For women who aim to have complexion perfection, it's quite a shock when hormones wreak havoc on skin during and after pregnancy. Here, skin specialists weigh in on the most effective and safe procedures, plus over-the-counter products for everything from acne to melasma.
Pregnant woman looking in mirror
Credit: Image Source/ Veer

I admit it. I'm vain. So the many unglamorous aspects of my first pregnancy threw me for a loop. I could deal with the burgeoning belly, the indescribable fatigue. I even made peace with the forced exchange of my chic hobo bag for a schlepper tote -- a preggo's must-have accessory to transport the loads of nausea-quelling carbs. But nothing prepared me for the hormonally induced atrocities that cropped up on my once-radiant complexion.

At five weeks, angry red welts appeared below my right eye and next to my mouth. At seven weeks, barely-there freckles darkened and expanded into what can only be described as septuagenarian-style liver spots. By the end of my first trimester, itchy, ugly, concealer-defying red patches began crisscrossing my forehead, chin, and chest. I was confused. Where was my pregnancy glow? After conferring with other fecund females, I was convinced that the glow -- that mommy-to-be incandescence portrayed in glossy magazines -- must be the result of serious airbrushing or a genetic blessing that had obviously passed me over.

Thanks to skyrocketing hormones, more than 50% of pregnant women develop a "pregnancy mask," the darkening of pigmentation around the mouth, cheeks, and forehead also known as melasma or hyperpigmentation, and many also develop acne. Exhaustion and water retention may lead to under-eye pouches, while increased blood flow can cause spider veins across the face of about two-thirds of pregnant women. Determined to acquire a soupcon of Heidi Klum's luminosity, I decided to investigate in-office medical treatments as well as over-the-counter products geared to common post-pregnancy skin conditions. Keep in mind that women should not have any cosmetic procedures done while pregnant or breastfeeding, says Leslie Baumann, M.D., a Miami dermatologist and author of The Skin Type Solution, and be sure to consult a dermatologist before pursuing any of the treatments listed here.


What it is: Elevated levels of estrogen and progesterone trigger melanocytes, causing dark spots to appear on the skin.

In-Office Treatments

Harold Lancer, M.D., the go-to derm for West Coast celebrity moms Denise Richards and Lisa Rinna, believes the key to minimizing melasma after childbirth is micropolishing the skin. "The type of micropolishing that I perform, the Lancer Glow ($1,500/ $2,500 with laser), is like removing tarnish from silver," says Dr. Lancer. "It polishes, buffs, and tones the skin on the face, neck, and chest with micro-fine crystals at a high speed to slough off the top layer of skin and promote high cell turnover." Like almost all cosmetic, noninvasive surgeries, this treatment is not covered by insurance.

Chicago-based dermatologist Charles Zugerman, M.D., tackles melasma with a postpartum series of Intense Pulsed Light (IPL) treatments ($2,400 for four treatments). Light energy, also known as photorejuvenation, delivers a series of gentle, noninvasive pulses to the skin. "IPL absorbs at the same wavelength as pigmentation," Dr. Zugerman says. "It's far gentler than laser and highly effective at treating skin conditions that arise with pregnancy." One week after IPL he performs microdermabrasion ($100), an exfoliating treatment, to remove dead skin.

Lisa Airan, M.D., the Manhattan-based skin guru known for her cutting edge approach to pregnancy-induced skin problems, advises new mothers who have finished breastfeeding to use TriLuma (about $99), a prescription-grade triple-action steroid cream containing the bleaching agent hydroquinone, a potent ingredient that decreases the formation of melanin and will reduce or eliminate dark patches within eight weeks.

Over-the-Counter Solutions

To prevent melasma, women should avoid the sun at all costs both while pregnant and after giving birth. "Exposure -- even driving in a car or sitting with an open shade on an airplane -- can darken existing freckles or stimulate hyperpigmentation," explains Dr. Airan. The sun's ultraviolet rays cause melanocytes to produce the pigment melanin, which can cause melasma to develop. Wiping with sunscreen pads is a simple and convenient way to protect against ultraviolet rays. One of the options available is MD Skincare Sunscreen Pads with Vitamin C SPF 30 ($30). They provide both UVA and UVB protection and are nourishing to sensitive skin.

