Dermabrasion 101

Dermabrasion is one of three commonly used office-based surgical skin resurfacing and rejuvenation procedures. The technique takes its origin from ancient Egypt in 1500 B.C. where healers used a form of sandpaper to even out scars. Today the technique has seen over 3500 years of evolution.

Dermabrasion mechanically removes the most superficial layers of the skin and allows your skins normal healing properties to rejuvenate the skin itself. It is designed to reduce or remove moderate wrinkles, fine lines, skin blemishes, and uneven skin surfaces. In addition to wrinkle treatment, the technique has been used to treat acne scars, hide or camouflage surgical or traumatic scars and in select cases to remove precancerous lesions.

Microdermabrasion is not the same treatment as dermabrasion and will not be discussed further than this paragraph. Microdermabrasion is a much more superficial and thus a less dramatic rejuvenation procedure with little to no recovery period. Being a more mild procedure than dermabrasion, multiple treatments of micordermabrasion are often required and may never achieve the same degree of rejuvenation as traditional dermabrasion. Microdermabrasion uses a device that sprays a fine beam of aluminum oxide microcrystals to superficially peel the skin surface while simultaneously removing the tissue debris. As microdermabrasion is not as invasive a procedure, non-medical personnel offer this treatment through many spas and clinics.

Skin rejuvenation can also be performed with lasers or chemical peels. These modalities will not be discussed in this article.

CAUTIONS
Patients with darker skin complexions (Fitzpatrick skin types III to VI) may experience permanent skin discoloration or blotchiness with dermabrasion procedures. Patients of African, Asian and Hispanic descent should specifically be cautioned about skin discoloration.

PRE-TREATMENT CARE

Patients with a history of oral herpes infections should be placed on oral acyclovir prior to this treatment to avoid a herpes flare or extension of the condition following dermabrasion.
THE PROCEDURE
Dermabrasion is performed in an out-patient (often office) setting under local anesthesia. Full-face dermabrasion is performed under conscious sedation or general anesthesia, often with the assistance of an anesthetist. A small motorized hand piece rotates a wire brush or diamond fraise at speeds of 15,000 to 30,000 rpm. Skilled manipulation of the rotating brush or fraise removes the upper layers of skin in the areas requiring treatment. This results in a raw, open, partial thickness (through skin) wound that heals by epithelialization of the surface of the skin in a relatively short period of time. Initially the small pinpoint bleeding of the raw wound may be alarming but will subside rapidly with appropriate wound care.

THE RECOVERY
The recovery following dermabrasion skin resurfacing is approximately 2-3 weeks. Early post-operative pain is controlled with prescription medications for the first few days. Most patients require only over-the-counter medications or are comfortable without pain medication within days of the procedure. The skin may weep for the first 10-12 days but eventually stops as the surface layers of the skin are restored. Redness of the treated area is a normal part of recovery and disappears within 3-4 weeks of the procedure. Complete sun avoidance on the treated area must be observed until the redness in the skin has disappeared. Remember good sun protection should still be observed well after the healing period, as it was likely the sun damage to your skin that has driven you to seek this form of treatment in the first place.

Make-up can be used to cover the early skin discoloration once the skin has healed. Please ask your physician or surgeon for directions on when make-up can be used safely.
COMPLICATIONS

A discussion of potential complications is essential with every discussion about a surgical procedure. It is important to know that although complications from surgery are possible they are not common. Some possible complications associated with a dermabrasion are listed into both early and late complications:

EARLY
* Excessive surface bleeding
* Redness (fades with time)
* Infection (viral)
* Skin sensitivity

LATE
* Hyperpigmentation
* Hypopigmentation
* Milia
* Asymmetry (between sides)
* Residual wrinkles
* Scarring

For a more detailed discussion on expected results, recovery, and specific complications, please see your individual surgeon.

COST
Dermabrasion procedures are not covered under most insurance plans and the final cost for such procedures will be at the discretion of the plastic surgeon performing the procedure. Most surgeons quote costs based on the number of aesthetic areas being treated. The average cost of this procedure, is $1000 and higher.

