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6 Postpartum Body Problems--And How to Fix Them

Though most fade to a pencil-thin line in a year or two, they never completely disappear. "The key to making scars less visible is treating them early," says Debra Jaliman, M.D., a clinical instructor of dermatology at Mount Sinai School of Medicine, in New York City.

What works: Mederma, an over-the-counter topical gel. Studies suggest its active ingredient, onion extract, helps realign the skin's collagen and smooth out scars. The gel, which is safe to use while you're nursing or pregnant, works best on scars under a year old but may minimize ones you've had for as long as eight years. Other treatments include self-adhesive foam strips, such as Curad Scar Therapy Cosmetic Pads. "They apply slight pressure, which may flatten the scar and lighten the redness," says David Leffell, M.D., professor of dermatology and surgery at Yale School of Medicine and author of Total Skin. Doctor's-office procedures, such as laser treatment and steroid injections, typically give better, faster results but cost more.

What doesn't: Vitamin E products. Moisturizer can help skin look younger, and the massaging action can soften a new scar. "But there's nothing about vitamin E that can actually change the skin's collagen, nor is there any proof that topically applied vitamins have any impact," says Stephen Metzinger, M.D., a plastic surgeon and director of burn services at Children's Hospital, in New Orleans.

Quickest fix: Trade in your teeny bikini for a suit that provides more coverage. Or cover the scar with a cream like Dermablend or a spray-on foundation like Era Face. Both are long-lasting and available in multiple shades, and they won't rub off on your clothes.

"During pregnancy and nursing, hormones cause breast tissue to expand, and the surrounding skin stretches to accommodate this," says Aron Kressel, M.D., chief of plastic surgery at Metropolitan Hospital, in New York City. "Afterwards, the tissue shrinks, but the skin is no longer as elastic." Though the only permanent picker-upper for your postbaby breasts is plastic surgery, you don't have to go under the knife to get a little lift.

What works: Exercise. "Working out won't boost your bra size, because breast tissue is fat, not muscle," says Courtney Barroll, a personal trainer at Equinox Fitness Clubs, in New York City. "But exercise can tone the pectoral muscles around the breasts, giving them a lifted and perkier appearance." Some bust-buffing moves: push-ups (balance on either your knees or, more advanced, your toes elevated on a step or low bench); chest flies lying on your back; pull-overs; and chest presses. However, get your doctor's okay before exercising postpartum.

What doesn't: Breast-firming pills or creams. "There's no evidence they tighten the skin or restore its elasticity," Dr. Kressel says.

Quickest fix: A supportive bra. Be sure to find the right fit -- ask knowledgeable lingerie sales staff for help. Look for a wide band for support, an uplifting underwire, and cups made of sturdy rather than sheer fabric. And to prevent further sagging, wear a sports bra when you work out.

Up to 70 percent of expectant moms get this "mask of pregnancy." Hormone fluctuations cause dark patches on the forehead, cheeks, and upper lips that often fade postpartum but don't go away completely.

What works: Prescription bleaching creams, steroids, and tretinoin (the main ingredient in Retin-A) either alone or in combination. Many patients see improvements within a few weeks. (The downside: These creams can cause temporary redness, peeling, and dryness; you can't use them while you're nursing or pregnant; and not all insurance companies cover them.) A series of glycolic peels done at your doctor's office can also help by removing the top layer of skin. Over-the-counter beauty products containing 2 percent hydroquinone or licorice extract may also reduce discoloration. But no matter how you wipe out your spots, you must use sunscreen vigilantly to maintain results.

What doesn't: Over-the-counter lightening or fade creams that don't contain the above ingredients. Most will only superficially lighten the skin.

