Pregnancy glow or hormonal chaos? Understanding skin changes during pregnancy

Beauty & Lifestyle Health & Wellness Post Pregnancy Pregnancy Wisdom of Healing

Your skin is doing things you’ve never seen before—and you’re not sure if you should be celebrating or calling your dermatologist. The reality is that pregnancy transforms your complexion in ways that are both fascinating and frustrating, driven by dramatic physiological shifts that affect every woman differently.

Here’s what’s really happening beneath the surface, why your skin might be glowing (or breaking out), and how to care for it safely during these transformative months.

The biology behind pregnancy’s contradictory skin effects

The mythical “pregnancy glow” has a solid biological foundation, but understanding why some women radiate while others struggle with breakouts requires looking at how your body responds to pregnancy’s cascade of changes.

During pregnancy, your blood volume increases by approximately 30-40% starting at 6-8 weeks gestation, peaking around 28-34 weeks. This surge in circulation brings more blood to the surface of your skin, creating that coveted rosy, flushed appearance many associate with pregnancy glow. Your plasma volume alone increases by 50-60% by late third trimester, fundamentally changing how blood flows through your body.

Simultaneously, estrogen and progesterone levels rise dramatically to support both maternal health and fetal development. These hormones trigger your sebaceous glands to work overtime, producing more natural oils that give skin a dewy, luminous sheen. Your elevated body temperature during pregnancy adds another dimension, literally making your skin warmer and contributing to that flushed look.

But here’s the catch: that same oil production that creates glow in some women causes acne breakouts in others. If you’re prone to oily skin or acne, the increased sebum can clog pores and lead to inflammation. It’s the same hormonal mechanism producing opposite outcomes depending on your skin type, genetics, and how your individual sebaceous glands respond to pregnancy hormones.

The pregnancy glow typically begins during the second trimester, when hormone levels have somewhat stabilized and blood volume is significantly increased. However, not all pregnant individuals experience it—and that’s completely normal.

Common skin conditions that emerge during pregnancy

Beyond the glow-or-breakout spectrum, pregnancy can trigger specific skin changes ranging from mildly annoying to genuinely concerning.

Melasma, often called the “mask of pregnancy,” appears as brown or grayish patches typically on the cheeks, forehead, nose, and upper lip. It develops when pregnancy hormones stimulate melanocytes—the cells that produce skin pigment—to go into overdrive. Sun exposure intensifies it, making sun protection non-negotiable during pregnancy. While melasma can fade postpartum, some women find it persists for months or years.

Linea nigra is that dark vertical line that may appear down the center of your abdomen, caused by the same hormonal stimulation of melanin production. Most women notice it developing during the second trimester. It’s harmless and typically fades after delivery, though the timeline varies.

Pregnancy acne isn’t just a few extra pimples. For some women, particularly in the first trimester when hormone levels are surging most dramatically, it can mean cystic breakouts, increased oiliness across the face and back, and skin that feels completely foreign from their pre-pregnancy baseline. The frustration is compounded by the fact that many effective acne treatments aren’t safe during pregnancy.

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is an itchy rash that typically appears in the third trimester, often starting on the abdomen and spreading to the thighs, buttocks, and arms. While intensely uncomfortable, it’s not dangerous to you or your baby and resolves after delivery.

Spider veins and varicose veins develop when increased blood volume puts pressure on blood vessels, particularly in the legs. The hormonal changes also relax blood vessel walls, making them more prone to visible dilation. These may diminish postpartum but don’t always disappear completely.

Building a pregnancy-safe skincare routine

The frustrating reality of pregnancy skincare is that many conventional treatments are off-limits. Retinoids, high-concentration salicylic acid, and certain essential oils all carry potential risks during pregnancy, leaving you with a narrower toolkit for managing skin issues.

For managing excess oil and breakouts, start with gentle, non-comedogenic cleansers twice daily that clean without stripping your skin’s protective barrier. Look for products with azelaic acid, which is generally considered safe during pregnancy and helps with both acne and hyperpigmentation. Clay masks used once or twice weekly can absorb excess oil without harsh chemicals. Resist the temptation to over-cleanse or use aggressive scrubs—this often backfires, triggering even more oil production as your skin tries to compensate.

For hyperpigmentation and melasma, sun protection is your most powerful tool. A mineral-based sunscreen with zinc oxide or titanium dioxide (SPF 30 or higher) applied daily—even indoors, even on cloudy days—helps prevent darkening of existing patches. UV exposure through windows can worsen melasma, so this isn’t negotiable if you’re managing pigmentation issues. Vitamin C serums may help brighten skin, though results won’t be dramatic during pregnancy since the hormonal trigger remains active. Think of it as damage control rather than reversal.

For dryness or sensitivity, focus on hydration from within through adequate water intake and from outside with gentle, fragrance-free moisturizers containing hyaluronic acid and ceramides. Many women find their skin becomes either dramatically more oily or unexpectedly dry during pregnancy—there’s little middle ground. If you’re experiencing dryness, avoid hot showers which strip natural oils, and apply moisturizer to damp skin to lock in hydration.

For stretch marks, manage your expectations. Despite what expensive creams promise, there’s limited evidence that topical products prevent stretch marks, which result from rapid skin stretching combined with genetic factors. That said, keeping skin well-moisturized improves comfort and may help with elasticity. Cocoa butter, shea butter, and vitamin E are safe options that at minimum prevent the itching that accompanies rapidly stretching skin.