DISCLAIMER
This website does not cover all of the medical knowledge related to dermabrasion nor does it deal with all possible risks and complications of skin resurfacing procedures. Although it is designed to provide the patient with greater depth of information in some areas, it is not intended to substitute for the in depth discussion between patient and surgeon that must occur prior to any surgical or treatment procedure. For a more detailed discussion on expected results, recovery, and specific complications, please see your plastic surgeon or dermatologist.

Author: Dr. Bryce J Cowan BSc MSc MD PhD FRCS(C)
Plastic, Reconstructive, Mohs & Aesthetic Surgeon

Dry Skin Tips and Facts

Dry Skin?
Dry skin is a problem not just in the winter with its cold temperatures, and howling winds, but dry skin can come from using harsh cleansers, having too hot a bath or even getting on an airplane. Here are a few tips to help you minimize that annoying, itchy dry skin: If you want more skin care tips, visit www.DermatologyCare.ca .

Form a Barrier:
Moisturizers are designed to reduce water loss from the epidermis (the outermost layer of the skin). In addition to preventing further dryness, they provide a barrier against soot and dirt, make your pores seem smaller and offer a temporary feeling of smoothness.
Say “No” to Hot Baths

Don’t take long, hot baths because this can exacerbate dry skin in the winter months. Instead try short, lukewarm baths or showers. When you get out of the shower, gently pat dry your skin and then moisturize right away.
Moisturize! Moisturize!

A moisturizer is essential - A moisturizer performs several important functions. It replaces lost water and water-binding ingredients (such as glycerin) help keep it in the skin. Find products like Olay® Ribbons, that cleanse and moisturize, saving you one extra step.
Your Skin Wants Water!

Drink lots of water - Increase your body’s natural moisture level by staying hydrated throughout the day.
Dry lips?

Licking them won’t bring relief - it will only make them more dry and chapped. To keep your lips soft and smooth, apply a moisturizing lip salve, especially before bed.
Careful How You Cleanse

With the cold, harsh, dry winter, using mild cleansers on the skin will help prevent against dry, itchy skin.

To Shower or Bathe?
Do you have dry skin? Try showering or bathing every other day instead of daily. This will help your skin maintain the oils that are so essential to great-feeling skin.

“Airplane” Skin
Does your skin and hair feel tight or dry when you get off of an airplane? The humidity on a plane can reach as low as 1% humidity on long flights and it can take just a 3 hour flight to sap all the moisture from your skin and hair. So stay hydrated during and after your flight, limit your intake of coffee and alcohol - they just make things worse, carry your moisturizer in your hand luggage to slather on mid flight and before you deplane, splash your face with water and follow by your moisturizer.

Seal In The Moisture
Want skin that is soft and smooth? When drying off after a bath or shower, apply lotion or body oil while you’re skin is still damp. This will help seal in moisture and leave your skin feeling great.

Can It Be Contact Dermatitis?
Has your skin suddenly become red, itchy or inflamed? Maybe a red rash? You may be experiencing contact dermatitis. Remember that moisturizers can play an important preventative role by increasing the skin’s hydration levels and maintaining and repairing the skin barrier.. Inflamed skin is warmer so more water evaporation takes place therefore more moisturizing is needed.

Soothe Your Skin
Dry or sensitive skin, eczema and other factors can result in itchy skin. A traditional way to sooth the itch is to add oatmeal to your bathwater.

Adult Acne SkinCare

Suffering from adult acne can be a devastating blow to your self-esteem. You may wonder what your co-workers, friends, and even family are thinking about you. You may stay home alone on Friday nights, afraid to go out and meet that special someone. You may worry your employer just gave that big promotion to your colleague instead of you due to the look of your bad skin.

The good news is you live in a time with more treatment options than ever and there is no reason for you to suffer. Many great adult acne treatments are on the market today. Many are affordable and easy to get .Treatments that will not irritate your skin, but will provide results abound. Below are a few tips to make finding them easier.

Look for the Guarantee

The majority of respectable skin care manufacturers provide a decent guarantee on their products. Simply because these companies know that their products cannot solve every person’s acne problems (even though they put their best foot forward to do so). Any reputable company should stand behind their skin care cream, gel or remedy with a money back guarantee if you don’t get the results you expect.

