Many women aren't prepared for the physical changes they'll experience after childbirth. Here are some ways to help with the transition.
A woman’s mental and physical well-being requires tests, treatments, and preventions that men just don't have to deal with. But this isn't always discussed. From fibroids to diets to natal care, women's health is extremely nuanced. With this in mind, Shondaland wanted to take a distinct look into the world of women's health, all in the hopes of fostering well-rounded wellness.
“No one told me this was going to happen!?” It’s a sentiment that new and newish mothers find themselves uttering over and over again to each other and, frankly, to anyone who will listen. That’s because — despite an ever-growing mountain of information about the myriad things that happen to your body during pregnancy — there is surprisingly little out there about what happens to you afterward.
And the symptoms women encounter post-baby aren’t just happening below the belt. You knew there might be stretch marks, you’d heard stories about plastic gloves full of ice chips, but were you warned about what might happen to your face? That you might breakout in cystic acne? Were you given a warning about receding hairlines? Probably not.
“While a woman is pregnant, there is so much focus on her,” says Laura Laursen, MD, an OB/GYN at Chicago’s Rush University Medical Center. “But after she delivers, all that attention goes to the new baby.”
The realities of postpartum life are, to many, still a little too real for mainstream conversation. This made headlines in the run-up to Oscar night, when an ad for the postpartum care brand’s Frida Mom — that would have given 23.6 million American viewers a rare, raw glimpse into the physical struggles the majority of new mothers face —was rejected as “too graphic” by both ABC and the Academy.
No one’s saying that when there’s a newborn to keep alive, your splotchy weird skin should be at the top of the priority list. But Breighl Robbins, an integrative health practitioner and the founder of new post-partum wellness brand Ebi, argues that it’s healthy for new moms to think about themselves, too. “Until recently, there was such a dearth of options related to recovery,” Robbins says. “Women were expected to scramble to find what they needed, and make the best of it.”
Here are a handful of beauty wildcards to help you get a handle on whatever might pop up — both during pregnancy and the year (and, admittedly, sometimes longer) post-baby.
Hair, Hair, Hair
It’s an age-old cliche that after you have a baby, you never have time to wash your hair. But that’s not the half of it: Early motherhood is a follicular see-saw. Post-baby hair loss usually starts three months after giving birth and lasts until around month six. And it’s surprisingly random; some women experience it with one child and not another.
“The widely accepted reason for postpartum hair loss is shifts in estrogen, a female hormone that helps keep hairs in the anagen, or growth, phase,” says Annabel Kingsley, a trichologist (aka hair and scalp expert) at New York’s Phillip Kingsley salon. Estrogen levels are through the roof when you’re pregnant, hence the voluminous mane, but as they drop postpartum, so does your hair, literally. “The shedding makes sense, but often the scale tips a bit too much and you end up losing, initially, more hair than you gained.”
Kingsley rattles off a host of other factors beyond hormones that can contribute to hair issues: iron deficiency, gestational diabetes, thyroid imbalances, poor eating habits, severe blood loss during birth, and general anesthesia. “High stress levels and severe psychological distress, such as with postpartum depression, can even be the sole cause of hair loss,” she adds.
To contend with all this hair trauma, Kingsley underscores the importance of an iron-rich diet (think beetroot, spinach, and steak) and a little extra scalp attention. “A healthy scalp won’t prevent hair loss, but an unhealthy one can make it a lot worse,” she says. Shampoo no less than every three days—removing sebum keeps follicles unblocked—and regularly use a treatment (she recommends Philip Kingsley’s Tricho 7 Volumizing Scalp Drops or Stimulating Scalp Toner; another option is Act + Acre Scalp Detox). Hair usually starts to feel like its pre-pregnancy self around the time your baby turns one, but if shedding persists, ask your doctor to do bloodwork to make sure nothing else is awry. “Iron, ferritin (stored iron) and Vitamin B12 deficiencies are incredibly common post-pregnancy and they almost always contribute to hair loss,” Kinsley explains.
Protecting skin is critical during pregnancy, but also in the months after, when hormones are still going haywire. “It takes a while for levels to return to normal after birth,” explains New York dermatologist (and mother of two) Dendy Engelman, MD. With hormones running high, UV exposure can result in hyperpigmentation, aka melasma, the diffuse brownish pigment also known as chloasma — and sometimes ominously dubbed the “mask of pregnancy” — that can show up on cheeks, forehead, and upper lip (it also often appears in women taking hormonal birth control). According to NYC dermatologist Carlos Charles, MD, melasma is especially prevalent among women with darker skin tones. The best way to handle it: avoid getting it in the first place, via dutiful sun protection, preferably by wearing a hat plus a physical or mineral sunblock, such as zinc oxide. The good news is, if melasma does show up, you don’t have to wait to treat it. Engelman says an over-the-counter glycolic acid (which is an alpha hydroxy acid [AHA] versus a beta hydroxy acid) is safe to use in lower percentages while pregnant and breastfeeding.