For busy new moms who can't get to the dermatologist right after giving birth, there are gentle at-home scrubs and polishing kits designed to rejuvenate damaged skin. Skin Effects by Dr. Jeffrey Dover Micro-Dermabrasion Kit ($30), sold at drugstores, is an at-home treatment consisting of two steps. It uses exfoliating crystals to remove dead skin cells and a moisturizer that hydrates freshly resurfaced skin. Mass-market products with bleaching agents aim to reduce the appearance of dark areas, but moms must wait until they are done breastfeeding before using them. Olay Regenerist Targeted Tone Enhancer ($19) has an amino peptide complex combined with patented Pro-Retinol, a less irritating form of vitamin A, to boost cell turnover and work deep within the skin's surface to reduce the appearance of dark spots. Good Skin All Bright Moisturizing Sunscreen SPF 30 ($12) is a multitasking cream that prevents further discoloration with UVA and UVB protection while glucosamine, mulberry root, and yeast extracts work to accelerate the skin's natural exfoliation process, in effect buffing away the dark spots.

Nonspecific Dermatitis

What it is: Changes in hormones can induce red, flaky patches on the face.

In-Office Treatments

To combat dermatitis, Dr. Lancer favors a new treatment called TMT (Transcutaneous Mesodermic Transport) Oxygen Therapy ($300-$400 per session). "It uses an electrical current to transfer soothing vitamins, including A, C, and D, as well as elastin and collagen, through the skin's surface," he explains. "I then seal the skin with a mist of an oxygen and deionized water blend. The water needs to be deionized because it reduces the amount of electricity on the skin's surface, allowing more nutrients to transfer through." He recommends doing the treatment twice a week for five weeks and then once a week as needed.

Over-the-Counter Solutions

Dr. Lancer suggests ultra-soothing, anti-inflammatory products suited to sensitive skin. Fragrance-free, noncomedogenic (won't clog pores) cleansing lotions are the least irritating and most hydrating. Dr. Zugerman is a big fan of Cetaphil Gentle Skin Cleanser ($6). For either spot treatment or preventing flaky, raw areas, try an emollient-rich cream like Dermalogica Super Rich Repair ($75). It's packed with natural lipids like shea butter, evening primrose oil, and jojoba seed oil, all of which help to reinforce the skin's barrier layer.

"Products formulated to treat rosacea can also be effective at healing nonspecific dermatitis because they help to regulate excessive blood flow," says Dr. Lancer. For daily use, choose a moisturizer with sun protection to help reduce further damage. Eucerin Redness Relief Daily Perfecting Lotion ($15) not only includes an SPF of 15 but also has a sheer green tint to conceal red blotches, as well as licorice root extract to heal them. For more intense flare-ups, try an anti-inflammatory treatment like B. Kamins Chemist Booster Blue Rosacea Treatment ($67), a topical cream that visibly reduces redness almost immediately.

Spider Angiomas

What it is: Due to hormonal changes and possibly weight gain, pressure in the veins increases, causing blood vessels in the face to enlarge, leaving a red, spiderlike mark.

In-Office Treatments

It's possible for swollen vessels to improve three to six months after delivery, but for stubborn spider veins that stay put, Dr. Airan uses the Lyra Laser (about $750 per treatment). The 1,064-nanometer wavelength laser beam passes through skin to heat, coagulate, and zap targeted blood vessels, getting rid of them in seconds. Dr. Zugerman uses IPL after childbirth for smaller blood vessels ($600 per treatment), and for larger ones, he uses a 532- or 940-diode laser ($200 and up per treatment).

