Pregnancy glow or hormonal chaos? Understanding skin changes during pregnancy
Ever wonder why some pregnant women seem to radiate while others battle unexpected breakouts? The truth is, pregnancy transforms your skin in wildly different ways—and both experiences are completely normal.
Your body undergoes dramatic physiological changes during pregnancy that directly impact your skin’s appearance. Understanding the mechanisms behind these shifts helps you navigate them with confidence and adapt your skincare routine to support your changing body.
The science behind pregnancy glow
That coveted pregnancy glow isn’t folklore—it stems from measurable biological changes happening throughout your body.
During pregnancy, your circulating blood volume increases by 30-40% above non-pregnant levels, starting from 6-8 weeks gestation and peaking around 28-34 weeks. Your body produces approximately 45% more blood, flooding your skin with oxygen and nutrients. This enhanced circulation creates a plumper, more radiant appearance as increased blood flow reaches the tiny capillaries near your skin’s surface.
Blood flow alone doesn’t account for the glow. Your sebaceous glands shift into overdrive during pregnancy, producing elevated levels of natural oils that give skin a dewy sheen. When this heightened sebum production combines with increased intravascular volume, the result is what we recognize as pregnancy glow—essentially, your skin becomes both better nourished and naturally more lustrous.
The hormonal surge driving these changes also affects other glands. Eccrine and sebaceous gland activity increases throughout most of your body during pregnancy, while apocrine glands decrease their output. For many women, this translates to skin that appears more hydrated and vibrant. Enhanced sebaceous activity even causes Montgomery tubercles—small papules on your areolas—to enlarge as your body prepares for breastfeeding.
Why some women experience the opposite
If you’re dealing with breakouts instead of radiance, you’re experiencing an equally valid response to pregnancy’s hormonal cascade.
Research reveals conflicting patterns in how pregnancy affects acne vulgaris—some women see improvement, while others experience worsening breakouts. Your individual hormonal response determines which direction your skin takes, and neither outcome suggests anything wrong with your pregnancy.
The same hormones creating glow for some trigger skin chaos for others. Cortisol levels triple by the end of pregnancy compared to non-pregnant values, while aldosterone increases three-fold in the first trimester and ten-fold by the third trimester. This physiological hypercortisolism—a normal state during pregnancy—can manifest as increased oil production that clogs pores and triggers inflammatory acne.
The variable nature of these changes explains why your skin might behave differently than your friend’s or even differently than during a previous pregnancy. Eccrine gland activity increasing throughout your body can also lead to hyperhidrosis, or excessive sweating, particularly noticeable everywhere except your palms. These heightened glandular responses affect each woman’s skin differently based on her unique hormonal profile and skin type.
Common skin conditions during pregnancy
Beyond the glow-or-breakout spectrum, pregnancy introduces several specific dermatological changes you might encounter.
Melasma, often called the “mask of pregnancy,” appears as brownish patches on your face, typically on your cheeks, forehead, or upper lip. This hyperpigmentation results from hormonal influences on melanin production and affects a significant number of pregnant women. The condition becomes more pronounced with sun exposure, making sun protection particularly important during pregnancy.
Generalized hyperpigmentation darkens areas like your nipples, areolas, and the linea nigra—the vertical line running down your abdomen. These changes reflect your body’s increased melanocyte activity, which typically intensifies as pregnancy progresses. While sometimes concerning, this pigmentation serves no known physiological purpose and usually fades postpartum.
Striae gravidarum, or stretch marks, develop as your skin stretches to accommodate your growing baby and rising cortisol levels affect skin elasticity. These reddish or purplish streaks commonly appear on your abdomen, breasts, thighs, or hips. They represent actual tears in the dermis layer of your skin, though genetics largely determines your susceptibility regardless of preventive measures.
Increased sweating from heightened eccrine gland activity can extend beyond normal perspiration levels, creating discomfort particularly in humid environments or during physical activity. This physiological response reflects your body’s increased metabolic rate and blood volume rather than any pathology.
The variability in which conditions you’ll experience—if any—underscores an important truth: experiencing or not experiencing specific skin changes during pregnancy is completely normal. Your body’s response reflects your individual physiology, not the quality or health of your pregnancy.
Safe skincare strategies for pregnancy
Navigating pregnancy skincare requires careful attention, as many standard treatments pose risks to your developing baby. Adapting your routine protects both your skin and your pregnancy.
For managing breakouts, use gentle, non-comedogenic cleansers twice daily to remove excess oil without stripping your skin’s protective barrier. Products containing azelaic acid or glycolic acid in appropriate concentrations are generally considered safe and can help manage acne without the risks associated with retinoids or high-concentration salicylic acid. Always avoid touching your face with unwashed hands, as this transfers bacteria that exacerbate breakouts. Before using any prescription acne medications, consult your healthcare provider to verify safety during pregnancy.
