Pregnancy: Pigmentation, Stretch marks and other Skin Changes

by Dr Wan Chee Kwang
June 15, 2023

Pregnancy is a special time, full of joy and anticipation as you prepare to welcome a new baby. But what you may not quite welcome are the physical transformations that it brings about. Having treated women in Singapore who have gone through labour, we know that pigmentation and stretch marks, however common, can be concerning and stressful. 

While these skin conditions are a natural part of pregnancy, it is important for you to understand them for your physical and mental well-being. This article will explain just what kind of biological processes are causing your skin to change, the ways you can care for your skin and available removal treatments.

Common skin changes during pregnancy

While some women enjoy the pregnancy glow, others find that their skin has lost its suppleness. With pregnancy, your body undergoes a variety of hormonal changes that can affect your skin. Some of the common skin changes include pigmentation, stretch marks, acne and varicose veins.

While they can be uncomfortable and even embarrassing, these skin conditions are usually harmless and will resolve themselves after pregnancy. 

Pigmentation during pregnancy

If you are pregnant, you may experience a darkening of the skin, known as pigmentation. A common form of pigmentation in pregnant women is melasma, where the skin produces extra pigments. This condition is also referred to as chloasma or ‘the mask of pregnancy’. It affects between 50 to 70% of pregnant women and is characterised by dark patches on the cheeks, forehead, chin and mouth.

Causes of pigmentation

Pigmentation in pregnancy is related to a shift in hormones. While a rise in oestrogen and progesterone may be responsible for that ‘pregnancy glow’, excessive amounts of these hormones can have the opposite effect by darkening your skin.

These hormones cause your body to overproduce melanin, a natural pigment that gives your skin its colour. When melanin is produced in large amounts, it causes the skin to become darker than normal. 

Care for pigmentation

Having pigmentation can be upsetting, but you will be relieved to know that it is usually harmless. The dark patches usually subside after your baby is born, although it may take months to fade completely. To prevent pigmentation, it may help to adopt a few lifestyle changes during your pregnancy.

  1. Staying in the shade

Where possible, avoid sun exposure and seek shaded areas when going out.

  1. Cover up

Protect your skin from harsh ultraviolet (UV) rays by wearing loose clothing that covers your body well. 

  1. Wear your sunscreen

UV exposure can induce or worsen your pigmentation. It is best to apply sunscreen to your skin both before leaving home and even at home if it’s a particularly hot day. This is because sunlight may stream into areas of your home, exposing you to excessive UV rays.

Stretch marks during pregnancy

Stretch marks are bands of lines or streaks running across your skin. When touched, they feel like a slight ridge or an indentation. Stretch marks happen when your skin is stretched to adapt to your growing belly. 

When this happens, collagen and elastin fibres break down, causing your skin to lose its elasticity and develop streaks. Stretch marks commonly appear reddish, purplish, or greyish and can also cause itchiness and dryness. You may notice stretch marks on your abdominal area, thighs, buttocks, and breasts. 

Though stretch marks may look stark, they are natural. It may also be helpful for you to remember that your stretch marks are not indicative of poor health of you or your baby. And the good news is that stretch marks can lighten and fade over time, which is likely around six months after your baby is born.

The width of the stretch marks may remain, though. See our section on what happens to your skin after pregnancy for treatment options.  

Care for stretch marks

While stretch marks may fade over time, you can still moisturise your skin to relieve the itchy they cause. Some common ingredients in moisturisers are cocoa butter, vitamin E and coconut oil. 


Acne is one of the dreaded skin conditions caused by pregnancy hormones. If you are suffering from acne, you are not alone. According to a French survey, more than 40% of pregnant patients have acne. 

Causes of acne

The elevated hormone level in the first trimester is the primary factor in pregnancy-related acne. The higher level increases the natural sebum production of your skin, increasing the chances of breakouts on the face and body. 

It's difficult to predict who will get acne when pregnant. However, if you have a history of acne or experience acne flare-ups at the beginning of your menstrual cycle, your risk may be higher than others. 

If you don't get acne in the first trimester, it's unlikely that you'll experience breakouts, at least of a bad variety, in the second or third trimesters.

Care for acne during pregnancy

Pregnancy acne may go away after the baby is born and when your hormone levels return to normal. It is best to practise good skincare while pregnant to manage your skin condition. Here are some skincare habits you may want to start following:

  1. Cleanse twice a day to keep your skin’s oiliness under control.
  2. Use a gentle, oil-free cleanser.
  3. Rinse your skin with lukewarm water.
  4. Apply moisturiser after cleansing and patting your skin dry.
  5. Do not over cleanse, as this may over stimulate your oil glands.
  6. Avoid touching your face to prevent the spread of bacteria.
  7. Change your pillowcases frequently to avoid contact with dirt and buildup.

Taking care of your skin at home may not provide satisfactory results if your acne is bad and if you suffer from post-inflammatory hyperpigmentation. You may be looking for professional treatments, such as laser removal procedures. See here for options available at 1Aesthetics.

