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Forest Trees

Stretch marks, acne, melasma and
hair loss/thinning

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Stretch marks

Stretch marks are narrow, streak-like lines that can develop on the surface of your skin. They can be pink, red, purple, or brown, depending on your skin colour. They are a common side effect of pregnancy, affecting around 8 out of 10 pregnant women. And can appear on any area of the skin (dermis) that has grown and changed its shape or size during pregnancy as your bump grows or when your breasts enlarge postnatally.

During the perinatal phase stretch marks are most likely to appear on your belly and breasts. But they can also affect any other area of your skin that has stretched e.g. your back, thighs and buttocks. When and where stretch marks appear will be different from woman to woman.

Signs of stretch marks

You may not notice stretch marks developing at the time as they can form slowly or be

hidden underneath your bump or breasts.


  • Itchiness around an area of skin.

  • Red raised streak-like lines.

  • Silvery narrow streaks within your skin.

  • Looser, less elastic skin texture.


The colour of stretch marks usually fade with time and become pale of silvery upon on your skin.


What causes stretch marks?

Stretch marks occur in a layer of your skin called the dermis. The dermis has elastic qualities which means that it can usually stetch a little and then return to its normal shape and structure.  However, stretch marks occur when your dermis has been so overstretched that it can no longer restore itself back to its normal shape and size, and its new shape causes streak-like patterns within your skin.


You may be more likely to get them if you:

  • Have a full-term pregnancy

  • Have multiple gestation

  • Gain excess body fat during pregnancy.

  • Are overweight.

  • Lose lots of weight after pregnancy.

  • Use certain steroid creams or tablets.

  • Have a genetic tendency (family member) with stretch marks

  • Have Cushing's syndrome (this is a rare side effect).

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Stretch mark treatment tips

Stretch marks are not harmful and do not cause medical problems so they are not a medical concern. However, they may cause you concern about your physical appearance.


Stretch marks usually fade over time but may not disappear completely. Because the structure of your dermis has been changed beyond its capacity, it cannot likely be changed back, so stretch marks cannot be removed and there is no specific treatment for them.

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Many creams and lotions claim to prevent, reduce, or remove stretch marks. But there's no reliable evidence that they work. There is also limited evidence about whether oils or creams help prevent stretch marks from appearing in the first place.


However, there are steps that you can take to help reduce the redness and improve the overall appearance of your stretch marks which include:

  • Retinoid (often called tretinoin) creams or hyaluronic acid – these may help if used on new stretch marks, but you should not use retinoid creams if you're pregnant as they may harm your baby

  • Light or laser treatments.

  • Microdermabrasion which removes a thin layer of skin.

  • Vitamin E oil to help nourish your skin in general.


You would need to pay for these treatments as they're not available on the NHS.


Perinatal acne is a breakout of pimples that can occur on your face, neck, chest back or anywhere where on your body where you have sebaceous glands that secrete sebum (an oil that moisturises your skin. It is a common symptom of pregnancy and can also occur during postpartum recovery.

What causes perinatal acne?

During pregnancy the production of the hormone progesterone increases which causes an increase in sebum which is an oil released from your skin pores. If you pores becomes clogged with too much oil, dead skin cells or bacteria then you are likely to break out with a pimple or acne.


The production of progesterone will have peaked by the 3rd trimester, so you may have experienced more hormonal acne at the end of your pregnancy which will then subside.  However, for some women, acne will continue or resurface when your periods because of your normal monthly hormonal fluctuations.


If you experienced acne prior to pregnancy, then it may be that your skin produces a lot of sebum which will have made you more likely to experience perinatal acne.


Flare ups of acne can also be triggered by several different hormones and lifestyle factors, for example:

  • Increase in the hormone progesterone.

  • Increase in male hormones (androgens).

  • Increase in the stress hormone (cortisol).