I’d suggest you avoid anything that doesn’t have at least a 30 day guarantee (the minimum time to see if a product works). You should be able to find information about a products guarantee on the side of the packaging, or on the company’s website.

Check Ingredients for Harsh Chemicals

Before choosing an acne product, familiarize yourself with the ingredients. Not all companies - but some - use harsh chemicals to kill acne bacteria. The down side to this is these chemicals can also negatively affect your skin.

The most popular ingredient to remedy acne is Benzoyl peroxide, yet this is also one of the ingredients that can irritate your skin. If you do use a product containing Benzoyl peroxide, start with a very small dose and work your way up to the suggested amount.

If you want to avoid Benzoyl peroxide all together consider using straight Hydrogen peroxide from your bathroom cabinet (the same thing we use on cuts and scape’s). This product should be easier on your skin as well as affordable.

Use it long enough to see results

There are hundreds of various adult skin care products for acne on the market today. Most of these products require at least a month of steady usage to get results. Be sure that you are giving whatever product you choose at least 4-6 weeks before you discontinue use. If you stop using a product sooner than this then you could risk wasting time and money on a product that otherwise would’ve cleared your skin.

Oil Production in your Skin

The skin has many oil (sebaceous) glands, which secrete oil that contains wax esters, triglycerides, and squalene - a hydrocarbon that is an intermediate in the formation of cholesterol. These fats (or lipids) form a film that helps keep moisture in the skin. While increased sebum production results in oily skin, the opposite is not always the case, as dry skin can also arise from an impaired skin barrier. Oil production can be affected by diet, stress, and hormones-as well as genetics. In a study of twenty pairs each of identical and nonidentical same-sex twins, identical twins had virtually identical amounts of oil production, while the nonidentical twins had significantly different amounts.

No amount of blotting and scrubbing will “remove” the skin’s oil production, and many of us unknowingly destroy the natural beauty of the skin in pursuit of clarity. The skin’s own sebum mechanism is there to regulate own moisture. Drying your skin profusely with oil-stripping, foaming cleansers, detergents and de-greasers like soap and sulfates, or alcohol-based toners that leave the skin feeling tight (always a sign it’s been stripped), will only cause the skin to “rebound” with excess oiliness and destroy its protective and anti-bacterial “matrix,” leaving it sensitized. By stripping the natural acid mantle of the skin, these deep cleaning products actually make skin more vulnerable to bacteria and inflammation. Dabbing benzoyl peroxide often destroys the beauty of the skin by causing flaking, while more aggressive treatments, such as antibiotics or Accutane can cause a cascade of side-effects.

Maintaining a Healthy Skin Barrier

The skin serves numerous functions - detoxifying, protecting, regulating - but the primary protective or barrier function is the most obvious. The top layer of skin cells has the most important function in maintaining the effectiveness of the barrier. Here the individual cells overlie each other and are tightly packed, preventing bacteria from entering and maintaining the water-holding properties of the skin.
Fatty substances (lipids) are secreted by the cells during the course of their journey from the base layer of the skin to the top. These lipid molecules join up and form a tough connecting network, in effect acting as the mortar between the bricks of a wall.

The cell wall barriers are simply layers of fats that surround the watery contents. Therefore, the communication mechanisms must operate through these fatty cell walls. In fact, many of the substances that are involved in this communication process are various fats since it is easiest for fats to move within the fatty layers that comprise the cell walls. Despite its bad reputation, proper fats and cellular fats are of major importance in our body’s biochemistry and physiology.

Damage to the skin barrier can result from a combination of genetic predisposion and exposure to sensitizing chemicals and other substances. That is why avoiding irritants is as important as using products that help. In skin care, the most common irritants are usually perfumes and preservatives.

Fatty substances control the majority of our body’s physiology through receptors that activate many important genes. Likewise, our skin barrier is comprised of a supporting structure of collagen, a protein that contains fats that serve a critical function. These fats prevent the excess loss of water through our skin and prevent the cells of our body from becoming dehydrated and dying.

