Common Skin Conditions During Pregnancy

Skin conditions during pregnancy fall into three categories: benign hormone-related changes, preexisting skin conditions, and pregnancy-specific disorders. Benign hormonal skin changes (e.g., hyperpigmentation, striae gravidarum, hair and nail changes, vascular changes) are common during pregnancy and often improve or resolve postpartum. Topical therapies, including tretinoin, hydroquinone, and corticosteroids, can be helpful in the postpartum treatment of melasma. The severity of preexisting skin conditions such as acne vulgaris, condylomata acuminata, herpes simplex, hidradenitis suppurativa, and psoriasis varies during pregnancy. Treatment options for chronic skin conditions during pregnancy often differ from usual practice because of safety concerns. Discussion of potential risks and benefits is important. Low- to midpotency topical corticosteroids are generally considered safe during pregnancy, whereas extensive use of high-potency corticosteroids may be associated with low birth weight. Pregnancy-specific skin conditions include atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis, intrahepatic cholestasis of pregnancy, and pustular psoriasis of pregnancy. Conditions that may cause adverse fetal outcomes and require consideration of antenatal fetal surveillance include intrahepatic cholestasis of pregnancy, pemphigoid gestationis, and pustular psoriasis of pregnancy.