Hormonal acne that occurred because of prenatal progesterone will usually subside and settle down within 6-8 weeks after birth. However, if your acne has not cleared up within three to six months, then you may have an underlying hormonal imbalance that is not related to perinatal hormone changes. And you could consider seeing your GP or a dermatologist.

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Acne treatment tips


Because perinatal acne is usually a hormone driven condition that may be temporary, the best way to treat it is to improve your lifestyle practices and stick to your usual gentle skincare routine or establish a new simple one and keep it simple.

  • Eat a well-balanced wholefoods-based diet to support hormone balance.

  • Reduce your consumption of processed, refined, carbonated, sugar-filled foods/drinks.

  • Hydrate well and try to drink 2 litres of non-caffeinated drinks per day.

  • Reduce stress and increase the quantity and quality of your sleep.

  • Resist the urge to pick or squeeze your spots.

  • Try not to use harsh skincare products or chemicals as this may dry out your skin and worsen the problem, as well as increase your toxic load.

  • Try not to use abrasive scrubbing or exfoliation that may aggravate your skin.

  • Adopt a gentle skincare ritual of using natural products such as rose water and a light moisturiser that won’t clog your pores.

  • Use warm (not hot water) to wash your skin.

  • Clean your make-up brushes often.

  • Change your pillowcases frequently.


If you do choose to see your GP or a Dermatologist and would like to try out a medicalised topical treatment. Then your options will depend on whether you are breastfeeding or not. Acne treatment chemicals, medication, and toxins such as azelaic acid, salicylic acid, glycolic acid, benzoyl peroxide and retinol. Can be transmitted to your baby via your breastmilk. So, you will need to consult a professional to ensure that any topical or ingested medication for acne is safe for your breastfeeding baby.


Melasma is a skin condition wherein hormones cause your colour producing cells (melanocytes) to produce extra pigment that manifests as darker patches of skin. The patches may be brown or grey in colour and tend to appear on your forehead, cheeks, chin, or around your mouth. These are often called the ‘pregnancy mask’.

During pregnancy hyperpigmentation is very common and can affect many other arears of your body too including your nipples, armpits, belly, and genitals which may also become darker in colour.

Melasma may start at any point in your pregnancy, but it usually occurs during the second or third trimester and the patches may get darker as your pregnancy progresses. They may also darken if you are exposed to sunlight.


What causes Melasma?

Melasma is caused by the release of hormones that trigger Again, there are a variety of factors at play when it comes to darkening pigment. Your skin colour and type may make this condition more or less noticeable.

People with more pigment in their skin - for example, those of African, North African, Middle Eastern, Latin or Hispanic, Asian, Indian, or Mediterranean descent - are more likely to develop chloasma, as they naturally have more active melanin production.

  • Hormone fluctuations.

  • Genetic tendency (someone else in the family had/has melasma).

  • Vitamin deficiency of iron or vitamin B12.

  • Exposure to the sun (which can make them darker).

  • Certain skincare products.


Overall, between 50-70% of women will develop melasma during pregnancy.

Melasma treatment tips

Melasma and hyperpigmentation will likely improve and fade after birth naturally, but it may take several months. There are a few tips that may help to prevent melasma from getting worse.


  • Be patient and wait for it to fade naturally.

  • Eat a well-balanced wholefoods-based diet to support hormone balance.

  • Reduce stress and increase the quantity and quality of your sleep.

  • Try to reduce your exposure to sunlight.

  • Wear a sunhat and cover your skin when outdoors.

  • Use a sunscreen containing Zinc oxide or (SPF 30 or higher).


If you would prefer to seek professional treatment then you can talk to your GP or dermatologist about treatments such as light therapy, microdermabrasion, chemical peels, laser treatments or topical treatments such as hydroquinone, tretinoin, or corticosteroids.

Remember that any treatment options may vary if you are breastfeeding so make sure that you discuss that with your medical consultant before applying any treatment.

