Abby NiziolAnnapolis, Annapolis MD, Maryland, Maryland State House, State House, Legislature, pregnancy, skincare, skin, sensitive skin, pregnancy skin, pregnancy skincare, skincare tips, nursing, nurse, nurse practitioner, familynursepractitioner, family nurse practitioner, RN, FNP, LPN, CNA, historic, small town, quaint, sister, skinisin, skin is in, skin disease, skincare routine, skin care, skin clearing, skin calming, skin clarifying, skin protectant, sunscreen, chemical sunscreen, physical block, physical sunscreen, zinc oxide, zinc, titanium, titanium dioxide, hormone, hormones, estrogen, angioma, angiomas, mole, moles, dermatology, derm, dermatology nurse practitioner, melasma, chloasma, mask of pregnancy, hyperpigmentation, oral contraceptives, SPF, SPF 30, SPF 50, birth, postpartum, labor, hydroquinone, presription, chemical peel, peel, laser, lasers, steroid, steroids, azelaic, azelaic acid, Finacea, retinol, retinols, retinoid, retinoids, linea nigra, pregnancy line, delivery, skin tag, skin tags, acrochordon, acrochordons, benign, liquid nitrogen, vascular, cherry, cherry angioma, cherry angiomas, hemangiomas, hemangioma, genetic, palmar erythema, erythema, spider angioma, spider, spider nevi, nevi, nevus, first trimester, psoriasis, acne, rosacea, eczema, rash, rashes, board certified, boardcertified, PUPPP, pruritic urticarial papules and plaques or pregnancy, polymorphic eruption of pregnancy, pregnancy rash, antihistamine, prurigo, prurigo of pregnancy, atopic dermatitis, pemphigoid, pemphigoid gestationis, second trimester, third trimester, premature, premature birth, newborn, infant, oral steroid, vitamin A, vitaminA, retin-A, Retin-A Micro, Atralin, Renova, tretinoin, retinoic acid, tazarotene, Tazorac, Fabior, Adapalene, Differin, EpiDuo, EpiDuo Forte, Accutane, isotretinoin, Claravis, Myorisan, Absorica, Amnesteem, benzoyl peroxide, salicylic acid, teratogenic, pregnancy category, acne prone, Proactiv, Neutrogena, Clearasil, Clean & Clear, Acanya, Onexton, BHA, beta hydroxy acid, Aveeno, Burt's Bees, Burt's Bees Mama Bee, Tri-Luma, avobenzone, oxybenzone, Botox, Filler, dermal filler, Dysport, Xeomin, Restylane, Radiesse, Juvederm, wrinkles, fine lines, beauty, blog, blogger, beauty blog, beauty blogger, beautiful, beautiful travels, intrepid, intrepid beauty, intrepidbeauty, travel, travel blogger, travel blog, traveling, AHA, AHAs, alpha hydroxy acids, lactic, lactic acid, glycolic, glycolic acid, mandelic acid, mandelic, clindamycin, Cleocin, Mustela, Mama Mio, Pretty Mommies, Mommies, mothers, mothers day, Belli, Belli Beauty, history, Revolutionary, Revolutionary War, sail, sailing capital, sailing capital of the world, US Naval Academy, Naval, Naval Academy, United States Naval Academy, spring, springtime, Thomas Dance, Matthew Henson, North Pole, discover, discovery, blogging, sunblock, cosmetics, aesthetics, aesthetician, gypsy, wanderlust, wander, mountains, landscapes, outside, get outside, outdoors, women, solo, solo travel, new places, girls who hike, girlswhohike, girls, prenatal, postnatal, prenatal skincare, skincare during pregnancy, postnatal skincare, pregnancy safe, avoid during pregnancy, social, good skin

