Perceptions and management of pregnancy-related skin changes
Today’s report also covers research into the prevalence of sexual dysfunction in women with skin diseases, striae distensae in Black and White women, and more (1, 590 words, 7.5 minutes)
Good morning, and welcome to the Women in Dermatology newsletter from Chronicle Companies. We’re pleased to have you join us. This biweekly bulletin will update you on new findings regarding dermatologic issues that affect women and the female dermatologists who care for them. We welcome your feedback and opinions, so let us know if you have any comments, observations, or suggestions. You can email them to us at health@chronicle.org
According to research in the Journal of Cosmetic Dermatology (Apr. 2024; 24(S4):e70132), pregnancy can cause skin changes such as hyperpigmentation, melasma, stretch marks, and vascular changes. These changes may drive women to look for ways of restoring their skin's appearance. The study analyzed the perceptions and satisfaction of pregnant and postpartum women regarding skin changes and the use of skincare products. The researchers found that most women experienced skin changes during pregnancy, relied on social media for skincare advice, had moderate knowledge of products, and often used them despite dissatisfaction and side effects.
The researchers conducted a cross-sectional survey between May and July 2024 in Jordan. The final sample included 388 women who had experienced at least one pregnancy, with participants recruited through an online, self-administered questionnaire. The survey included questions about socio-demographic characteristics, skin-related complaints before and during/after pregnancy, skincare routines, and attitudes toward skincare products.
The findings revealed that 91.12% of participants reported skin-related complaints during or after pregnancy, with all of them experiencing hyperpigmentation. Other conditions, such as cellulite, hair loss, and wrinkles, also increased during this period. However, acne and eczema showed a decline postpartum. Despite widespread complaints of hyperpigmentation, only 4% of the participants used depigmentation products. Additionally, 41% of women relied on basic skincare routines involving cleansers and moisturizers, while only 17% used sunblock.
The results also showed that social media was the participants’ primary source of information regarding skincare products, followed by personal experience. Only 34% consulted dermatologists for skin concerns, while others relied on friends, relatives, or personal judgment. Retail pharmacies were the most common point of purchase for skincare products, with 42% of participants using them regularly. Knowledge levels about skincare varied, with 40% reporting medium levels of knowledge and 39% believing that the products effectively reduced symptoms. Satisfaction with results led some women to recommend skincare products to others after delivery or lactation.
Despite positive perceptions about product efficacy, 43% of the participants experienced side effects such as skin redness after using skincare products. Alarmingly, only 21% sought professional advice from dermatologists to manage these side effects, while 29% either ignored them or took no action. The authors note that unrealistic expectations fueled by advertising may have contributed to dissatisfaction among some women. They emphasize the need for healthcare providers to educate pregnant women about skin changes during pregnancy and guide them toward safe and effective interventions.
The Takeaway: The study found that most women experience skin changes during or after pregnancy, with hyperpigmentation being the most common. Social media is a main source of skincare advice, with few participants consulting dermatologists for skin concerns. A low percentage of women in the study sought professional help for skincare side effects, highlighting the importance of healthcare providers regarding education of women about safe and effective skincare practices during pregnancy.
Indigenous Skin Spectrum Global Summit this Saturday (04/05/25)
There is still time to register for the first Indigenous Skin Spectrum Global Summit, which will be held in Montreal on April 5, 2025.
The 2025 Indigenous Skin Spectrum Global Summit is dedicated to improving the cultural competence of healthcare providers worldwide. Our world-renowned faculty will provide practical and up-to-date clinical information on the latest and best research in the context of Indigenous, circumpolar, and rural communities.
In the video below, Summit chair Dr. Rachel Asiniwasis (Regina) invites physicians worldwide to learn more about the unique dermatologic challenges facing Indigenous, rural, and circumpolar populations worldwide.
Whether attending in person or virtually, delegates will hear experts worldwide provide insights on how physicians can support equitable health for these populations.
Don’t miss an informative talk by Dr. Archana Kakadekar, an anatomical pathologist specializing in dermatopathology and breast pathology, exploring the latest research on dermatopathology in skin of colour. Dr. Kakadekar is based in Saskatoon.
More details on the Global Summit are at this link.
From the literature on women in dermatology
Differences in clinical features and risk factors for striae distensae in Black and White women
A study in the Archives of Dermatological Research examined differences in the clinical features, risk factors, and comorbidities of striae distensae among Black and White women. The researchers found that Black women, on average, had a significantly higher number of striae than White women and were more likely to have lesions on the lower legs, armpits, and buttocks.