Quickest fix: Cover up. Work with two concealers, suggests makeup artist Trish McEvoy, author of The Power of Makeup. Use one a shade lighter than the melasma and another that matches your natural skin tone. With your fingertips or a sponge, dab the lighter concealer into the brown patch with a patting motion. Then, apply the skin-matching concealer around it and blend. Set with translucent powder. Other tricks: If the melasma is around your mouth, downplay lips with nude liners and natural gloss. And divert attention to your eyes with eye-opening colors, a lash curler, and volumizing mascara.

Even if you've dropped most of your baby weight and you religiously do stomach crunches, that bulge around your belly doesn't seem to budge. That's because it's mostly stretched-out skin and muscle, says Lisa Masterson, M.D., an ob-gyn at Cedars-Sinai Medical Center, in Los Angeles.

What works: Moves that target the transverse muscles -- those that wrap around the abdominals horizontally. (Regular crunches focus on lengthwise muscles.) Try the slide: On a slippery floor, like wood or linoleum, get into a push-up position, balancing on your forearms. Place a folded towel under your toes, and as you pull your abs in, slide your knees toward your chest. Do two sets of five to eight reps, three times a week; work up to three sets. "Regular cardiovascular exercise will also help reduce overall body fat," Barroll says.

What doesn't: Electronic abdominal exercise belts. You've seen them on infomercials, but they're ineffective and painful, says a study by the American Council on Exercise. And the Federal Trade Commission has charged one of the top-selling brands with making false claims.

Quickest fix: Body-shaping underwear. Not your grandma's corset -- the latest tummy-toning undergarments are made of breathable, nonbinding fabric and are comfy enough to wear every day. Our favorites: Barely There Seamless Brief ($10), Maidenform's Flexees Underwonder Bare-Control Brief ($23), and Spanx Pantyhose Power Panties ($25).

These thin scars on the stomach, hips, breasts, or butt usually start out red and then lighten within a year. "Whether you get stretch marks depends a lot on genetics and how quickly you gain weight," says David J. Goldberg, M.D., director of laser research in the department of dermatology at Mount Sinai School of Medicine, in New York City. The earlier you treat them, though, the better your chance of fading them.

What works: Retin-A cream. It's most effective on newer, red marks, but steer clear of it if you're pregnant or nursing. "Retin-A builds up collagen, the firming fibers that were broken when skin was stretched," Dr. Jaliman explains. Side effects include temporary redness and flaky, dry skin. Microdermabrasion -- a procedure in which tiny crystals are blasted against your skin to remove the top layer and stimulate collagen production -- can treat older stretch marks. In addition, the FDA recently approved a new laser treatment that adds pigment to older, lighter stretch marks so they blend into surrounding skin.

What doesn't: Vitamin K creams. "Varicose veins are too deep for a topical cream to reach and provide any benefit," Dr. Jaliman says.

Quickest fix: Pants and long skirts. Or camouflage veins with waterproof makeup, like Dermablend or Era Face, or with self-tanning lotion. "The veins will appear less blue against tanned skin," McEvoy says.

As many as 40 percent of pregnant women develop dilated blood vessels near the skin's surface, most often on the calves and thighs. "Heredity, hormones, and the pressure on the veins of pregnancy pounds all play a role," Dr. Masterson says. Varicose veins may improve after childbirth, but they won't go away completely.

What works: Sclerotherapy. A doctor injects the affected leg veins with a solution that causes them to close, then fade or disappear within about two weeks. More than one session may be needed, and experts recommend waiting at least six months after delivery to begin. Temporary side effects include stinging at the injection site, muscle cramps, and redness or brown spots. Keep in mind that sclerotherapy typically isn't covered by insurance unless the varicose veins are causing pain.

What doesn't: Vitamin K creams. "Varicose veins are too deep for a topical cream to reach and provide any benefit," Dr. Jaliman says.

Quickest fix: Pants and long skirts. Or camouflage veins with waterproof makeup, like Dermablend or Era Face, or with self-tanning lotion. "The veins will appear less blue against tanned skin," McEvoy says.

Copyright © 2003 Michele Bender. Reprinted with permission of Parents magazine November 2003 issue.

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