Darker pigmentation of the face, vulva, umbilicus, areolae and the line down the middle of the abdomen, known as the linea nigra, is usual in pregnancy, although this is less obvious if the woman has fair or red hair. On the face, the darker patches usually appear on the nose, cheeks and forehead, and this is called chloasma or the ‘mask of pregnancy’. This will almost certainly fade after delivery. Moles and freckles are also likely to darken.
This change in pigmentation is thought to be caused by increased hormone levels during pregnancy. While fading appreciably, particularly on the face, after the baby’s birth, darker pigmentation of the nipples, areolae and umbilicus usually persists for some time. Stretch marks (striae gravidarum) can appear literally overnight. These are red or purple streaks caused by the elastic fibres under the skin giving way, allowing the skin to stretch at that point. They fade eventually, becoming white and silvery in appearance, but they never disappear completely. They are most likely to appear on the abdomen. Women are particularly susceptible to them if they put on too much weight, have polyhydramnios, or are having twins. While there is no evidence to show that the many creams and oils on the market said to help preventactually do so, the massage involved in applying them can be relaxing and comforting. Keeping weight gain within the recommended limits is the single most important factor which will reduce chances of getting in a normal pregnancy. Stretch marks on the buttocks and thighs are usually the result of excessive weight gain.
Stretch marks sometimes appear on the breasts, especially if they were small before pregnancy and have enlarged considerably. It is very difficult to avoid these, although wearing a bra day and night will help to minimize them.