Pregnancy and Skincare

Two of our staff members, Dr. Kailey Winton and nurse Jovanna Butler, are expecting babies later this year (wheeeee!). Here are some of their top tips and products for treating pregnant skin.

What many pregnant women don’t know is that excellent and effective treatments are available for treating pregnancy skin — whether you’re struggling or not. Growing a baby brings on a surplus of hormones that can boot your skin’s appearance into an entirely new dimension. Yes, some women glow. But others glower at the acne, eczema, facial hair, and inability to use most medical grade creams like retinols — commonly known around Derma Spa as liquid gold (if you want to know more about the wonders of retinol click here for an article by Dr. Kailey Winton or for a patient’s perspective, click here for an article by Susan Hollis.

How has your skin changed through pregnancy?

Nurse Jovanna: This time around, I consider myself very lucky in this department. During my previous pregnancies I experienced a variety of skin peculiarities throughout that included acne, discolorations and other delightful surprises. This time around I’ve experienced very little! Chalk it up to different pregnancy or my trusty skincare products, I’ve had little to no changes other than slight pigmentation.

Dr. Winton: As someone who’s dealt with adult hormonal acne for years, pregnancy has fortunately been good for my skin. I’m lucky as the effect of pregnancy on acne is variable (it can improve, remain unchanged, or worsen). I’ve been using prescribed azelaic acid gel 15% twice daily which has kept most breakouts at bay.

What skin creams and treatments have you foregone for the pregnancy?

Nurse Jovanna: Sadly, I’ve taken nightly retinol and my favourite cleanser that contains salicylic acid out of my daily regimen. I miss them both dearly. My cleanser was great for keeping any adult acne at bay and I assure you it’s true you don’t know how much you miss retinol till it’s gone! Although I miss both of these products I am lucky enough there are solid substitutes that are deemed safe during my pregnancy!

Dr. Winton: I’ve stopped all topical retinoids and most treatments (injectables, laser, IPL, microneedling, etc).

What pregnancy-safe creams and treatments do you rely on now?

Nurse Jovanna: Although it presents a little differently, my current skin care regimen keeps me glowing! I’ve been able to keep much of the same, however I’ve substituted my nightly retinol for an AFA gel. It also encourages cell turn over, however it is made of amino acids which are deemed safe for pregnancy. I’ve been slightly dryer since my pregnancy commenced so the daily hydrating cleanser by ZO has been an easy daily-use substitute!

Dr. Winton: I use Zo 10% vitamin C serum and sunscreen daily in the morning. There are many good options — personally I like Tizo tinted SPF40 as it’s mineral based. I use prescribed azelaic acid gel 15% twice daily for acne and redness. And a good hydrating cream at night like Skin Medica’s HA5. I really enjoyed getting AFA peel treatments during my first pregnancy but I have yet to get one this time around. Life is just busier with the second!

Are there any facial skin creams the public should be aware of that are not safe for pregnant and breastfeeding women?

Dr. Winton: In pregnancy we are mindful about what we put into our bodies, and we take a similar approach to what we put on our skin. Many over-the-counter (OTC) skincare creams are safe but there are a few products/ingredients pregnant women should avoid:

• Retinoids: OTC these are called “retinol,” there are also prescription topical and oral retinoids (eg. Accutane). Oral retinoids like Accutane can cause birth defects. Topical retinoids do not pose the same risk but should still be avoided.

• Hydroquinone: is a topical skin lightening/depigmenting agent for conditions like melasma.  Although there has been no link shown between its use and adverse pregnancy effects, the concern is that our bodies tend to absorb more of this drug compared to other topical products.  It’s therefore best to avoid exposure.

Other products that should be used with caution include:

• Salicylic acid: in general, lower concentrations of salicylic acid are considered to be safe (eg. 0.5-2%) but there have been no studies done with its use topically in pregnant women.

• Benzoyl peroxide: in general, considered to be safe as minimal amounts are absorbed through the skin. Again, there have been no studies done with its use topically in pregnant women.

• Glycolic acid: in general, also considered to be safe as minimal amounts are absorbed through the skin. Once again, there have been no studies done with its use topically in pregnant women.

If you have questions about what is safe during pregnancy I would encourage women to check with their maternity care doctor.

Have you ever used something on your skin that you later found out was not recommended for pregnancy? How did you handle that?

