• Hormones as the Cause: Most changes (pigmentation, hair) are hormone-related and harmless
• Sunscreen is a must: Mineral-based UV protection effectively prevents “pregnancy mask” (melasma)
• Patience with stretch marks: Creams can help, but massage and acceptance are often the best approach
• Aftercare: Many changes disappear on their own after birth; for varicose veins or severe stretch marks, dermatological treatments are available if desired

While the growing baby bump is the most noticeable physical change during pregnancy, there are also other common changes to the skin, hair, and nails during this time. Here, you’ll learn what expectant moms should prepare for and how these changes may be prevented.

Glow or Risk? Understanding Pigment Changes

The most common skin change during pregnancy involves changes in skin pigmentation—usually hyperpigmentation, or a darkening of the skin. About 90% of all pregnant women are affected by this! (Hassan, I., et al., 2015). Hyperpigmentation is primarily caused by increased secretion of the hormones progesterone, estrogen, and melanocyte-stimulating hormone (MSH). Pigment changes can occur in various forms and are, fortunately, harmless. In most cases, these changes disappear on their own after childbirth (Erlandson, M., et al., 2023).

Melasma: When the “pregnancy mask” appears

Melasma, or the “pregnancy mask,” refers to irregular, darker pigmentation of the facial skin. In other words, melasma causes darker “spots” on the face. These can appear over a large area, affecting the face (almost) entirely, or occur only in small, isolated spots. However, you don’t need to worry about melasma, because you’re in good company: Up to 75% of all pregnant women have what’s known as the “pregnancy mask.” The pregnancy mask is exacerbated by sun exposure—and can therefore be at least partially mitigated by ensuring you use adequate sun protection (Erlandson, M., et al., 2023). You’ll find a section with key information on sun protection at the end of this article.

The Linea Nigra: A Common Feature on the Baby Bump

Many pregnant bellies are marked by a dark line that runs vertically down the center of the abdomen. This line is also caused by an increase in skin pigmentation and is nothing to worry about. It can vary in prominence and usually fades on its own. In most cases, the linea nigra becomes noticeable starting in the second trimester (Erlandson, M., et al., 2023).

Hyperpigmentation in sensitive areas

Hyperpigmentation often begins as early as the first trimester and can particularly affect the nipple and areola. These areas usually just become slightly darker or browner (especially in fairer skin types) than you are used to. The genital area may also become slightly darker. No matter how unusual and strange these changes may seem, they are no cause for concern (Erlandson, M., et al., 2023).

What really helps against stretch marks?

The world-famous stretch marks are also called striae gravidarum and are arguably among the most dreaded skin changes during pregnancy. Here, too, up to 90% of all pregnant women are affected—from the abdomen to the breasts, buttocks, or limbs, essentially the entire body can be affected. Incidentally, stretch marks do not occur only during pregnancy, and there are also different types that differ visually. During pregnancy, these are usually reddish to purple streaks that are typically short and irregular in shape. Sometimes they are visually compared to small flames. Stretch marks do not necessarily disappear after pregnancy (Erlandson, M., et al., 2023).

Prevention and Treatment of Stretch Marks

Precisely because stretch marks can sometimes remain, they are a source of anxiety for some women. It is therefore no surprise that there are numerous skincare creams that promise to prevent or improve the appearance of stretch marks. Unfortunately, creams designed to prevent stretch marks perform poorly in scientific studies and are therefore not recommended (Brennan, M., et al., 2012).

If stretch marks are already visible, creams containing 0.1% tretinoin or glycolic acid show promise. Particularly good results can be achieved when the products are applied to stretch marks that are as fresh as possible (Algarra Sahuquillo, J., et al., 2026). Other experts, however, recommend products containing hyaluronic acid or Indian pennywort in combination with a daily massage (Erlandson, M., et al., 2023).

Despite all this, good skincare with high-quality ingredients—and often combined with massage—is always a good and, above all, soothing option for expectant mothers. For many pregnant women, this very ritual is a very pleasant one, often performed together with the expectant father or mother.

If stretch marks persist and cause discomfort, laser therapy, for example, can be considered after pregnancy (Farahnik, B., et al., 2016).

Hair and nails take on a life of their own

During pregnancy, many women report thicker hair on their heads, which is also stimulated to grow more due to hormonal changes. Some women may also experience increased hair growth around the face, on the limbs, or on the back compared to their usual pattern.

Unfortunately, increased hair loss after childbirth is also part of the experience for many women. This hair loss can last up to 18 months after giving birth—though it can also be significantly shorter. And here’s some good news: very few women suffer from extreme hair loss. In most cases, it’s barely even noticeable to others.

Nails also grow faster during pregnancy but can be more brittle than before pregnancy. A blessing and a curse at the same time! (Erlandson, M., et al., 2023)

Vascular changes ranging from redness to spider veins

Blood vessels also change during pregnancy, and these changes are sometimes visible. Vascular changes generally do not pose a serious health problem. However, if you are unsure, please be sure to seek medical advice! Of course, this applies not only to vascular changes!