A major sign of a defective skin is the dryness that results from excessive water loss. This water can not be applied topically but must be ingested. To prevent the excessive water loss and the resulting dry skin, we must repair the skin barrier. We find that the skin composition in individuals with dry skin is due to an improper mixture of the skin fats. This is commonly due to a deficiency in our diet of the correct fats, those contained in natural olive oils, avocados, and healthy nuts, etc. On a nutritional basis, we can provide these necessary fats through the skin sometimes through topical treatments containing natural butters or oils, like Shea, olive and cocoa butter. The epidermis is not a usual means to acquire nutrition but it can absorb enough fatty substances to correct the fat imbalances that are the cause of the defect in the skin’s barrier function and thus correct the dry, itchy skin or sensitive skin problem. Try to be aware of chemical preservatives in any topical products you do use.

Although many products today are labeled “fragrance free,” that is really a misnomer. Nearly all products contain some fragrance to mask their chemical odor; so-called fragrance-free products may just contain fewer chemicals than others. What’s more, the fragrances used in many products (even pricey perfumes) are commonly synthetic. For sensitive individuals, this chemical brew can be a problem To make matters worse, many natural fragrances are now extracted using harsh solvents rather than old-fashioned distillation methods, in which fewer chemicals come into contact with the essential oil of the flower. Unless you can determine the extraction method used, be cautious. This is one reason many individuals react negatively to the essential oils used in aromatherapy massages and related products – many are of a synthetic, chemical composition.

According to several studies, various preservatives including formaldehyde, parabens, and others commonly used in skin, hair, and beauty products can also provoke allergic reactions. Although the preservatives are needed to maintain product shelf life and only minute amounts are present in any given product, many products contain these same chemicals, including skin care products, makeup, medications, antiperspirants, toothpaste, and foods. Many of these products are used on a daily basis, causing a higher reaction rate. As a result, the overall exposure to these harmful ingredients is higher than would occur if only a single product were used. Studies show that massage therapists have more contact dermatitis – or skin inflammation - due to exposure to these extracts.

Until recently, few studies investigated the cumulative impact of repeated exposures to preservatives in a variety of products and ingredients. For the majority of people, these product preservatives are an additional benefit, not a problem. But, as the chemical compositions increase, so do the allergic reactions.
If you suffer from sensitive, allergic skin or severe dry skin, you may be among those who will have a problem or reaction to these chemical-laden products. In this case, it is your role as an informed consumer to carefully read labels for all products that come into contact with your skin - internally or externally- to assure that they don’t contain the listed ingredients that you must avoid. Your skin barrier does a lot to protect you naturally, help it out when you can and feed it nourishing chemical-free products whenever you can.

Acne Medications

Tretinoin (Retin-A) is available only with a physician’s prescription. It comes in liquid, cream, and gel forms, which are applied to the skin. Isotretinoin (Accutane), which is taken by mouth in capsule form, is available only with a physician’s prescription. Only physicians experienced in diagnosing and treating severe acne, such as dermatologists, should prescribe isotretinoin.
Recommended Dosages

The recommended dosage depends on the type of antiacne drug. These drugs usually come with written directions for patients and should be used only as directed by the prescribing physician. Teens who have questions about how to use the medicine should check with their physician or pharmacist.

Patients who use isotretinoin usually take the medicine for a few months, then stop for at least two months. Their acne may continue to improve even after they stop taking the medicine. If the condition is still severe after several months of treatment and a two-month break, the physician may prescribe a second course of treatment.
Precautions

Isotretinoin Cautions

Isotretinoin can cause serious birth defects, including mental retardation and physical deformities. This medicine should not be used during pregnancy. Females who are able to bear children should not use isotretinoin unless they have very severe acne that has not cleared up with the use of other antiacne drugs. In that case, a woman who uses this drug must have a pregnancy test two weeks before beginning treatment and each month she is taking the drug. Another pregnancy test must be done one month after treatment ends. The woman must use an effective birth control method for one month before treatment begins and must continue using it throughout treatment and for one month after treatment ends.

