Pregnancy's Effects on the Skin

In the 1984 article by Jeffrey P. Callen, MD, various skin changes associated with pregnancy were discussed. These changes are due to metabolic, endocrinologic, and physiologic alterations and include pigmentation changes, nail and hair growth variations, increased glandular activity leading to conditions like hyperhidrosis and acne, and increased vascularity causing spider angiomas and palmar erythema. Structural changes such as striae gravidarum can occur due to the expanding abdomen. Preexisting skin conditions may also be affected, with some worsening and others improving during pregnancy. Specific pregnancy-related dermatoses, such as pruritus gravidarum, herpes gestationis (not related to herpesvirus), PUPPP, and Spangler's papular dermatitis, were highlighted, with some posing potential risks to mother and fetus. Treatment is typically conservative, but severe cases of herpes gestationis may require systemic corticosteroids. The use of systemic medications is generally discouraged, especially tetracycline and DES, due to potential risks. The article underscores the need for physician expertise in managing these conditions.