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Pregnancy Advice #1: Acne Breakouts
- Acne Breakouts:
Treatment options for acne during pregnancy are limited. Category X is defined as drugs that are toxic during pregnancy and while nursing (i.e. tetracyclines). Category B drugs are defined as safe to use during pregnancy and nursing. Category C is defined as no well controlled trials exist in pregnant or nursing women. Topical and oral retinoids (i.e. Accutane, Isotretinoin, topical tretinoin, adapalene, tazorac, Ziana, etc.) are avoided because of toxicity and potential harm to an unborn fetus. All oral contraceptives are still classified as a pregnancy category X by the FDA and are therefore considered off limits for use as an acne treatment for pregnant women. Spironolactone often used for recalcitrant hormonal acne is contraindicated during pregnancy.The Debate: Benzoyl Peroxide and Salicylic Acid
Though high doses of salicylic acid in its oral form have been associated with birth defects, many dermatologists consider topical salicylic acid (Category C drug) to be perfectly safe for the acne treatment in pregnant women. Benzoyl Peroxide, another Category C drug, is likewise avoided by some and freely prescribed by others. It is always best to consult with your dermatologist before using any over-the-counter or prescription treatments/medications during pregnancy.Something Safe for Mom & Baby:
Among commonly prescribed oral and topical antibiotics, Erythromycin is considered relatively safe. Another alternative, approved as an acne treatment in Europe, is Azelaic Acid. Data support the safety of Azelaic Acid in pregnant women. Azelaic Acid (AzA), a saturated dicarboxylic acid found naturally in wheat, rye, and barley, is present in foods – including Rice Krispies® and corn flakes, which is consumed by women and children every day. When treating a pregnant woman with acne, dermatologists in the US might consider prescribing Azelaic Acid 15% gel, as an off–label alternative to other topical treatments.
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Pregnancy Advice #2: Dark Spots/Melasma
- “Mask of Pregnancy”:
Melasma, often called the “mask of pregnancy”, typically results in dark patches on the cheeks, forehead, lips and nose. It is believed to be a result of hormonal changes, sun exposure, or a combination of both. Commonly used over-the-counter and prescription bleaching creams should be avoided during pregnancy, as studies have not been conducted on its safety during pregnancy. Some examples of products that contain hydroquinone are the following: AMBI® EVEN & CLEAR™,Lustra, Epiquin Micro, Eldoquin, Melanex, and Tri-Luma Cream®.Something Safe for Mom & Baby:
An ounce of prevention is a pound of cure with the use of sunscreen everyday, whether you are pregnant or not. It can also help prevent melasma. A physical sunblock with SPF 30 or higher will protect your skin from pesky free radicals, shielding it from cancer causing UV rays. I highly recommend a physical sunblock such as Neutrogena® Ultra Sheer™ Dry-Touch Sunblock (SPF 55, 70 & 85) and the AVEENO® Continuous Protection® line. It is important to just make sure the physical sunblock contains non chemical, insoluble ingredients such as zinc oxide and titanium dioxide, which protect against damaging UVA and UVB sunrays. In addition, consider Vitamin C creams as well as glycolic and kojic acids, which are safe treatment options during pregnancy especially for melasma.
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Pregnancy Advice #3: Skin Rejuvenation
- Skin Rejuvenation:
Stay away from BOTOX®, injectable fillers, and laser/light therapy procedures. There are no studies for BOTOX®, injectable fillers, and laser/light therapy procedures in pregnant women; it should be avoided due to the potential risk to the fetus and developing embryo. Instead, focus on a diet rich in anti-oxidants, have adequate amount of sleep/rest, and you consume an abundance of water. You should also wear sunglasses to prevent squinting from sun rays (which contributes to wrinkles), as well as protecting the macula from degenerating.Something Safe for Mom & Baby:
C E Ferulic from SkinCeuticals is an antioxidant serum that boosts the skin’s natural protection against photoaging (damage to the skin caused by intense and/or prolonged exposure to the sun) by eight times! It neutralizes free radicals, as well as increases collagen growth. Active Serum from iS Clinical helps reduce fine lines and wrinkles, as well as help treat acneic skin and uneven pigmentation. This serum contains sugar cane extract and bilberry extract, which speed up the skin’s natural exfoliation process without over drying. White willow bark extract, a natural anti-inflammatory with anti-microbial properties, increases cell turnover and reduces sebum blockage.