If you went off the pill before becoming pregnant, that shift alone can be seismic for skin. The estrogen in birth control pills can reduce acne, Laursen says, “so removing those pills will sometimes lead to more of it.” Hormonal fluctuations during pregnancy and in the period after, particularly with the return of your menstrual cycle, can cause an increase in progesterone and androgens that can lead to more oil production, and, in turn, more acne. It’s like puberty all over again. Hormone surges can also lead to more intense breakouts—so suddenly you may find yourself dealing with acne of the painful, cystic variety for the first time. There’s no magic bullet here: Even after pregnancy, doctors will tell you to steer clear of most gold-standard acne remedies (retinoids and Retin-A, tetracycline, Accutane), especially if you’re breastfeeding. Engelman suggests swapping in products with antioxidants and exfoliating glycolic acid instead. “Vitamin C, resveratrol, and Vitamin B3 are all proven to be powerful at reducing oxidative stress,” she adds. Her favorites: Skinceuticals CE Ferulic, Skinbetter Alto Defense Serum and L’Oreal’s new 10% Pure Glycolic Acid Serum.
Though it’s largely hereditary, eczema is often triggered by something that happens to be a regular postpartum occurrence: stress. Lack of sleep, which is unavoidable in early motherhood, can be another trigger. The usual treatment rules apply to postpartum flare-ups, when skin appears dry, red, scaly and cracked: Consistent moisturizing with a product that is both emollient and fragrance-free (like Cerave moisturizer); brief, lukewarm showers; and fragrance-free soaps and laundry detergent. Engelman advises layering products for optimal moisturization. “Instead of applying one thick, heavy cream, layer products, starting with the lightest and finishing with the thickest, to provide multiple barriers,” she says. “The more pliable and moisturized skin is, the less it will be prone to crack and itch.”
These small, red itchy bumps around the mouth — often mistaken for acne — are another hormonal side-effect. Bacterial or fungal infections, rosacea, and environmental factors like excess heat can also contribute to flare-ups. Engelman advises patients to avoid fluoridated toothpastes, take a daily probiotic, and use a face wash with sulfur such as Mario Badescu Special Cleansing Lotion C. Depending on the level of intensity, the bumps can take up to a month to clear up.
Keloids and Skin Tags
The raging hormones that helped you build a human can also rev up your own skin cell production, causing benign growths known as skin tags, often along the neckline and underarms (wherever clothing rubs against the skin). Both Engelman and Charles say skin tags are harmless, but they can get caught on clothing and jewelry, becoming inflamed or infected. And you may just dislike the look of them. If so, they can be removed by your dermatologist with liquid nitrogen, electrodesiccation, or surgically.
Keloids, or large raised scars formed by an overgrowth of scar tissue, will be especially familiar to women with darker skin. “They can occur in response to any form of trauma or inflammation,” says Charles, “and are often seen after C-section deliveries, along the incision line.” There are lots of ways to treat keloids: the PicoSure, a “picosecond” laser treatment, which targets pigmentation; steroid shots break up the excess collagen in thicker scars; and photodynamic therapy uses light to target keloid fibroblasts and other lesions. Plastic surgeons and dermatologists can also perform scar revision surgery, which involves excising the scar with a small punch and suturing it closed. But all of these options are best done after you’ve stopped breastfeeding.
Varicose Veins and Stretch Marks
Most of us do know varicose veins and stretch marks are a common after-effect of childbirth. This is because an overall increase in blood volume and fluid, plus rapid changes in body weight, can be a direct path to both varicose veins (dilated superficial blood vessels) and stretch marks (slender red and white scars). To counteract the increased pressure on veins during pregnancy, Laursen tells patients to elevate their legs as much as possible, wear compression socks, and avoid long periods of sitting, standing, or exercising. Essentially, keep moving your legs. Engleman treats varicose veins with sclerotherapy, in which a solution is injected into the vein, forcing it to collapse, which stops blood flow. “Unless someone has a major issue with needles, it’s not particularly painful,” Engelman says. “The vein will turn into a scar and fade after a few weeks, and most people report a 50 to 90 percent improvement.”
