feel downright spartan when she’s pregnant, but there is one area of virtual freedom. You can maintain well-groomed hands and feet. According to Dr. Fawzia Zawahir, a Jersey City, N.J.-based pediatrician trained in maternal-fetal health, “Manicures and pedicures are OK, because nail lacquer is not absorbed into the nail bed.”

According to Dr. Zawahir, the issue of absorption is key. “The areas of greatest concern are with those products that can cross the placenta," she says. "Things that cross the placenta can affect the way DNA replicates, which may lead to birth defects.”

Collagen Injections, Facials and Other Treatments
There is a Food and Drug Administration (FDA) system that outlines the risk associated with certain drugs and chemicals for pregnant women. According to this system, category A drugs carry no risk and category B drugs are not associated with risk to date. However, with category C, drug risk cannot be ruled out. Category D drugs have positive evidence of risk, and category X drugs are completely off limits during pregnancy.

Rogaine, Retin-A, hydroquinone and Botox are all classified as pregnancy category C and are completely off limits for pregnant women. However, collagen is not rated by the FDA, and there is some controversy about whether it’s safe to get collagen injections during pregnancy. “When collagen is injected into the body, it undergoes an inflammatory process, which can have pathologic effects and potentially lead to a miscarriage,” says Dr. Leonard Grossman, a New York City-based plastic surgeon and director of the New York Center for Plastic Surgery.

With respect to skin care, Dr. Grossman often performs microdermabrasion on pregnant women, which he says, “you can get anytime.” He adds that in his European practice, he has widely used the injectable substances, Perlane and Restylane, which are made from an organic substance that is produced in our bodies. Although not FDA-approved in the United States, Perlane and Restylane are widely used in Europe and by some U.S.-based doctors in an off-label capacity to plump up wrinkles and lips. If a patient is interested in exploring these injectables as alternative plumping agents, she should speak with a doctor who can offer more informaton.

Dr. Downie and Dr. Grossman both agree Botox is off limits during pregnancy. Moreover, Dr. Zawahir suggests that a woman can feel absolutely confident using any chemical-free, emollient-based skin cream during her pregnancy.

The best thing to do during pregnancy is to stay healthy. Many women feel that motherhood and vanity don’t mix, but feeling good about yourself, including your appearance, provides a solid foundation for self-esteem, and by extension, the ability to become the best parent you can.

Want to see more?

• Beauty Procedures and Pregnancy: What’s Safe and What’s Not?
• Put Your Best Face Forward: Beauty During and After Pregnancy
• Terrific Tresses: Pregnancy or Not, You Can Have Great Hair
• Talk about it!

About the Author: Nicole Gray is a freelance writer and the mother of one.