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Pregnancy Advice #4: Salon/Spa Services
- Hair Coloring:
Permanent hair dye applied to the entire scalp can potentially be absorbed into the body. According to the American Medical Association, it is recommended to stay away from hair coloring during pregnancy. Dying your hair three times while you are pregnant is equivalent to smoking one to four cigarettes. There are no well controlled studies to guarantee the safety of permanent hair dye usage in pregnancy; however, on the other hand, there is no evidence saying it can lead to birth defects either. Consider color-enhancing glosses as a good alternative which also makes hair super shiny. Ask your colorist about semi-permanent and demi-permanent dyes, which contain nearly no ammonia or peroxide. To minimize exposure to salon chemicals, allow eight weeks or more between appointments and always request the first appointment of the day.Hair Removal:
Waxing unwanted hair using a natural wax is safer than depilatories, which may cause an allergic reaction and can potentially seep into pores. Waxing may be more painful when pregnant and some women may experience broken blood vessels from the procedure. No studies exist to test the safety of laser hair removal and other laser/light-based treatments in pregnant women. I would recommend to err on the side of caution and to avoid such procedures while pregnant.Tanning:
Self-tanners only stain the skin’s surface and are not absorbed into the body. A second perk: provides a warm glow, without the damaging effects of UVA and UVB rays from the sun and tanning beds.Hot Spa Treatments/Hot Tubs:
Hot tubs, hot baths, hot stone massages and body wraps can possibly cause miscarriages during the first trimester, by elevating the mother’s own body temperature to simulate a high fever. Fever during pregnancy can also put the unborn baby at risk for developing birth defects.Manicures/Pedicures:
Artificial nails and some nail polishes contain chemicals that can potentially put the developing fetus’ brain at risk. In addition, inhalation of the chemicals and glues associated with artificial nails may be damaging. Nails grow faster and are stronger during pregnancy, so acrylic nails and tips should be unnecessary. If you decide to go to a salon, make sure they are reputable in cleanliness (i.e. sterilization of tools) and experienced in the care of pregnant women. For pedicures, ask for cool water pedicures, since warm water may increase the body temperature. Since massages are commonly associated with pedicures, limit the massages to below the ankle. Certain pressure points located in the ankles may induce labor. Also, deep tissue massages on the legs can be dangerous, due to the possibility of dislodging any blood clots.
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Pregnancy Advice #5: Dental Care
- Dental Care:
Avoid treatment and procedures that can wait until after your pregnancy is complete, such as whitening, dental x-rays, and elective dental work. X-rays can potentially expose the developing fetus to irradiation and bleaching solutions may be accidentally ingested. At home whitening toothpastes should be okay to use. During pregnancy, hormone levels are elevated, which allows your gums to be more susceptible to disease. Plaque, which is basically made up of bacteria, makes the gums more sensitive and susceptible to gingivitis. The altered level of hormones during pregnancy can also cause the gums to bleed and/or become tender and swollen.Something Safe for Mom & Baby:
Go for regular cleanings more often than usual, especially during the second and third trimester. Be sure to practice good oral hygiene procedures, such as brushing twice daily, flossing daily, and changing toothbrushes every 4-6 weeks. Be sure to use a proven antibacterial toothpaste containing fluoride as well. You should also eat a nutritious, well-balance diet, increase your calcium and phosphorous, and snack on foods that are low in sugar, salt, fat, and high in fiber.