The propensity for stretch marks is often genetic. Women of color are especially susceptible to these, and if you have a family history of them, you are more prone to get them during pregnancy. They do tend to fade over time, but Engelman says studies have shown that several over the counter remedies can aide this process: Bio Oil, the cult-beloved, no-frills oil developed for scar treatment; Serica Moisturizing Scar Gel; and one of Serica’s key ingredients: Pracaxi Oil, made from an Amazonian “superfruit.”
While there is plenty of debate about the safety of various skincare ingredients during pregnancy and breastfeeding, there is also a dearth of good data on the subject. The FDA buckets ingredients into categories: Category A and B are considered OK for pregnancy and breastfeeding women, while Categories C, D, and X should be avoided. The watchlist below is widely agreed upon by the FDA and most healthcare professionals.
In terms of deciding whether or not to continue using the many other ingredients in your regular skincare regimen, there’s no rulebook: It depends on who you ask. For peace of mind, many women, and some experts, prefer to go as natural as possible with whatever they put on their skin. “We need more substantial evidence to know what and how much is absorbed into the bloodstream, therefore I always advise my patients to err on the side of caution,” Engelman adds. If you have doubts about a product, the online database of the Environmental Working Group [EWG] — an organization that definitely errs on the side of caution—is a good place to search by product or ingredient.
Here, five ingredients to keep an eye on, both during pregnancy and post-partum:
While most dermatologists don’t believe you have to go all organic all the time, they will usually advise looking closely for one word on beauty ingredient lists: fragrance. It can be a sneaky catch-all for a wide array of chemicals. “Fragrances are usually made up of other harmful chemicals, like parabens, benzene derivatives, aldehydes and more,” says Engelman. “Short term, they can cause irritation and redness,” to which pregnant and post-partum women are especially prone. Engelman reels off a whole lexicon of fragrance words to look out for — parfum, perfume, linalool, limonene, eugenol, citronellol, geraniol or cinnamal—and advises seeking out fragrance free products when possible.
This chemical has been linked to cancer as well as other nervous system issues and respiratory irritations. Some in-salon hair-straightening procedures still use formaldehyde, and it can also still be found in some nail polishes. Look for polishes labeled 3-Free or 5-Free (like JINsoon Nail Polish). In mascara, watch out for diazolidinyl urea, which has been found to release formaldehyde. (Vapour Beauty makes a mascara that is a safe bet.)
Retinol and Retinoids
Shown to boost collagen production and speed skin’s self-renewal process (known as cell turnover), these Vitamin A derivatives are dermatology’s most frequently name-checked anti-agers. But both the prescription strength and over-the-counter varieties should be shelved during pregnancy and while breastfeeding—they’ve been linked to birth defects and disruption in fetal development. Accutane, or the oral form of Vitamin A available by prescription, is also off limits. For the safest “active” alternative, swap in products with Vitamin C instead.
Salicylic Acid and Benzoyl Peroxide
Both salicylic acid and benzoyl peroxide are tried-and-true acne fighters. Though they don’t get the same cautionary warning as the Vitamin A family, but opinions are divided on using them either during or post-pregnancy. Some doctors, including Laursen, think it’s fine for new and expectant moms to use them in small doses, while other skincare experts advise patients to avoid them if possible. If you have doubts, seek out other effective options like glycolic and lactic acid, prescription topical antibiotic clindamycin, and sulfur-based acne treatments.
Chemical sunscreens often contain a multitude of questionable ingredients, such as parabens, phthalates, and oxybenzone. The latter, in particular, “has been linked to low birth weights, which is a risk factor for future coronary heart disease, hypertension, type 2 diabetes, and other diseases,” says Engelman. “It can also affect the body's hormones, which may cause developmental problems in unborn babies.” Look for a mineral sunscreen whose primary ingredient is zinc oxide or titanium dioxide; both Elta MD and Cerave make good options.
Fiorella Valdesolo is a writer, editor, and the co-founder of the James Beard award-winning magazine Gather Journal. She regularly writes about beauty, health, style, design, culture and travel for a variety of print and online publications. She lives in Brooklyn with her partner Nate and daughter Aluna. Her dream interview is Stevie Nicks. Find her on Twitter @Fifival.
[from this original article by Fiorella Valdesolo https://www.shondaland.com/live/body/a30933285/the-surprising-ways-your-body-changes-after-childbirth-and-how-to-deal-with-it/]