The authors evaluated and photographed 143 female patients for this single-centre, two-part prospective study. The number, location, morphology, and type of striae were assessed during the clinical evaluation. The results showed that striae appeared white or skin-coloured in Black women and white or violaceous in White women. The findings also showed a near-significant association between urinary incontinence and striae in White women, and smoking was significantly associated with striae distensae only in White women. Additionally, Black women were more likely to use creams to reduce striae appearance.
Dermoscopy for monitoring therapeutic response to hybrid cooperative complexes of hyaluronic acid in women with VLS and atrophy
A study published in Frontiers in Medicine evaluated the efficacy of hybrid cooperative complexes of low-high-molecular-weight hyaluronic acid for treating vulvar atrophy and lichen sclerosus (VLS). The researchers found that these complexes can significantly improve the quality of life, sexual function, dermatoscopic features, and symptom severity in women with VLS.
The study included 15 female patients who received two hybrid cooperative complex injections, one month apart. The authors assessed patients at baseline, one month, three months, and six months post-treatment using video-dermatoscopy, ultrasound, the Dermatology Life Quality Index, and the Female Sexual Function Index. The results showed significant improvements in quality of life and sexual function, as well as skin thickness, homogeneity, and smoothness. Furthermore, symptoms such as pain, itching, and burning were significantly reduced. Dermatoscopic features, including scales, vascularization, and purpuric lesions, were notably diminished within six months.
Global prevalence of sexual dysfunction in women with skin diseases
A systematic review and meta-analysis published in BMC Women’s Health investigated the global prevalence of Female Sexual Dysfunction (FSD) in women with dermatologic disorders. The researchers found there is a high prevalence of FSD in women with skin diseases. Specifically, the global prevalence of FSD among women with skin diseases is 61.3%.
The authors analyzed 24 studies from 2007 to 2023, covering conditions such as psoriasis, vitiligo, and hidradenitis suppurativa. Subgroup analyses revealed that African women had the highest prevalence of FSD among women with skin diseases. The prevalence rate for FSD in psoriasis was 59.2%, for vitiligo the rate was 69.8%, and for hidradenitis suppurativa the rate was 56.5%. FSD was linked to significant psychological and social impacts, emphasizing the need for early diagnosis and targeted interventions.
A systematic review in Clinics and Practice analyzed the effects of pregnancy on dermatologic conditions, focusing on disease incidence, severity, maternal-fetal outcomes, and treatment strategies. The researchers found that pregnancy significantly affects dermatologic health, with some conditions, such as intrahepatic cholestasis and pemphigoid gestationis, increasing fetal risks, while others, including atopic and polymorphic eruptions, have minimal impact.
The authors reviewed relevant PubMed, MEDLINE, and Web of Science studies and included 8,490 cases in the final review. The findings categorized conditions into physiological changes, pregnancy-related exacerbations of pre-existing skin disorders, and pregnancy-specific dermatoses. The results showed that dermatologic issues are common during pregnancy and that some conditions are linked to adverse fetal outcomes, such as fetal distress, while others have minimal impact. Additionally, treatment efficacy varied, with corticosteroids, antihistamines, and ursodeoxycholic acid commonly used and showing inconsistent results. The authors emphasized the need for early diagnosis and individualized care to optimize outcomes.
Kalamazoo, Mich.-based radiologist Dr. Biren A. Shah speaks with dermatologist Dr. Diana Westgate about her specialty, and Dr. Westgate shares her perspective on dermatology education and residency.
A case of generalized pustular psoriasis during pregnancy
A case report in the Journal of Dermatological Treatment described a 35-year-old pregnant woman who developed generalized pustular psoriasis (GPP) at 12 weeks of gestation, experiencing erythematous papules, pustules, severe pain, joint stiffness, and high fever. She was initially treated with spesolimab, which provided temporary relief but led to an adverse reaction after a second dose. High-dose corticosteroids were attempted but proved ineffective, prompting a switch to secukinumab, an anti-IL-17A biologic, which resulted in significant clinical improvement. The patient’s symptoms resolved after 12 weeks of secukinumab treatment, allowing for the safe discontinuation of corticosteroids without rebound effects. She later delivered a healthy baby at 39 weeks, with no complications reported for either mother or child.
“Vitiligo is not cosmetic in any sense of the word. When vitiligo is mislabelled as cosmetic, it undermines the significant impact the condition can have on a person’s overall health and mental wellbeing.”
— Dr. Nada Elbuluk, a Los Angeles-based dermatologist in an interview with She Knows.
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