Spider and varicose veins

Another daunting pregnancy discovery is spider and varicose veins. Spider veins are small dilated blood vessels that appear near the surface of the skin. They resemble a spider’s web and hence they are named “spider veins”. They are typically red, blue or purple. Varicose veins are similar but larger and more swollen.

Spider veins most often appear on the inside of the legs or the back of the calves, causing swelling in the feet and ankles.They are more common in the second and third trimesters of pregnancy because of the extra weight and pressure that are put on the veins.

Causes of spider and varicose veins in pregnancy

Spider and varicose veins can be caused by a range of factors, but during pregnancy, they are mainly due to increased pressure in the abdomen. As your uterus grows, it puts extra pressure on the veins in the legs, which can cause them to become swollen and twisted.

Another physiological change during pregnancy is an increase in blood volume. Even though blood volume can increase by up to 50%, the number of veins your blood runs in remains the same. This puts your vascular system under pressure as it works harder to circulate the extra blood. As a result, veins enlarge and become more visible, rising to the surface of your skin.

Care for varicose veins

While many women experience varicose veins during pregnancy, they are not a cause for alarm. They usually disappear after you give birth.

To reduce the risk of developing varicose veins during pregnancy, there are steps you can take. 

  1. Regular physical activity, such as walking, swimming and yoga, can help to improve circulation and reduce the risk of varicose veins. 
  2. Avoid standing for long periods of time.
  3. Wear compression stockings. 
  4. Maintain a healthy diet and avoid putting on too much weight.

Your skin after pregnancy

As you celebrate the birth of your child, you may find the body you once knew has been transformed by the rigours of pregnancy. 

Your skin that stretched during pregnancy may not return to its original state after you give birth. You may notice looseness and sagging of your skin, before it can regain its elasticity in the months to come. 

If you deliver your baby through a caesarean section, you may also find an additional change to your skin. A keloid scar may form over the section of your abdomen that is cut. A keloid scar develops when the body overproduces collagen while repairing damaged tissue. It is a scar that is raised, thick and often dark.

Treatment options

The symptoms of the above skin conditions may not immediately subside after the birth of your child. For conditions like acne scars, pigmentation and stretch marks, your symptoms may take more than six months to fade. Stretch marks, for instance, can lighten, but their width may remain the same.

We understand if you might prefer to have these imperfections disappear quickly instead of waiting for months. You can consider some removal treatments to regain your clear and smooth skin .

At 1Aesthetics, we offer evidence-based solutions to help our clients in Singapore look better and feel more confident in their skin. To remove pigmentation and stretch marks, one of the treatment options available is fractional picosecond laser.

Pigmentation removal

Fractional picosecond laser treatment can target and break down excess pigment for pigmentation removal. This results in a clearer, more even skin tone and improved texture. This method is also useful in the treatment of freckles and sun spots.

Fractional picosecond laser is a type of laser treatment that administers short bursts of energy to create tiny "fractional" injuries in the skin. Fractional picosecond lasers only treat a portion of the skin, leaving the surrounding tissue intact, as opposed to traditional lasers that treat the entire surface. 

This causes a pattern of tiny wounds that start the body's natural healing process and stimulate the synthesis of collagen and elastin, which improve the skin's texture and appearance.

Acne scar removal

Acne scar treatment isn’t a one-size-fits-all solution. Factors like type of acne scar and skin type can vary from person to person. At 1Aesthetics, we tailor acne scar removal treatments accordingly and often adopt a multimodal approach.

For mild to medium-depth acne scars, fractional laser is an effective treatment. The laser is applied to the skin in a fractionated pattern, creating thousands of microscopic wounds in the skin. This causes a controlled injury to the skin, which triggers the body's natural healing response, stimulating collagen production and new skin cell growth.

Stretch marks removal

Stretch marks are commonly regarded as unsightly by women and may affect their self-confidence. At 1Aesthetics, we usually suggest a combination of treatments for the removal of stretch marks, which may include topical treatments, chemical peels, fractional resurfacing devices and collagen stimulating fillers.

Fractional resurfacing devices can visibly improve the length, width, depth and colour of your stretch marks. Vascular lasers can also help with stretch marks.

Keloid scar removal

A combination of treatments including lasers and intralesional injections can work well for flat and small keloids, which are typical of C-section scarring. However, bigger and more protruding keloids may require keloid removal surgery in conjunction with other treatments for a better result.

No one-size-fits-all solution

We believe there is no one-size-fits-all treatment for everyone, especially for women who have gone through something as transformational as pregnancy. Pregnancy is different for every woman, and so are the changes it causes in the skin.
At 1Aesthetics, we want you to feel better about yourself after giving birth to your newborn. We prioritise your individual needs and customise a treatment plan according to your specific condition. To find out which removal method suits you best, book a consultation today.


  1. Ivan Bolanca, Zeljana Bolanca. (2008). Chloasma-the mask of pregnancy. PubMed
  2. Brigitte Dréno, Eric Blouin, Dominique Moyse,  Isaac Bodokh, Anne Chantal Knol and Amir Khammari. (2014). Acne in pregnant women: A French survey. PubMed Central.
  3. Priya Soma-Pillay, MB ChB. (2016) Physiological changes in pregnancy. PubMed Central.

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