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Postnatal Hair loss

Following birth, you may notice that you start to shed more hair than usual when you style, wash or run your fingers through your hair. It may fall out evenly or in certain places e.g. around your hairline.

This is quite normal and can start any time after birth, but usually peaks between 3-5 months and then starts to subside at six months and usually has stopped 1 year after birth.

Postnatal hair loss is quite common with approximately 50% of women will experiencing it. And in most cases, it is not something to worry about.

What causes postnatal hair loss?

Your hair growth occurs in phases: a growth phase, resting phase and a shedding phase, which then repeats as a cycle. During this cycle the average woman will shed about 50-100 hairs daily, which is not particularly noticeable.


However, during pregnancy the high levels of estrogen cause your hair to stall in the growth phase and not enter the resting or shedding phase as soon as it usually would. So, your shedding decreases and you retain more hair. Making it appear thicker and fuller during pregnancy.


After birth your estrogen levels decrease which causes your hair growth cycle to enter the resting and then shedding phase. This causes hair loss to suddenly increase so that you lose that extra hair that you retained during pregnancy.

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Postnatal hair loss treatment tips

Hair loss can be quite concerning. It’s helpful to remember that postpartum hair loss is absolutely normal and is usually a temporary phase. Once your pregnancy-related hormones settle down, your hair cycle will return to normal.

There is not much that you can do to prevent postpartum hair loss but there are a few hair care tips that you can try to help protect your hair and keep it as healthy as possible.


  • Eat a well-balanced diet that includes iron, vitamin C, Vitamin D, Omego-3s and magnesium.

  • continue to take your prenatal vitamins.

  • Try not to use harsh hair styling chemicals such as dyes, perms and relaxers.

  • Try not to use damaging high heat appliances such as hairdryers, straighteners and tongs.

  • Shampoo only when needed and use a good conditioner.

  • Detangle slowly and gently with your fingers or a wide-toothed comb. 

  • Use scrunchies or clips– don’t use elastic bands to tie up your hair.

  • Style your hair loosely, not tightly.

  • Try a new haircut to make your hair appear fuller and blend in regrowth.

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Red flags - when to seek help

It is vital that you take care of yourself and focus some of your time and attention on your self-care. This will help you to nurture yourself and spot any warning signs so that you can seek medical assistance when required. 


Familiarise yourself with the list below and make sure that you tell your health visitor or GP if you experience any of these symptoms, as they could indicate an underlying problem that requires further investigation or support.

  • If you have stretch marks and more fat on your chest and tummy, a build-up of fat on the back of your neck and shoulders, but slim arms and legs. A red, puffy, rounded face as these could be symptoms of Cushing's syndrome.

  • Your acne skin is very red and inflamed.

  • Your acne blemishes are deep, inflamed, and painful.

  • Your acne blemishes cover a significant part of your face and/or body.2

  • You skin is scarred from acne.

  • A clean diet, hydration, simple skincare and managing stress has not helped.

  • Over-the-counter treatments have not helped.

  • Your acne is getting worse.

  • Your melasma is painful, itchy, sore, or severely irritated.

  • If your skin condition is causing you severe mental or emotional distress.

  • If your hair loss is particularly severe e.g. coming out in clumps and/or patchy.

  • If you are still shedding hair six months to 1 year after birth.

  • If you develop any skin related scalp condition that is causing hair loss.

How you can support your partner

You can support your partner by ensuring that they are well nourished, well rested, have the supplies and emotional support that they need and are watchful of their health.


Below are some ways that you can be supportive:


  • Ask your partner how you can help and support them.

  • Listen to your partners concerns and validate their feelings.

  • Prepare nutrient dense foods for meal and snacks.

  • Encourage your partner to continue taking prenatal vitamins or a multivitamin.

  • Purchase supplies that will help their particular condition (see tips sections).

  • Remind your partner that most of these postnatal symptoms are temporary.

  • Encourage your partner to see professional advice if any of the red flags are apparent.

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