Why don’t we take pregnancy skin issues more seriously?

After giving birth to her two children, Samantha Terry has red stretch marks which now cover much of her abdomen. They extend from her thighs to her navel. They go up and down on both sides of her hips and waist. “I look like I got scratched by a tiger,” the 30-year-old told HuffPost.

Some days she’s not bothered by them — a very small price to pay for the two children whom she adores more than anything. Other times, she feels “disgusting” and embarrassed. And when she tried to tell a few older women she knows about it, she was immediately shut down, recalling how lucky she is to be a mother and how every woman who gives birth goes through it.

“It would be nice to be able to talk about it a bit more,” Terry said. “It makes you feel guilty for complaining.”

Bodies go through tremendous changes during and after pregnancy, including skin changes. Estimates suggest that up to 90% of pregnant women have stretch marks. Up to 50% of women suffer from melasma, or the development of brown or blue-gray patches on the face, cheeks or arms. More than 50% develop acne – and there are more skin problems that occur, such as varicose veins, hair loss, eczema flare-ups, and so on.

Some of these changes are temporary; others are long-term or permanent. But all of them can become a source of emotional discomfort for mothers like Terry. And too often women who have been pregnant feel like there is nothing that can be done to help them or someone they can talk to openly about how they are feeling.

An area of ​​pregnancy and postpartum that is simply not studied

Over the past decade, doctors have begun to understand the impact certain skin conditions can have on people, not just physically, but emotionally. Studies have linked severe acne to suicidal ideation, for example, and calls have been made to develop a more integrated system of care between dermatologists and mental health professionals to understand the impact of stress and hormones on the skin and the consequences that skin problems can have. .

But for those who have given birth, the link between skin and mental health is still often overlooked. Frank Wang, a clinical dermatologist at Michigan Medicine and one of the few researchers to study stretch marks specifically, told HuffPost that “there is very little information about the emotional and psychological impact of stretch marks.”

He and his team recently published the results of a small survey of 100 newly postpartum women which found that a third of those who developed stretch marks had “a lot” or “moderately” discomfort about them. This embarrassment prevented them from wearing certain clothes, engaging in certain social activities, and damaged their self-esteem.

Of course, many women are not particularly concerned with skin changes during pregnancy; some cherish them. But Wang thinks it’s incumbent on researchers and clinicians who work with pregnant women to find ways to support those who feel unsafe and to address their practical concerns as well as the feelings these concerns evoke.

“With everything in medicine, it’s always very individual. On the one hand, we live in this great age where we’re taught to embrace the things we have…and that’s positive in many ways. But I think there are people who are very distressed by their skin problems,” he said. “A skin disorder doesn’t have to be life-threatening, but it can really impact how people view themselves and their quality of life.”

How can we support people after pregnancy

For Theresa, 31, stretch marks were not a major source of stress during or after pregnancy, although she did have them. She was much more bothered by the severe acne that developed under her breast during pregnancy and eventually turned into cysts. These cysts burst – quite painfully – while she was breastfeeding her daughter and are now permanent scars.

Theresa, who asked to use her first name only because she was talking about something sensitive for her, spoke to her doctor at the time, but received no advice on how to manage her acne. And the only conversation she had with a loved one at the time didn’t go well. While pumping for her newborn in the NICU, a family member saw her cysts and wondered if they were making her breast milk unsafe.

“It really disturbed me mentally and emotionally,” Theresa said of the whole experience, adding that her scars are always a source of insecurity, especially during sex.

One of the challenges in better treating these issues is that for some of the conditions that occur during pregnancy and after, there simply isn’t much that doctors can do to help. Wang is working to better understand what causes stretch marks and how to treat them, but there really aren’t many evidence-based ways to prevent or treat them right now, he said — and many are expensive. The same goes for issues like melasma or even treating acne during pregnancy when many commonly used medications are dangerous.

But there are certainly ways to better support women emotionally.

“What ends up happening is even when a woman comes in and says, ‘This really bothers me, I don’t feel safe,’ they’re told, ‘Oh, but you have a happy, healthy baby. good health. What it basically says is, ‘It doesn’t matter what you say and what you feel. You should focus on these other things here,” Paige Bellenbaum, founding director of The Motherhood Center mental health clinic in New York City, told HuffPost. Women are told these issues are “unimportant” or “peripheral”, even though everywhere they look they are being told otherwise, she added.

Indeed, postpartum women are constantly inundated with mixed messages about how they “should” look and feel. They see ambitious images of moms who immediately “bounced back,” as well as marketing campaigns tapping into the body positivity movement by urging them to embrace their body changes with serene, pure positivity. All the while they are being told explicitly and not that they should focus on their gratitude for being mothers.

Instead, women should just be given the space they need to talk about what they’re struggling with, Bellenbaum said.

“A different way to respond to someone who draws attention to how they experience their body during or after pregnancy is to make room for it and be curious,” Bellenbaum said. “Like, ‘tell me more about it’…instead of telling someone they shouldn’t feel that way.”