Best ways to care for your skin post pregnancy

There's so much that's wonderful about becoming a new mum and enjoying family life. But after pregnancy comes physical changes that many women would like to address. Here, Dr Lowe guides you through some post-baby skincare strategies.

Melasma (Mask of Pregnancy)
Melasma is the formation of irregular pigmented patches that put in an appearance on sun-exposed areas, especially the face, usually on the cheeks and forehead and above the lips. It's often worse in women with olive skin and is a very common condition during and after pregnancy. In fact, it's estimated that at least 50 per cent of women experience melasma to some degree, which is why it's often referred to as the 'mask of pregnancy'. It can also be triggered by the contraceptive pill.

It's thought to be caused by increased levels of the hormones oestrogen and progesterone, which stimulate melanocytes to produce more melanin - the same pigment that causes skin to tan. It can occur many months - or even years - after pregnancy or taking the Pill. We believe that the hormonal shifts may alter the pigment cells, so they become more sensitive and responsive to low levels of UV light.

After giving birth, some women see a spontaneous fading without treatment, although this is rather rare. More frequently, many see an improvement in the winter, only for the melasma to return in sunnier weather. But the good news is there are treatments that can help. The ones I select are dependent on whether the melasma is deep or superficial.

Dr Lowe's Post-Pregnancy Treatment Plan
* I suggest that both during and after pregnancy, patients use a broad-spectrum sun protection daily. I would advise against using sunscreens containing oxybenzone. There's no point in commencing any other treatment unless you are prepared to apply moisturiser with sunscreen every day, because even low levels of UVA coming through windows can darken melasma.

After your baby's delivery:
* More than likely, I will then prescribe a lightening cream from the selection of prescription strength hydroquinones. I suggest prescription lightener is applied to the whole face at night.
* Active treatments vary. One of the best is the new Fraxel Dual laser, so-called because it has two wavelengths. With this laser, I can treat the melasma and also any other sun damage and wrinkling if necessary.
* Follow up treatments can include mircodermabrasion, IPL (Intense Pulsed Light) or peels. 

Stretch Marks
Stretch marks are another common occurrence after pregnancy and are stripe-like areas of skin that can be mildly discoloured or reddish purple in nature. We don't know the true mechanism that causes stretch marks to form but we think that as well as the physical stretching of the skin, oestrogen may have an effect on the collagen and elastin. What's more, as there is often little correlation between the size of the mother or baby and the appearance and severity of stretch marks, there may be a genetic component too.

Dr Lowe's Post-Pregnancy Stretch Marks Treatment Plan
* As stretch marks can improve and disappear after giving birth, I advise waiting at least three or four months - even longer - before embarking on treatment.
* If they don't improve, some of the stronger prescription retinoids can help. I usually suggest an application twice a week to start with, which is then washed off after ten minutes. Usually have to continue with this for at least 6 months.
* The Fraxel laser can prove useful, with the Fraxel Dual more suitable for milder marks. For those that are more prominent, occasionally, I will run over them very lightly with a low setting Fraxel CO2 laser to stimulate new collagen and elastic tissue to tighten the stretch mark. If they are purple, then the vascular lasers can be used instead.

Sagging Skin
As the abdomen stretches during pregnancy and some of the muscles lose tone, the skin can become saggy following childbirth. If the mother-to-be is having her child later in life, as many women are, the skin's loss of elasticity as a result of the ageing process may contribute to the problem.

Dr Lowe's Post-Pregnancy Treatment Plan
* It's worth waiting a few months after childbirth to let your weight stabilise and allow the skin to contract as much as it can naturally in problems areas such as the abdomen, thighs and love handles. Our latest fat freezing treatment Zeltiq is highly effective on these areas.
* If you still have lax skin on the abdomen, it's possible to treat it with radiofrequency (RF), which produces energy that heats areas of collagen in the skin, causing it to tighten. Over time, the body may also form new collagen, increasing the tightening effects. I'm impressed with the results that can be obtained with the latest Mono-polar Radiofrequency ThermaCool Comfort Plus machine. It's more comfortable for the patient than older models. This means we can use more energy, which in turn, produces more noticeable effects.

Thread Veins
Another problem that patients report during and after pregnancy is the appearance of thread veins (often referred to as spider veins). They are most commonly found on the face, chest and legs and are associated with increased levels of oestrogen. Again, my advice is to wait at least three to four months following childbirth before embarking on treatment as they often go away without intervention. However, if they don't, they can be treated in various ways, the best course of action dependent on their severity and location.

Dr Lowe's Post-Pregnancy Treatment Plan
* For the face and body, I can use a vascular laser, which heats the tiny veins, and coagulates the blood inside. The vessel wall then collapses and over the following weeks, as the body works to remove the blood, the appearance of the vein clears.
* If the spider veins are on the legs, I will often treat them with sclerotherapy. Using a very fine needle, a painless solution is injected into the vein, which causes its walls to stick together. This means that vein become less visible or disappears altogether.