Summer is prime time for sun exposure, which can damage your skin. During pregnancy, your body has a greater surface area, which means you'll need more sunscreen than usual.
Plus, you're also at increased risk for melasma, often called the "mask of pregnancy," a discoloration of the skin that leads to brown patches on the face. Increased estrogen levels combined with sun exposure can raise the activity of pigment-producing cells, explains Sarah Myers, MD, an associate professor of dermatology at the Duke University Medical Center, in Durham, North Carolina. Wearing sunscreen -- one that blocks both UVA and UVB rays and has an SPF of 30 or higher -- and a hat can help prevent melasma. Reapply sunscreen every two hours, more often if you're sweating or swimming.
For many women, melasma fades naturally after they give birth. But if it does not, a dermatologist can prescribe a bleaching cream. "A lot of these creams contain ingredients that are harmful to a developing baby during pregnancy and breastfeeding, so you'll need to wait until you're done to use them," says Diane Berson, MD, an assistant professor of dermatology at the Weill Medical College of Cornell University, in New York City. "For darker patches, a light chemical peel or a laser treatment may help."
During hot days, your skin can rebel in other ways too. "Heat and humidity can leave you prone to heat rash," Dr. Berson says. It consists of small, itchy red bumps -- often called prickly heat -- that develop wherever you have tight clothing or friction. Common areas include beneath or between the breasts, on the neck, or under the arms. To prevent the rash, keep skin dry and wear loose-fitting clothes made of breathable fabrics such as cotton. If your skin becomes really itchy, you may want to apply a 1 percent hydrocortisone cream, Dr. Berson says.
It's not just your skin that's affected by the sun and heat. Summer also increases the risk for dehydration. This can be dangerous during pregnancy because it can compromise nourishment of the baby, increase the risk of blood clots, and even lead to preterm labor. In hot weather, your body cools itself by sweating, which can cause you to lose a significant amount of water, explains Sharon Phelan, MD, medical director of the maternity and infant care project at the University of New Mexico, in Albuquerque.
Signs of dehydration include a dry mouth, thirst or light-headedness, nausea, and abdominal cramping. If you experience any of these symptoms, seek rest in a cool place and drink water. If the symptoms don't subside within 30 minutes, call your doctor.
To prevent dehydration, you should try to drink at least 12 eight-ounce glasses of noncaffeinated fluids per day (as caffeine can actually dehydrate you), Dr. Phelan says. Incorporate into your diet lots of fruits and vegetables, which contain substantial amounts of water. "Your urine should be light yellow, and you should need to go to the bathroom every four hours," she adds.
Edema (Fluid Retention)
While you might blame fluid retention on drinking too much water, that's not the cause. The real problem: Your body's ability to move fluids around isn't quite up to par during pregnancy. As a result, fluid is pulled down to areas below your heart, such as your legs and feet.
In most cases, fluid retention (aka edema) is more of a discomfort than something to worry about. But if you experience severe puffiness, alert your doctor so she can check you for preeclampsia, a potentially dangerous form of high blood pressure. To ease fluid retention, try "lying down with your feet elevated higher than your heart," Dr. Phelan advises. You might also try applying a cool compress to the area for 10 to 15 minutes to ease swelling.
Even if you're retaining water, keep drinking plenty of fluids and cut back on salty and starchy foods. "Eating lots of sweet or starchy things can raise your blood sugar, and that spike can pull more fluid into your bloodstream, making you more puffy," explains Wendy Wilcox, MD, MPH, an assistant professor of obstetrics and gynecology at the Montefiore Medical Center, in the Bronx, New York. The solution: eat more lean protein and vegetables, and cut back on breads, pastas, and sweets. One thing that's an absolute no-no: "Diuretics. They can decrease blood flow to the uterus and cause stress and growth retardation to the baby," says Randy Morris, MD, medical director of IVF1, in Chicago, a center devoted to the treatment of infertility, recurrent pregnancy loss, and women's reproductive problems.
Wearing support hose can help. However, it also adds to the heat. A less steamy option: immerse yourself in cool water up to your shoulders for 30 minutes, according to research at the Sacred Heart Medical Center in Eugene, Oregon. Experts believe that the force of the water may push extra fluids back into the blood vessels.
Your Body's Distress Signals
In some cases, your symptoms may signal a potentially dangerous heat illness. If the symptoms persist, seek prompt medical attention. Get into a cool environment and start filling up on fluids if you experience any of the following:
- Your skin becomes cool or pale
- You feel nauseated or start vomiting
- Your pulse rises
- You feel dizzy or weak
- You have a bad headache that doesn't improve with acetaminophen
- You have abdominal cramping that lasts for 15 minutes or more
- You have a fever of 102 degrees F. or higher
- You feel confused or disoriented
Originally published in the June 2008 issue of American Baby magazine.
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