Females who are able to bear children and who want to use this medicine should discuss this information with their healthcare providers. Before using the medicine, they will be asked to sign a consent form stating that they understand the danger of taking isotretinoin during pregnancy and that they agree to use effective birth control.
People using this drug should not donate blood to a blood bank while taking isotretinoin or for 30 days after treatment with the drug ends. This will help reduce the chance of a pregnant woman receiving blood containing isotretinoin, which could cause birth defects.
Isotretinoin may cause a sudden decrease in night vision. If this happens, users should not drive or do anything else that could be dangerous until vision returns to normal. They should also let the physician know about the problem.

This medicine may also make the eyes, nose, and mouth dry. Ask the physician about using special eye drops to relieve eye dryness. To temporarily relieve the dry mouth, chew sugarless gum, suck on sugarless candy or ice chips, or use saliva substitutes, which come in liquid and tablet forms and are available without a prescription. If the problem continues for more than two weeks, check with a physician or dentist. Mouth dryness that continues over a long time may contribute to tooth decay and other dental problems.
Isotretinoin may increase sensitivity to sunlight. Patients being treated with this medicine should avoid exposure to the sun and should not use tanning beds, tanning booths, or sunlamps until they know how the drug affects them.

In the early stages of treatment with isotretinoin, some people’s acne seems to get worse before it starts getting better. If the condition becomes much worse or if the skin is very irritated, they should check with the physician who prescribed the medicine.

Retinoids for Dry Skin and Wrinkles

Dry skin recommendations and supplements that can help your skin

RETINOIDS

The group of medicines known as retinoids are derived from Vitamin A. Creams containing the retinoids retinol and retinaldehyde can be obtained over the counter at pharmacies and supermarkets. Other topical retinoids containing tretinoin or isotretinoin require a doctor’s prescription. Adapalene is a related prescription medicine.  Topical retinoids can be applied to any area but are most often used on the face, the neck and the back of hands.

When you first start using the retinoid, apply your night cream first then re-apply the retinoid. Do this every third night for two weeks. Then apply moisturizer followed by retinoid every other night.
If no redness occurs after two weeks you can adjust your regimen and apply the retinoid after cleansing but before your night cream. Then apply the night cream after the retinoid. Do this, using the retinoid every other day, for one week.

If you experience redness or flaking, begin using the retinoid every night. In about twenty-four weeks you will notices fewer wrinkles and smoother skin as well as preventing future wrinkles.
Since retinoids speed up the rare at which skin cells divide, some flaking is normal. This flaking is not additional dryness, but rather dead skin cells sloughing off. You can use a facial scrub once or twice a week before an important event to remove these fakes, allowing your skin to look radiant. Stronger products are more irritating than those with a lower percentage of retinoids, so you can switch products depending on your needs.

AYURVEDA AND SKIN CARE

An occasional attack of dry skin, rash or pimples – although frustrating - is a normal part of the flux of life. As the temperatures change, so does our skin’s constitution. As hormone levels rise and fall in the course of a month and as our diet and activity vary from day to day, the subtle balance of the body chemistry naturally shifts as well, creating shifts in our mood and even changes in our physical appearance.

Ayurveda recognizes these subtle imbalances and gives us the tools to correct them before they are out of control or turn into a full-blown disease. To be sure, imbalance does not necessarily mean disease, we can be quite healthy and still experience symptoms of imbalance. However, perpetual imbalance can lead to disease if it is not corrected in its early stages.

Ayurveda supports the belief that skin and health problems are affected or caused by our behavior. “Undigested” emotions, tension, and stress, can create hormonal imbalance and weaken the immune system. We now know common stressors are leading factors of body toxins and of skin disease. For example, psoriasis is exacerbated by worry and anxiety; acne/ rosacea, by anger and frustration; eczema, by a variety of stresses, depending upon the person’s constitution; and cystic acne, by depression, “holding on” to upsets, and emotional attachments in general. Other significant factors in skin disorders include the overconsumption of refined, canned, and processed foods like sugar, sweets, chocolate, fatty and fried foods, salt, seafood, and red meat. Consuming too many processed foods can result in digestive disorders and poor elimination (constipation). Lack of exercise and rest; and improper external cleansing and skin care will further create skin and health problems.