Annapolis, Maryland + Skincare During Pregnancy

Abby NiziolAnnapolis, Annapolis MD, Maryland, Maryland State House, State House, Legislature, pregnancy, skincare, skin, sensitive skin, pregnancy skin, pregnancy skincare, skincare tips, nursing, nurse, nurse practitioner, familynursepractitioner, family nurse practitioner, RN, FNP, LPN, CNA, historic, small town, quaint, sister, skinisin, skin is in, skin disease, skincare routine, skin care, skin clearing, skin calming, skin clarifying, skin protectant, sunscreen, chemical sunscreen, physical block, physical sunscreen, zinc oxide, zinc, titanium, titanium dioxide, hormone, hormones, estrogen, angioma, angiomas, mole, moles, dermatology, derm, dermatology nurse practitioner, melasma, chloasma, mask of pregnancy, hyperpigmentation, oral contraceptives, SPF, SPF 30, SPF 50, birth, postpartum, labor, hydroquinone, presription, chemical peel, peel, laser, lasers, steroid, steroids, azelaic, azelaic acid, Finacea, retinol, retinols, retinoid, retinoids, linea nigra, pregnancy line, delivery, skin tag, skin tags, acrochordon, acrochordons, benign, liquid nitrogen, vascular, cherry, cherry angioma, cherry angiomas, hemangiomas, hemangioma, genetic, palmar erythema, erythema, spider angioma, spider, spider nevi, nevi, nevus, first trimester, psoriasis, acne, rosacea, eczema, rash, rashes, board certified, boardcertified, PUPPP, pruritic urticarial papules and plaques or pregnancy, polymorphic eruption of pregnancy, pregnancy rash, antihistamine, prurigo, prurigo of pregnancy, atopic dermatitis, pemphigoid, pemphigoid gestationis, second trimester, third trimester, premature, premature birth, newborn, infant, oral steroid, vitamin A, vitaminA, retin-A, Retin-A Micro, Atralin, Renova, tretinoin, retinoic acid, tazarotene, Tazorac, Fabior, Adapalene, Differin, EpiDuo, EpiDuo Forte, Accutane, isotretinoin, Claravis, Myorisan, Absorica, Amnesteem, benzoyl peroxide, salicylic acid, teratogenic, pregnancy category, acne prone, Proactiv, Neutrogena, Clearasil, Clean & Clear, Acanya, Onexton, BHA, beta hydroxy acid, Aveeno, Burt's Bees, Burt's Bees Mama Bee, Tri-Luma, avobenzone, oxybenzone, Botox, Filler, dermal filler, Dysport, Xeomin, Restylane, Radiesse, Juvederm, wrinkles, fine lines, beauty, blog, blogger, beauty blog, beauty blogger, beautiful, beautiful travels, intrepid, intrepid beauty, intrepidbeauty, travel, travel blogger, travel blog, traveling, AHA, AHAs, alpha hydroxy acids, lactic, lactic acid, glycolic, glycolic acid, mandelic acid, mandelic, clindamycin, Cleocin, Mustela, Mama Mio, Pretty Mommies, Mommies, mothers, mothers day, Belli, Belli Beauty, history, Revolutionary, Revolutionary War, sail, sailing capital, sailing capital of the world, US Naval Academy, Naval, Naval Academy, United States Naval Academy, spring, springtime, Thomas Dance, Matthew Henson, North Pole, discover, discovery, blogging, sunblock, cosmetics, aesthetics, aesthetician, gypsy, wanderlust, wander, mountains, landscapes, outside, get outside, outdoors, women, solo, solo travel, new places, girls who hike, girlswhohike, girls, prenatal, postnatal, prenatal skincare, skincare during pregnancy, postnatal skincare, pregnancy safe, avoid during pregnancy, social, good skin
Annapolis, Maryland + Skincare During Pregnancy

When my sister became pregnant, she was quick to inquire about her skin -

what she should use, what she shouldn't use, and what skin changes she might expect. 
 

Read on for what skin changes you may experience and some tips on what to use (and not use) during pregnancy, plus a reunion with my sister and baby niece in beautiful and historic Annapolis, Maryland.


My sister has always had beautiful ivory skin - even through her pregnancy. And it looks like she passed it along


Pregnancy (and hormones in general) can have quite an effect on the skin. Pregnancy makes us more prone to developing certain skin conditions and skin growths (exciting, huh?). It's also important to recognize that there are some skincare products that shouldn't be used during pregnancy. 


I highly suggest that every woman who is thinking about getting pregnant to have a full-body examination  with a board-certified dermatologic practitioner. This gives us a baseline of your skin, as skin changes are likely to take place during pregnancy. 


Common Skin Changes During Pregnancy


{ 1 } Melasma / Chloasma 

What Is It?

Melasma is a skin condition in which hyperpigmentation (skin darkening) occurs, typically on the face (cheeks, cutaneous upper lip, forehead, and nasal bridge are common areas). When a pregnant woman gets this hyperpigmentation, it's referred to as "chloasma," or "the mask of pregnancy." 

What Causes It? 

Melasma can be caused by changing hormones, which is why it's commonly seen in pregnancy. It can also be caused by oral contraceptives (birth control), and hormone replacement medications. Sunlight exposure can be also cause (and worsen) melasma. It seems that people with darker skin tones are more at risk for developing melasma. 

How To Treat It? 

You can help prevent melasma by wearing a good sunscreen on a daily basis. Use at least SPF 30, with a physical block in the ingredients (zinc oxide or titanium dioxide). Avoid any harsh skincare products, and avoid waxing (anything abrasive to the skin can worsen melasma). 

