Health Skin

Why Don’t We Take Pregnancy-Related Skin Problems More Seriously?

After giving birth to her two children, Samantha Terry has red stretch marks that now cover much of her midsection. They extend from her thighs to her belly button. They run up and down both sides of her hips and her waist. “It looks like I got scratched by a tiger,” the 30-year-old told HuffPost.

Some days, she’s not bothered by them — a very small price to pay for the two children she adores more than anything. Other times, she feels “gross” and embarrassed. And when she’s tried to bring it up to a few older women she knows, she has been immediately shut down, reminded of how lucky she is to be a mother, and how every woman who gives birth goes through it.

“It would just be nice to be able to talk about it a little bit more,” said Terry. “It makes you feel guilty for complaining.”

Bodies go through tremendous changes during pregnancy and after, including changes to their skin. Estimates suggest that up to 90% of expectant women get stretch marks. Up to 50% of women experience melasma, or the development of brown or blue-gray patches on their face, cheeks or arms. More than 50% develop acne — and there are more skin issues that arise, like varicose veins, hair loss, eczema flareups, and on and on.

Some of those changes are temporary; others are long-term or permanent. But all of them can become a source of emotional discomfort for moms like Terry. And too often, people who have been pregnant don’t feel like there is anything that can be done to help them or anyone they can talk to openly about what they’re feeling.

An Area Of Pregnancy And Postpartum That Just Isn’t Being Studied

Over the past decade, doctors have begun to understand the impact that certain skin conditions can have on people — not just physically, but emotionally. Studies have linked severe acne to suicidal ideation, for example, and there have been calls to develop a more integrated system of care between dermatologists and mental health professionals in order to understand the impact of stress and hormones on skin and the toll skin issues can take.

But for those who’ve given birth, the connection between skin and mental health is still often overlooked. Frank Wang, a clinical dermatologist with Michigan Medicine and one of the few researchers specifically studying stretch marks, told HuffPost that “there’s very little information about the emotional and psychological impact of stretch marks.”

He and his team recently released findings from a small survey of 100 newly postpartum women that found one-third of those who developed stretch marks had “a lot” or “moderate” embarrassment about them. That embarrassment prevented them from wearing certain clothes, engaging in some social activities, and harmed their sense of self-esteem.

Of course, many women aren’t particularly concerned by skin changes during pregnancy; some cherish them. But Wang believes it behooves researchers and clinicians who work with pregnant people to find ways to support those who do feel insecure, and to address their practical concerns as well as the feelings those concerns bring up.

“With everything in medicine, it’s always very individual. On the one hand, we’re living in this great age where we’re taught to embrace the things we have … and that’s positive in so many ways. But I do think there are individuals who are very distressed by their skin conditions,” he said. “A skin disorder is not necessarily life-threatening, but it can really impact the way people feel about themselves and their quality of life.”

How We Can Support People After Pregnancy

For Theresa, 31, stretch marks weren’t a significant source of stress during pregnancy or after, though she did have them. She was much more bothered by the severe acne that developed under her chest in pregnancy that eventually developed into cysts. Those cysts burst — quite painfully — while she was breastfeeding her daughter and are now permanent scars.

Theresa, who asked to use her first name only because she was speaking about something sensitive to her, spoke to her doctor at the time, but was offered no advice on how to manage her acne. And the only conversation she had with a loved one at the time did not go well. While she was pumping for her newborn in the NICU, a family member saw her cysts and questioned whether they made her breast milk unsafe.

“It really messed with me mentally and emotionally,” Theresa said of the whole experience, adding that her scars are still a source of insecurity, particularly during sex.

One challenge in better addressing these issues is that for some of the conditions that come up during pregnancy and after, there just isn’t much doctors can do to help. Wang is working to better understand what causes stretch marks and how to address them, but there aren’t really many evidence-based ways to prevent or treat them right now, he said — and many are expensive. The same holds true for issues like melasma, or even treating acne during pregnancy when many commonly used medications are unsafe.

But there certainly are ways to better support women emotionally.

“What ends up happening is even when a woman does come forward and say, ‘This is really bothering me, I feel insecure,’ they’re told, ‘Oh, but you have a happy, healthy baby.’ What that basically says is, ‘What you’re saying and feeling doesn’t matter. You should be focusing on these other things over here,’” Paige Bellenbaum, founding director of The Motherhood Center mental health clinic in New York City, told HuffPost. Women are told those issues are “unimportant” or “peripheral,” even though everywhere they look, they’re being told the opposite, she added.

Indeed, postpartum women are inundated with constant mixed messages about how they “should” look and feel. They see aspirational images of moms who immediately “bounced back,” along with marketing campaigns exploiting the body-positivity movement by urging them to embrace their bodily changes with serene and pure positivity. All the while, they’re told in ways explicit and not that they should focus on how grateful they are to be moms.

Instead, women should simply be given the space they need to talk about what they’re struggling with, Bellenbaum said.

“A different way to respond to somebody bringing attention to the way they’re experiencing their body during pregnancy or after is by making space for it and being curious,” Bellenbaum said. “Like, ‘tell me more about what that’s like’ … instead of telling somebody that they shouldn’t be feeling that way.”

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