Of course, we all seek external remedies for the most common skin problems as soon as they develop. But please be aware, even a topical ointment or detoxification treatment is only a temporary remedy. If you continue with unhealthy lifestyle choices, new toxins will soon appear.

One of Ayurveda’s fundamental concepts is that health and disease are holistic-that is, whatever happens in one part of the body happens to the whole body. There are no isolated health problems. Any physical or psychological symptom of imbalance indicates an imbalance in the body-mind unit. Keep this holistic picture in mind as you look to remedy common skin problems with ointments and expensive treatments and try to treat the whole person you are – your emotions, your diet, your lifestyle choices – not just your face.

Are Chemical Peels for You?

With so many beauty products, facial treatments and surgical procedures available these days, it can be overwhelming to choose a treatment that is right for you. First off, when trying any new skincare treatment or procedure, it is always important to do your research, seek out reputable sources and never be afraid to ask questions, after all, it is your face – you only have one, so treat it accordingly. Selecting the right specialist or understanding details of a surgical procedure will be time consuming, be prepared to put in the time necessary to make the best choice. Below are some tips to help you get started.

Choose carefully. The Consumer Guide to Plastic Surgery recommends you:
•    Check educational, training, background credentials and experience to ensure that he or she is well-qualified
•    Ask how many times they have performed this procedure
•    Ask to see before and after photos of patients who have had chemical peels - in some cases offices will give you contact information of previous patients as referrals.

Dermatologists, plastic surgeons, licensed estheticians and registered nurses can all perform chemical peels. However, depending on the type of peel, you might need to see a doctor. Ensure your procedure is both safe and effective.

Schedule a skin consultation. A chemical peel is an aggressive treatment, it’s important that you get an in-depth analysis of your skin beforehand. When at the consultation, make sure the specialist knows your medical history and any prescriptions you may be taking. Be prepared to ask questions, such as what is my skin type? What are my skin concerns? How can chemical peels improve my skin? What kind of peel is best for my skin type?

Become a peel expert. There are three types of chemical peels: superficial, medium and deep. In addition, they increase substantially in cost depending on the peel. The cost ranges from $150 to $300 for superficial peels; $1,000 to $2,000 for medium peels and $2,500 up to $5,000 for deep peels, according to Smart SkinCare:
Superficial: The mildest of chemical peels, superficial peels treat fine lines, discoloration, dryness, roughness and mild acne. Results are subtle and you will need regular maintenance sessions. Estheticians typically perform superficial peels. Common solutions: Alpha hydroxy acids or AHAs (e.g., glycolic acid, lactic acid), salicylic acid

Medium: These peels penetrate deeper into the skin, producing a second-degree burn. Medium peels treat wrinkles, pigmentation problems, sun damage and blemishes. You will need at least a week to recover. You’ll also need several peels to achieve desired results. Common solution: Trichloroacetic acid (TCA)
Deep: These peels target deep wrinkles, dramatic discoloration and skin lesions. Deep peels are the most effective, providing pronounced and long-lasting results. However, they are also riskier with longer recovery time—most people take two weeks off from work. A certified, experienced plastic surgeon must perform these peels. This peel is performed once. Common solution: Phenol

Consider your skin type. Be aware that a chemical peel is not always the best option for your skin type. These are several examples when a chemical peel isn’t appropriate or can be helpful. In most cases, a chemical peel should not be used on dry or sensitive skin. A peel might cause dryness, flakiness, itching and further inflammation. If you have inflammatory acne and deep cysts, you should also consult a dermatologist, as a chemical peel might not be the best treatment for those conditions.

Chemical peels are a good choice if you experience mild to moderate acne or acne scars: The acids in the peel work to both kill active blemishes on the surface and to prevent new blemishes from forming. By accelerating the exfoliation process, a chemical peel delivers clearer, healthier-looking skin.