For addressing pigmentation, prioritize sun protection above all other interventions. Apply broad-spectrum SPF 30 or higher sunscreen daily, even on cloudy days, as UV exposure significantly worsens melasma. Complement sunscreen with wide-brimmed hats when spending extended time outdoors. Vitamin C serums, safe during pregnancy, can help brighten skin and may reduce the appearance of dark spots. Remember that pigmentation changes typically fade naturally after delivery as hormones normalize, so aggressive treatment during pregnancy is unnecessary and potentially risky.
For overall skin health, hydration forms the foundation of pregnancy skincare. Aim for 8-10 glasses of water daily to support increased blood volume and maintain skin elasticity. Use fragrance-free, hypoallergenic moisturizers to combat the dryness some women experience. Take lukewarm rather than hot showers, as excessive heat strips natural oils and can exacerbate dryness. Apply moisturizer immediately after bathing while your skin is still damp to maximize absorption and lock in hydration.
For reducing stretch marks, maintain consistent moisturization, though understand that genetics largely dictate stretch mark development regardless of topical treatments. Products containing hyaluronic acid or shea butter may support skin elasticity. Focus on maintaining steady, healthy weight gain within your provider’s recommendations rather than relying solely on topical products.
Throughout these adjustments, listen to your skin’s signals. If a product causes irritation, discontinue use regardless of its “pregnancy-safe” label. Your skin’s sensitivity may change during pregnancy, requiring modifications to routines that previously worked well.
When to seek professional guidance
While most pregnancy skin changes are benign and temporary, certain symptoms warrant prompt medical attention.
Contact your healthcare provider if you experience sudden, severe acne that doesn’t respond to gentle care, as this may indicate hormonal imbalances requiring medical evaluation. Rapidly spreading or significantly darkening pigmentation beyond typical pregnancy patterns should also be assessed. Intense itching, particularly concentrated on your palms and soles, could indicate intrahepatic cholestasis of pregnancy—a serious liver condition requiring immediate treatment.
Any rashes, hives, or unusual bumps developing during pregnancy deserve evaluation, as do skin changes that cause you concern regardless of apparent severity. Your anxiety about your skin affects your overall well-being during pregnancy, making professional guidance valuable even for seemingly minor issues.
Your dermatologist and obstetrician can collaborate to ensure any treatments you pursue protect both you and your developing baby. Don’t hesitate to advocate for your skincare concerns—they’re a legitimate part of prenatal care.
What to expect after delivery
The good news: most pregnancy-related skin changes prove temporary. Pregnancy glow disappears relatively soon after delivery as hormones return to pre-pregnancy levels. Your blood volume gradually decreases, sebaceous gland activity normalizes, and that characteristic sheen fades within weeks to months postpartum.
Acne that worsened during pregnancy typically improves as hormonal fluctuations stabilize, though the postpartum period brings its own hormonal shifts that may temporarily affect your skin. Melasma and other pigmentation changes fade gradually, though complete resolution can take several months to a year. Sun protection remains crucial during this fading process to prevent darkening.
Stretch marks evolve from their initial reddish or purplish appearance to silvery-white lines over time. While they become less noticeable, they generally don’t disappear completely. Your skin’s texture and appearance will continue adjusting as your body recovers from pregnancy, with most changes stabilizing within the first postpartum year.
Embracing your changing body
Whether you’re experiencing that enviable pregnancy glow or navigating unexpected skin challenges, these visible changes reflect the extraordinary internal work your body is performing. The same hormones causing your skin concerns are supporting your baby’s development, regulating your cardiovascular adaptations, and preparing your body for birth and breastfeeding.
These transformations demonstrate your body’s remarkable capacity to create and sustain new life. Rather than fighting against every change, consider which adaptations genuinely affect your wellbeing versus which simply differ from your pre-pregnancy appearance. This distinction helps you focus your energy on self-care that truly matters while accepting the temporary nature of most pregnancy-related skin changes.
Your relationship with your body during pregnancy sets patterns that extend into postpartum recovery and beyond. Approaching skin changes with curiosity rather than judgment builds resilience and self-compassion—qualities that serve you throughout the demands of new parenthood.
For comprehensive support throughout your pregnancy journey, explore the pregnancy masterclasses at Beginning Academy. You’ll find evidence-based guidance on navigating both the physical and emotional transformations of pregnancy, from managing stress to preparing for childbirth. These resources offer practical, science-backed advice designed specifically for women seeking trustworthy information during this profound life transition.