Consider this realistic scenario: At eight weeks pregnant, you notice your usually clear skin erupting with painful cystic acne. Your dermatologist has you stop all your previous acne medications and switch to a simplified routine—gentle cleanser, azelaic acid treatment, oil-free moisturizer, and mineral sunscreen. Your skin doesn’t return to its pre-pregnancy state during pregnancy because the hormones are still surging, but the routine prevents worsening and keeps your skin manageable until postpartum when your hormone levels normalize.

When pregnancy skin changes require medical attention

Not all pregnancy skin changes are benign, and some warrant immediate professional evaluation beyond cosmetic concerns.

Seek medical attention if you experience severe itching, especially on your palms and feet, which could indicate intrahepatic cholestasis of pregnancy—a liver condition that requires monitoring and can affect fetal wellbeing. Similarly, sudden onset of severe acne that doesn’t respond to gentle care may signal hormonal imbalances worth investigating.

Watch for rapid changes in existing moles or new growths. Pregnancy increases blood flow everywhere, including to potentially problematic skin lesions. While most skin changes are harmless, pregnancy isn’t the time to ignore suspicious developments. Painful, spreading rashes beyond typical PUPPP also warrant evaluation, as do any skin changes accompanied by systemic symptoms like fever, joint pain, or unusual swelling.

Many dermatologists specialize in pregnancy-safe treatments and can provide targeted solutions that work within the constraints of what’s safe during these months. Don’t hesitate to seek expert guidance—managing skin issues during pregnancy often requires professional insight.

Debunking persistent pregnancy glow myths

Let’s clear up one stubborn myth: pregnancy glow has nothing to do with your baby’s sex. Despite old wives’ tales suggesting that carrying a girl “steals your beauty” while carrying a boy gives you that glow, there’s zero scientific evidence supporting this. Your skin changes are driven by your body’s response to pregnancy hormones—specifically estrogen, progesterone, and increased blood flow—not by fetal gender.

Similarly, not experiencing pregnancy glow doesn’t indicate something is wrong with your pregnancy. Skin changes vary dramatically between individuals, and plenty of healthy pregnancies produce no noticeable glow whatsoever. Some women experience their entire pregnancy with relatively unchanged skin, while others cycle through multiple skin phases. Both scenarios are normal.

The timeline of skin changes is also unpredictable. While pregnancy glow typically emerges in the second trimester, some women notice changes earlier or later, and some never experience the phenomenon at all.

Supporting skin health through nutrition and lifestyle

While topical treatments matter, what you put into your body significantly affects your skin during pregnancy.

Hydration becomes critical when your blood volume is increasing by nearly 50%. Adequate water intake supports that increased circulation and helps maintain skin elasticity. If you’re experiencing morning sickness or aversions to plain water, try adding lemon, cucumber, or drinking herbal pregnancy-safe teas.

Nutrition plays a direct role in skin health. Omega-3 fatty acids from sources like salmon and walnuts support skin barrier function and may help with inflammatory skin conditions. Vitamin C-rich foods aid in collagen production, which supports skin structure as it stretches. Zinc supports healing and may help with acne—found in lean meats, legumes, and whole grains.

Sleep quality directly impacts skin repair and regeneration. Your body produces growth hormone during deep sleep, which stimulates skin cell renewal. This is admittedly challenging during pregnancy, especially in later trimesters when physical discomfort disrupts rest, but prioritizing sleep when possible shows up visibly on your skin.

Stress management influences inflammatory skin conditions. High cortisol levels can worsen acne, eczema, and other skin issues. This is where holistic approaches to pregnancy wellness become valuable—not just for skin, but for overall wellbeing during this transformative time.

What to expect postpartum

Your skin journey doesn’t end at delivery. Postpartum brings another wave of hormonal shifts that affect your complexion, sometimes dramatically.

Many women find that pregnancy acne clears up within weeks after birth as hormone levels begin normalizing. The increased oil production that plagued you during pregnancy often resolves relatively quickly postpartum. However, some women experience a temporary worsening of acne in the early postpartum period before improvement occurs.

Melasma often (though not always) fades gradually over several months postpartum, especially with consistent sun protection. Some women find it persists longer, requiring targeted treatments like prescription creams or professional procedures once they’re done breastfeeding.

That pregnancy glow typically fades within weeks after delivery as blood volume returns to normal and hormone levels drop. Some women miss the luminous complexion; others are relieved to return to their baseline.

Postpartum is when you can reintroduce previously off-limits skincare ingredients like retinoids—though if you’re breastfeeding, check with your healthcare provider about specific products, as some ingredients can be transmitted through breast milk.

Embracing your pregnancy skin journey

These changes are part of a temporary, transitional state. Your skin during pregnancy looks different because your entire body is performing the extraordinary work of growing and sustaining another human being. The physiological transformations—increased blood volume, dramatically elevated hormone levels, heightened body temperature—are all essential for supporting your pregnancy, and your skin is simply reflecting those internal changes.

Whether you’re dealing with breakouts, dark patches, or experiencing that enviable glow, approach your skin with patience and gentleness. Simple, safe routines consistently outperform complicated protocols during these months. Focus on protection (sun exposure), gentle cleansing, adequate hydration, and moisturization. These fundamentals serve you better than chasing miracle cures that likely aren’t pregnancy-safe anyway.

Your skin is telling the story of the profound transformation happening within your body. That story might include glow, or it might include chaos—both are completely normal, and both are temporary chapters in your pregnancy journey.

If you’re looking for comprehensive support throughout your pregnancy—including evidence-based guidance on managing physical changes, reducing stress, and preparing for each stage—explore the pregnancy courses and resources at Beginning Academy. Our platform offers practical, science-backed approaches to navigating pregnancy’s challenges, from skin changes to sleep disruption to emotional wellbeing, supporting you through this transformative time.