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Annoying Acne

Oh, Those Hormones!

Being pregnant and having a pimple—or three—on your chin is one surefire way to draw attention to the fact that your hormones are in flux, and to leave you feeling a little more uncomfortable on top of it all. Hormone levels during pregnancy elevate, and two of the things believed to be the result of this are skin changes and acne.

According to a report in the Archives of Dermatology, up to 65 percent of the women surveyed believe there was a change in their acne during their pregnancies. The interesting thing, however, is that not all women suffered from more acne during pregnancy. They found that around 41 percent of the women reported that their acne improved while they were pregnant, while only 29 percent believed that it got worse.

It is believed that up to a third of all women have worsened acne while they are pregnant. This leaves a lot of women wondering why, what they can do to get rid of it and whether there’s a way to prevent it from happening in the first place.

Why Acne Becomes Visible

According to the Journal of Investigative Dermatology, it’s believed that the sebaceous glands are activated to grow and produce sebum (oil) with either increased male hormone or increased sensitivity of the androgen receptors on sebocytes (oil-making cells in our hair follicles). While all women make some androgens in their ovaries and adrenal glands, the hormonal balance during pregnancy can be altered to make more male hormones, to increase the sensitivity of the hormone receptors or both.

“Unfortunately, just making more oil is not enough to cause acne, so the story becomes more complex,” says Dr. Lawrence Mark, assistant professor of dermatology at Indiana University’s School of Medicine. “For reasons not yet known, the skin around hair follicles (maybe also hormonally related) does not slough off as well, and this causes a clog in the hair follicle pore (blackheads and whiteheads).”

When this happens, he explains, the sebum backs up and is eaten by normal bacteria living on the skin. An irritation, or inflamed red bump, is the result. When this happens, there is a further immune reaction in the inflammatory cells that leads to pus bump formation.

Prescription Precautions

A lot of people take prescription medications for acne, even prior to pregnancy. It’s important to know if it’s safe to continue taking it once you are pregnant. That’s one of the first things you should discuss with your healthcare provider, so that he or she can evaluate whether it’s something that could harm the baby. Some acne medications are believed to be linked to birth defects.

According to the American Pregnancy Association, up to 35 percent of infants born to women exposed to the prescription drug Accutane during the first trimester of pregnancy have birth defects, and there is an increased risk of miscarriage and infant death. These birth defects include such things as central nervous system defects, heart defects, and craniofacial defects.

Another popular prescription acne medication, Tetracycline, is thought to be linked to inhibiting bone growth and discoloring the teeth of the fetus. Retin-A, another such medication, carries warnings about use during or prior to becoming pregnant. To be on the safe side, it’s best to speak to your healthcare provider about any prescription and non-prescription acne treatments before and during pregnancy.

“Once acne occurs, prescription treatments are usually limited, due to concern over possible ill effects to the fetus,” Dr. Mark says. “I typically urge patients not to consider aggressive treatment while pregnant, as the problem will only last for a limited number of months.”

An Ounce of Prevention

So what can you do ahead of time, in order to avoid having acne problems during pregnancy? Not a whole lot. But there are some things that may make it a little better. Start by gently washing your face each day with a very mild soap and patting it dry with a towel. Look for makeup that won’t clog your pores, and be sure to wash it off before you go to bed every night.

“There is no specific prevention, other than gentle skin cleansing and avoiding heavily occlusive (pore-clogging) makeups, facial moisturizers, and medicaments,” Dr. Mark says. “I tell patients with active acne to avoid abrasive cleaners, since these can cause micro-cuts in the skin, which may worsen the inflammatory reaction of acne. This includes dermabrasion and micro-dermabrasion. Safe over-the-counter methods usually include continued use of gentle facial cleansers, astringents, low-concentration benzoyl peroxide washes, salicylic acid facial washes, and green-tinted cover-ups.”

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