Spider veins (Naevus araneus)

So-called spider veins, also known as naevus araneus or Eppinger’s stars, consist of a central red nodule or dot from which spider-like branches or “star-shaped points” radiate. They are often found on the face, neck, nape of the neck, or chest, and some people develop these spider veins for other reasons: sometimes without a clear cause, or due to medical conditions, sun-induced skin damage, or liver disease. About two-thirds of all pregnant women develop such changes, but in about 75% of cases, they disappear on their own once hormone levels return to normal after childbirth (Erlandson, M., et al., 2023).

Palmar erythema (red palms)

Reddened palms are among the skin changes that can occur even without pregnancy. During pregnancy, they affect about two-thirds of all expectant mothers and are more common and more pronounced in women with fairer skin. Palmar erythema is painless but can cause a sensation of warmth in the hands (Erlandson, M., et al., 2023).

Varicose Veins 

Varicose veins are also known as varices and are particularly well-known outside of pregnancy. However, they also occur in 40% of pregnancies. Varicose veins that develop during pregnancy tend to persist. They thus become a constant companion for women from that point on. Varicose veins are also generally harmless (Erlandson, M., et al., 2023).

Other vascular changes

Sometimes, vaginal erythema—redness in the vaginal area—can also occur during pregnancy. The gums are also more prone to inflammation and redness during pregnancy, which is why pregnant women should not only visit their gynecologist regularly but also see a dentist! (Erlandson, M., et al., 2023)

Safe Sun Protection During Pregnancy

Sun protection should never be neglected during pregnancy, as the skin is particularly sensitive to the sun at this time. In addition, certain skin changes, such as melasma, can be exacerbated by sun exposure.

Scientists recommend avoiding potentially harmful ingredients like oxybenzone when choosing a sunscreen during pregnancy. You should also avoid products containing ingredients like salicylic acid or parabens. Ideally, your sunscreen should be a mineral-based formula containing ingredients like zinc oxide, as these are considered particularly safe during pregnancy and offer good protection against UVA, UVB, and HEV (High Energy Visible) radiation. Since mineral sunscreens often cause the dreaded “white cast,” you can also opt for tinted sunscreens or apply foundation or other makeup over them. Additives such as vitamin E, niacinamide, or moisturizing ingredients like hyaluronic acid are considered safe during pregnancy. If you want to play it safe, opt for sunscreens rather than sun sprays so that you inhale fewer ingredients from the sunscreen product (Lim, H. W., et al., 2025).

Frequently Asked Questions on the Topic

Do stretch marks go away after childbirth?

They usually fade from reddish-purple to light, silvery-white lines, but often remain permanently visible as fine scars. Laser treatments can improve their appearance over time.

Why is my hair falling out after pregnancy?

Due to the drop in estrogen levels after childbirth, hair that was kept in the growth phase during pregnancy simultaneously enters the resting phase. This usually resolves on its own within a few months.

What is the best sunscreen to use during pregnancy?

Experts recommend mineral filters (zinc oxide or titanium dioxide), as these do not absorb into the skin and are hormonally safe.

Do I need to see a doctor because of red palms?

Palmar erythema is usually harmless during pregnancy. However, if severe itching or pain occurs, you should see a doctor just to be safe.

Is the linea nigra dangerous for my baby?

No, absolutely not. The dark line on your belly is simply a sign of increased pigment accumulation in the skin, triggered by hormones. It has no effect whatsoever on your child’s health or development.

Does melasma disappear immediately after childbirth?

Generally, the dark spots fade within a few months after giving birth, once hormone levels have returned to normal. For some women, however, it may take longer, especially if their skin continues to be exposed to strong sunlight without protection.

References

• Hassan, I., Bashir, S., & Taing, S. (2015). A clinical study of the skin changes in pregnancy in kashmir valley of north India: a hospital based study. Indian journal of dermatology, 60(1), 28–32. https://doi.org/10.4103/0019-5154.147782
• Erlandson, M., Wertz, M. C., & Rosenfeld, E. (2023). Common Skin Conditions During Pregnancy. American family physician, 107(2), 152–158.
• Lim, H. W., Piquero-Casals, J., Schalka, S., Leone, G., Trullàs, C., Brown, A., Foyaca, M., Gilaberte, Y., Krutmann, J., & Passeron, T. (2025). Photoprotection in pregnancy: addressing safety concerns and optimizing skin health. Frontiers in medicine, 12, 1563369. https://doi.org/10.3389/fmed.2025.1563369
• Brennan, M., Young, G., & Devane, D. (2012). Topical preparations for preventing stretch marks in pregnancy. The Cochrane database of systematic reviews, 11(11), CD000066. https://doi.org/10.1002/14651858.CD000066.pub2
• Algarra Sahuquillo, J., & Martín-Gorgojo, A. (2026). Stretch Marks: Systematic Review of its Therapeutic Approach. Actas dermo-sifiliograficas, 117(4), 104553. https://doi.org/10.1016/j.ad.2025.104553
• Farahnik, B., Park, K., Kroumpouzos, G., & Murase, J. (2016). Striae gravidarum: Risk factors, prevention, and management. International journal of women's dermatology, 3(2), 77–85. https://doi.org/10.1016/j.ijwd.2016.11.001