The good news is that pregnancy-induced melasma typically fades completely on its own after the baby is born. If it doesn't, there are topical prescription products that your dermatologic provider can prescribe to help lighten melasma. These include hydroquinone 4%, retinols, topical steroids, and azelaic acid. It's important to recognize that many of these topical SHOULD NOT be used during pregnancy. There are also chemical peels and lasers that can help lighten melasma. 


{ 2 } Linea nigra

What Is It?

"The Pregnancy Line" - or "linea nigra" to be more medically correct, is a brown-colored vertical line that extends down the midline abdomen, through the bellybutton, to the pubis. It's totally normal. It tends to be darker with darker skin types. 

What Causes It?

Like melasma, the changing of hormones is responsible for this hyperpigmentation. In fact, darkening of the nipples and other female parts is a very normal part of pregnancy. 

How To Treat It?

Patience. It will fade soon after delivery. 


 

{ 3 } Skin growths:

Moles 

You may get new moles or notice a darkening of your existing moles during your pregnancy. Most of the time this is a normal phenomenon; however, any changes in moles should be monitored by your dermatologic provider. 

Skin tags

Again, a shift in hormones make pregnant women more prone to developing skin tags. Most often, skin tags develop on areas where skin rubs against skin or other pieces of clothing, like under the arms, in the groin, around the neck, and under/around the breasts. Your dermatologic provider can assess these skin tags to ensure that they are benign (sometimes dangerous skin lesions can present like a skin tag) and they can be easily and safely removed during pregnancy with either liquid nitrogen or a scissor snip (yes...a pregnancy-safe numbing agent can be used). 


{ 4 } Vascular Changes: 

Pregnant women experience vascular changes due to increased blood volume and changing levels of estrogen - what does this mean for the skin? 

 Angiomas 

Cherry angiomas are small red dots that seem to be induced by hormones, specifically estrogen, and are also likely to be genetic. This means if your mom or dad have / had lots of these tiny red dots,  you may be prone to producing more of these with pregnancy and with age. These benign growths may be flat or raised, and are essentially a proliferation of new or existing tiny, superficial blood vessels.  

After pregnancy, these can be treated with lasers. 

PALMAR ERYTHEMA

Literally means "red palms."  During pregnancy you may notice your palms looking more red than normal, especially if you have a lighter skin tone. 

Spider Angiomas / Spider Nevi 

These look like a tiny patch of spider veins, typically seen on the face, neck, and upper extremities. These typically grow during the first and second trimesters, and seen more often in light-complected women. Though benign, these can be treated with laser post-pregnancy. 


{ 5 } 
Changing of Pre-Existing Skin Conditions

If you have a skin condition such as psoriasis, eczema, acne, or rosacea, you may noticed a change in your condition. For some women, pregnancy greatly improves their skin conditions, while for others, pregnancy may exacerbate any preexisting skin conditions. Every woman is different, and how her skin responds to pregnancy is very individualized. 


{ 6 } Pregnancy Induced Rashes

There are a handful of rashes that are induced by pregnancy. All rashes during pregnancy should be evaluated by a board-certified dermatologic practitioner, as some will require closer monitoring and can be associated with higher risk of fetal prematurity. Always consult your board-certified medical provider before taking any medication or using any topical products discussed in this article. 

The more common rashes we see include: 

Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)  
(AKA Polymorphic Eruption of Pregnancy)

  • Onset is typically in the late third trimester, or sometimes immediately postpartum
  • Rash typically starts on the abdomen, sometimes in stretch marks, and spreads to extremities within a few days (right around the belly-button, palms, soles, and face are typically spared)
  • Rash is intensely itchy, starting as red bumps or welts 
  • Most common in first-time pregnancies; unlikely to happen again in subsequent pregnancies
  • Will resolve within two weeks of delivery (topical steroids and / or oral antihistamines may help with itchiness) 

-Prurigo of Pregnancy(PP)

  • Intensely itchy rash that develops typically in 2nd-3rd trimester, but can occur at any time during pregnancy
  • Presents as red bumps or pustules, most often occurring on extensor surfaces (tops of arms, front of legs, etc) 
  • Women with history of atopic dermatitis (eczema) may be at higher risk of developing PP
  • Typically resolves after birth, however can persist for months postpartum
  • Topical steroids and oral antihistamines may help 

-Pemphigoid Gestationis (PG)

  • Autoimmune skin condition that develops 2nd-3rd trimesters
  • Typically starts with itchy red bumps around the belly-button, then will spread to trunk, and extremities within days to weeks, and will eventually turn into large fluid-filled, tense blisters
  • Giving birth will most likely resolve rash, but may persist for months or years. May experience flare-ups with subsequent pregnancies or use of oral contraceptives

  • Need monitoring throughout pregnancy as PG may lead to premature birth or secondary infection

  • 5-10% of newborns will be born with the rash themselves
  • May need more than topical and antihistamines - oral steroids may be prescribed


Pregnant or Nursing?