Become an expert on your chemical peel. Before having the chemical peel, make sure you ask every question possible to ensure you are aware of the entire procedure and its potential complications.
Examples like; what strength is the peel? How many sessions will I need? What are the pros and cons? What kind of discomfort, pain and other reactions can I expect during the procedure? How should my skin react after the chemical peel?

Communication is key in making your chemical peel a safe experience. Clarify you are experiencing normal reactions or seek immediate attention if you think you are not. Remember if something doesn’t feel right, only you can speak up about it.

About two to four weeks prior to your chemical peel, the specialist will ask you to incorporate pre-care products into your daily regimen. These products are designed to thin out the skin’s surface, allowing the peel to penetrate deeper and evenly. Your medical expert might prescribe Retin-A, an AHA product or hydroquinone cream.
When using these new products, you might have to discontinue your old ones. Your specialist will give you specific information about what products to use and avoid.
Depending on the type of peel, your results might be subtle or dramatic. Every skin type reacts a bit differently. Be realistic about the results and fully understand to what degree the peel will improve your skin and whether you will need additional sessions to maintain results.

Chloasma - skin changes through pregnancy

Chloasma  or the “Mask of Pregnancy” can cause blotchy discoloration on your face and splashes of darkened skin that may appear on the forehead, nose, and cheeks in a mask-like configuration on some pregnant women — more often in dark-skinned women.

What causes chloasma: Those mischievous pregnancy hormones are toying with you again, causing hyperpigmentation on many parts of your body. You might have noticed your freckles and moles are darker now, there’s probably a dark line down the center of your abdomen (the linea nigra), and your areolas are probably a deeper shade as well. (You might as well decide this is sexy.) Dark-skinned women usually notice such hyperpigmentation more, but light-skinned women aren’t off the hook completely — they too will get their fair share of darkening skin, though it may not be as noticeable.

Despite have clear skin most of their lives, many women find another “new experience” awaiting them once they discover a pregnancy.  The beginning stages can be small and unnoticeable pimples - usually showing around the jaw line or forehead due to hormonal fluctuations.

Three main factors contribute to acne: increased oil production, clogged pores, and a bacteria called P acnes. First, oil causes the dead skin cells to stick together, leading to a clogged pore, which is called a blackhead or a whitehead. Bacteria then moves into the pore, producing inflammation, which manifests as redness and pus. Addressing acne requires medications or treatments that decrease oil secretion, unclog pores, and kill bacteria.

As the pregnancy progresses, the acne will worsen. It is at this point, many women may frantically search for cures in their local drugstore or try home remedies. Perhaps they feel overwhelmed by the choices or confused by the long list of ingredients and decide to give up finding a solution. In some cases, the acne can grow to included pigmented or “age” spots as well.

All of these changes typically last the duration of the pregnancy and are due to hormonal changes and increased oil production, resulting in acne, while higher estrogen levels will activate skin color cells to make dark spots. This occurrence is so common in pregnancy that it’s been given the name “mask of pregnancy.” Sun exposure will exacerbate the issue further without a good sunscreen or sun protection.

Like many others, when facial skin suddenly becomes oily, the first reaction is to take away all moisture or anything ‘greasy’ that can increase the feel of oil on the skin layer.

Never fear, these again are temporary problems with easy fixes. First, stop using anything oil-based and switch to gel-based or water based sunscreens and moisturizers for the time being. Treat you skin as if it were the acne-prone, pigmented type and finally ask your doctor or dermatologist for a baby-safe acne treatment if the situation is really uncomfortable. Your skin should return to its previous condition soon after your baby is born.

•    In the meantime - Eat foods that contain folic acid (you’ll also get plenty in your prenatal supplement), since studies have shown that a folate deficiency can be related to hyperpigmentation. Good choices include green leafy vegetables, oranges, whole-wheat bread, and whole-grain cereal.
•    Stay out of the sun as much as possible and wear a sunscreen of at least SPF 15 (sunlight can also intensify hyperpigmentation). A hat and long sleeves are a good idea if you’re fair-skinned, headed to the beach, or have a historically sensitive complexion.

•    If you like, use a good concealer to cover particularly pesky spots, but skip bleaches or other chemically based lightening treatments until after you give birth. No peels or lasers, either.