Nurse Jovanna: I think if we are being honest, there are very few of us that have not eaten, consumed, applied or exposed ourselves to things at one point in our pregnancy that we later found out was a “no go.” During my second pregnancy I remember using a product that contained a higher strength of retinol than I realized. I simply stopped using it and my daughter is fine. Pregnancy brings joy, exhaustion, anticipation, excitement and every other emotion under the sun (much like motherhood). My advice — it’s important to not be too hard on yourself. Not just during pregnancy, but in life. When you know better, you do better and we are all constantly learning, growing and evolving. If you have questions or hesitations, reach out for more knowledge. If you find out down the road you’ve applied something you shouldn’t have simply stop using the product and don’t panic. Seek out a safe alternative and reach out to your healthcare professional. Above all, know you’re not alone!

Moving into the summer months, what kinds of sunscreens do you prefer?

Nurse Jovanna: It took me a long time to adopt the notion that sunscreen is not only for life but daily. Now it’s simply part of my everyday regimen. Sunscreens to me are very personalized. The great thing is there is a sunscreen for everyone. If you’re looking for your perfect sunscreen as we head into the summer months, I suggest having a complimentary skin consult so your consultant can direct you to your skin’s perfect match which will be dictated on your preference of tint or no tint? Oily or dry skin? Sheer or matte? Waterproof or not? SPF strength? Who would’ve thought sunscreen shopping could be so much fun! For me? I love a tint. On the weekends I have my “Mom” hat on which leaves makeup a thing of the past for at least a few days. That being said, the IS Clinical tinted sunscreen is a beautiful broad spectrum sunscreen that keeps me protected and also leaves me with a little glow to carry me through the weekend.

Dr. Winton: I like Tizo tinted SPF40 as it’s mineral based.

Have you had any experience with pregnancy-related melasma? If so, do you have any words of wisdom for other women who might be worried about this discolouration? Are there any lasers that can treat this condition safely after the baby is born?

Nurse Jovanna: Knock on wood, I have not. That being said, I have many clients and friends who have been affected by melasma during pregnancy. First things first, although a buzz kill — know this is more common than you think! Hormone levels change significantly during pregnancy, especially during the second and third trimesters. These changing hormones can result in excessive melanin production and in turn, dark patches on your skin. To start, there are simple steps you can take to keep this at bay like wearing a broad spectrum sunscreen, wearing UV protective clothing and hats, and avoiding direct sun bathing and peak sun hours. Pregnancy related melasma can fade after birth particularly in women who had not presented with melasma prior to pregnancy. If melasma was present prior to pregnancy this may not fade on it’s own. It’s important to remember melasma is a chronic condition which will need diligent protection and attention to keep at bay. Once the baby has been delivered, there are treatments and products such as peels, and lasers such as IPL which can treat the pigment. I always recommend a consultation before deciding on your treatment route. The last thing one would want is add insult to injury by deciding on the wrong plan. Your skin care professional will be able to evaluate your melasma and steer you in the right direction for your skin.

Stretch marks and loose tummy skin can be stressful for women who are carrying babies — do you have any tips for treating the abdominal area after birth?

Nurse Jovanna: Over 90% of women experience stretch marks during their pregnancy. I am one of the lucky 10% that do not. That being said, in the past I have applied bio-oil periodically!

Dr. Winton: Stretch marks in pregnancy, or striae gravidarum, is a form of dermal scarring of which the pathology is not well understood but is likely due to a combination of genetic, hormonal, and mechanical factors. They are incredibly common, affecting 75-90% of women in their third trimester of pregnancy. A common question I get is how to prevent them, and aside from gaining the recommended amount of weight for your pre-pregnancy BMI and using a topical cream containing hyaluronic acid, the evidence is limited. As with any scar, the skin will never be the same as it was before but there are many treatment options if patients wish to pursue them. First line, a nonablative laser will improve skin texture and colour most efficiently. Other options include microneedling and radiofrequency devices. Topically, retinoids can be used to increase collagen and hyaluronic acid cream helps to improve skin texture. Like many scar treatments, it’s often a combination of technologies over multiple visits that gives us the best outcomes.

Have you picked names and can/will you tell us? 
Nurse Jovanna: Haha! I would love to! I am an open book. Unfortunately I have no insight! My husband is naming this one (our fourth daughter) so I am eagerly waiting to hear the news of her name along with the rest of you. You will all be the first to know!

Dr. Winton: We have a short list but our lips are sealed!