Issue link: https://www.ascpskindeepdigital.com/i/1489006
52 ASCP Skin Deep Winter 2023 Another skin change that can occur during pregnancy is melasma, also known as "pregnancy mask." (See "More than Meets the Eyes" on page 29) According to Duncan, it usually happens closer to the third trimester, the same time pregnant clients might notice the darkening of abdomen skin called linea nigra. Melasma can affect up to 90 percent of pregnant people and seems to be caused by hormone surges, as both estrogen and progesterone stimulate melanin production in the skin. 4 Trampetti tends to see melasma most often in clients who already have high levels of melanin in their skin, but any pregnant person is susceptible to it. Duncan explains that the human body goes through every possible permutation during pregnancy, including changes to the cardiovascular, hematological, metabolic, renal, respiratory, and dermatological systems. 5 Such a physiological overhaul has huge effects on the skin—the body's largest organ. Trampetti notes that "skin with sensitivity to irritants can be even more sensitive during pregnancy." Estheticians and pregnant people should approach all ingredients and treatments with caution, even ones that have worked well in the past. "The joke is that you can read all the books on pregnancy, but your pregnancy isn't going to read any of them," Duncan says. It's difficult to know what to expect during pregnancy regardless of how much research one conducts. Many of the pregnancy-related skin changes will resolve naturally with the end of pregnancy. Estheticians should focus on counseling clients about the skin changes they might experience, but they should also provide reassurance that while it might not feel like it, pregnancy is a relatively short window of time. In some cases, it might be best to wait out these changes in the skin and delay procedures until after pregnancy. 6 INGREDIENTS TO AVOID Trampetti likes to take a customized approach with each client to address how hormone shifts might exacerbate current conditions. "I want to make sure we're including ingredients to fight a reaction, stop a process, or at least maintain it." She divides ingredients into two distinct categories: "don't use at all" and "ask your doctor." In the "don't use at all" category are vitamin A derivatives such as retinoids. Duncan concedes that FOR MANY, PREGNANCY IS A BEAUTIFUL, life-changing experience, but it can also be an overwhelming and confusing time. Pregnant people tend to receive advice and information from every direction, and for every piece of advice, there often seems to be another in direct conflict. Recommendations about what to eat, drink, and do can vary wildly, leaving expectant parents unsure about the best way to nourish and take care of their rapidly changing bodies. The same is true of prenatal skin care and skin treatments. Because of the ethical and legal concerns surrounding conducting tests on pregnant people, there's a distinct lack of concrete data about the effects of certain ingredients and drugs. This lack of safety information can even result in differing advice among medical professionals. 1 Moreover, pregnant patients often don't receive adequate advice from their medical professionals about products to use and avoid. A recent study found that during pregnancy, only 16.2 percent of patients surveyed received advice about personal care products. Among the ones who had not received advice, 78.8 percent said they would have appreciated it. 2 When it comes to a pregnant client's skin health, estheticians have a wonderful opportunity to fill this information gap, provide recommendations for their pregnant clients, and calm any concerns or frustrations. In general, experts say most esthetic procedures are perfectly safe to perform during pregnancy. 3 Pregnant clients deserve to feel beautiful and pampered, and there is a safe way to provide these much-needed services. At the same time, it is recommended that estheticians always encourage clients to consult with their medical professional, weigh the pros and cons, and make the best decision for their body and lifestyle. SKIN CAN CHANGE DRAMATICALLY DURING PREGNANCY You may have heard of the famed "pregnancy glow." Emily Trampetti, a multistate licensed esthetician who builds customized skin care regimens for pregnant clients, says this results from hormonal changes that cause increased circulation, blood flow, and oil production. "Oil production is really important to the hydration of our skin. It's keeping us hydrated and keeping our skin safe," Trampetti says. This increased oil production can also lead to breakouts. According to board-certified OB-GYN Erin Duncan, pregnant clients can experience more acne, and in some cases, they may have an emergence of cystic acne they didn't have before.