Skincare Products

To Avoid:

  1. Vitamin A Derivatives:
    • Retinols / Tretinoin
      • Topical prescriptions like Retin-A®, Retin-A Micro®, Atralin®, Renova® (these are brand names for the prescription "tretinoin") 
      • Stay away from any retinoid or retinoic acids (even over-the-counters) 
    • Tazarotene
      • Another topical prescription, brand names Tazorac® & Fabior® 
    • Adapalene
      • A topical that you can now get over-the-counter in the lower strength (0.1%, brand name Differin®), and by prescription for the higher strength (0.3%, brand name EpiDuo® or EpiDuo® Forte when combined with benzoyl peroxide)  
    • Isotretinoin (old brand name Accutane) 
      • Though isotretinoin is commonly referred to as "Accutane," brand-name Accutane doesn't exist anymore - now it's called Claravis™, Myorisan™, Absorica®, or Amnesteem®
      • These medications are highly teratogenic - meaning they will likely cause fetal harm
  2. Benzoyl Peroxide
    • The safety of using benzoyl peroxide hasn't yet been established - so we say err on the side of caution, and opt for other anti-acne treatments
    • This is an additive in many over-the-counter products (Proactiv®, Neutrogena® On-The-Spot Treatment, Clearasil®, Clean & Clear®, and more) as well as prescription topicals (EpiDuo®, and EpiDuo® Forte, BenzaClin®, Acanya®, Onexton®) 
  3. Salicylic Acid
    • Salicylic acid is a BHA (beta-hydroxy-acid) and should be avoided during pregnancy and nursing
    • In many over-the-counter brands - commonly seen in Neutrogena®, Aveeno®, Clearasil®, Burt's Bees®, Clean & Clear® products 
  4. Hydroquinone
    • This topical skin-bleaching cream can be purchased over-the-counter in the lower strengths (i.e. 2%), or by prescription for higher strengths (i.e. 4%). It is often combined with a topical steroid and tretinoin for increased effectiveness (brand name Tri-Luma®)
  5. Chemical Sunscreens
    • There are many chemical blocks in sunscreens - you'll want to specifically avoid avobenzone and oxybenzone, though opting out of a chemical block sunscreen altogether is probably the best option  
  6. Botox / Fillers
    • No Botox®, Dysport®, or Xeomin® (all neurotoxins to help with those fine lines & wrinkles) or dermal fillers (Resylane®, Radiesse®, Juvéderm®) etc. 

Pregnancy and Nursing

- Safe -

Skincare Products

  • Alpha-hydroxy-acids (AHAs) are typically considered safe during pregnancy and nursing. These include: 
    • Lactic acid
    • Glycol acid
    • Mandelic acid 
      • These are commonly used in peels - so just  because you're pregnant or nursing doesn't mean you can't get your chemical peels -it just means you may have to choose another peel containing only AHAs
  • Physical block sunscreens
    • Physical blocks such as zinc oxide and titanium dioxide are very safe for pregnancy and nursing (plus they're also more effective in blocking the sun's rays)
  • Clindamycin (Cleocin®) 
    • This topical prescription can help with troubled skin and is generally safe to use during pregnancy and when nursing 
  • Azelaic Acid (Finacea®)
    • Another prescription topical to help with troubled skin - generally considered safe to use in pregnancy and when nursing 
  • New skincare lines safe for pregnant and lactating women: 
    • Mustela®
    • Mama Mio™
    • Pretty Mommies™
    • Burt's Bees® Mama Bee
    • Belli® Beauty

Like mother, like daughter. Light skin, hair, and eyes are all factors that can increase your risk for developing skin cancer. 


Last weekend I traveled to Annapolis, the capitol of Maryland, to see my sister and new niece (they were visiting there as well).  It was my first time to Annapolis, and it was such a cute little town. Lots of history, lots of blossoming flowers, and lots of cute shops.  I got to babysit and talk skincare with my sister - through her pregnancy and beyond. 


Historic Annapolis - a quaint town with an 1800's vibe 


The waterfront is just minutes from Historic Annapolis. An easy five minute walk 


Annapolis is nicknamed "America's Sailing Capital" and "Sailing Capital of the World" - makes sense that it is home to the US Naval Academy 



The Maryland State House - the oldest State House still in legislative use


The Maryland State House is free and open to the public - though some rooms will be blocked off if in use 


Thomas Dance, the plasterer that was working on the inner dome, fell to his death while working in 1793, delaying the building process


Matthew Henson, co-disocverer of the North Pole, was born in Maryland in 1866



Brick pavers and narrow streets + cute shops. My favorite was The Annapolis Pottery (click here to check them out)



U N T I L  N E X T  T I M E ,
 

B E A U T I F U L
 
T R A V E L S


Medical Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website.