Over-the-Counter Solutions

There are no topical creams to eliminate spider veins on the face, so the best bet is a fabulous, full-coverage concealer. A favorite among makeup artists: Giorgio Armani Skin Retouch ($32). The solid cream camouflages even the darkest imperfections and comes in seven shades. Biotherm Forget It ($14) is another classic in this category because it's an easy-to-apply liquid cream that instantly masks unwanted marks. It also contains glycerin and vitamin E to smooth and nourish skin, resulting in better coverage. Applying concealers with a brush results in a more even, natural-looking finish, as well.


What it is: Elevated progesterone levels produced by the body to maintain a healthy uterine lining during pregnancy can cause increased secretion from oil glands, sebum buildup, and clogged pores.

In-Office Treatments

An aesthetician renowned for treating acne and irritated skin with her line of plant-based products, Sonya Dakar is considered Hollywood's "Fairy Skin Mother" by A-list mamas like Gwyneth Paltrow, Debra Messing, and Marcia Gay Harden. "To treat the common skin problems of pregnancy -- like acne and hypersensitivity -- women must use calming products with plant-based ingredients such as chamomile and lavender," Dakar says. She also offers a pore-clearing facial called the Triple Peel, which involves three separate exfoliating treatments: a pumpkin-based enzyme peel to slough off dead cells, a customized green tea peel to break up bacteria and brighten the skin, and a diamond peel, which is a resurfacing treatment ($555).

Over-the-Counter Solutions

Mild facial cleansers are an effective tool for treating acne in women who have sensitive skin or are still breastfeeding. Therapy Systems Balancing Gel Cleanser ($28.50) is a formula that safely balances the skin's natural oils while deep-cleaning pores. Look for products that include sulfur, a natural ingredient that has antibacterial and anti-inflammatory qualities to promote healing. The sulfur, aloe vera, and eucalyptus oil in the DDF Sulfur Therapeutic Mask ($28) work synergistically to purify the skin.

Once moms are done nursing, they can use more potent ingredients like salicylic acid and benzoyl peroxide to fight acne. At-home peels and topical ointments can take care of stubborn pimples and remaining scars. Crabtree & Evelyn's new skincare line includes a Blemish Control Acne Treatment Gel ($22) that not only heals breakouts but prevents new ones from popping up. It packs a punch with its 2% salicylic acid content and also contains soothing green tea, echinacea, and willowherb to calm the skin naturally. To accelerate healing of acne flare-ups and erase scars, try an at-home peel like L'OrZal Acne Response Intensive Adult Acne Peel kit ($25). This three-step peel uses salicylic acid to penetrate clogged pores and to extract impurities.

Dark, Puffy Eyes

What it is: Exhaustion and poor circulation can lead to dark circles and bags under the eyes.

Over-The-Counter Solutions

Using an eye cream or serum with nourishing ingredients like peptides and aloe vera will help hydrate the eye area and reduce swelling. Many dermatologists recommend Kinerase Under Eye Rescue ($75), which has kinetin, aloe vera, and eyeseryl tetrapeptide to reduce puffiness and the appearance of fine lines. If dark under-eye circles are the problem, try a brightening cream. Dove Energy Glow Brightening Eye Cream with SPF 8 ($11) is a vitamin-rich moisturizer that works to renew dull surface skin. Results may not be immediate after applying eye creams, so follow with a concealer designed specifically for this problem area. Clinique All About Eyes Concealer ($15.50) is a lightweight emollient cream that has color-correcting properties to counteract darkness, along with a special peptide complex that lessens a puffy, irritated appearance.

Postnatal Nirvana

Now, having just given birth to my second child, I have achieved something resembling postnatal nirvana. I have avoided acne with a lavender cleanser. Layers of SPF have minimized melasma. And I rectify routine bouts of dermatitis with doses of emollient-rich creams. Under-eye bags? Juggling work and family has somehow counteracted the benefits of aloe vera and peptides. But I haven't given up. My reunion with radiance has already been scheduled with a series of IPL treatments. Heidi Klum, you've been an inspiration!

Amy Tara Koch is a style columnist for the Chicago Tribune and writes for Self and Travel + Leisure. She lives in Chicago with her family.

Reprinted with permission from Child magazine.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.