Medforum: Which of these symptoms can be most worrying for a pregnant woman?

Dr A. Damasiewicz-Bodzek: Many of the symptoms listed above are expected by the pregnant woman and do not come as a surprise. Often, however, a source of worry for the pregnant woman are the pigmentary changes, which are sometimes very pronounced. An increase in the amount of pigment in the skin and mucous membranes manifests itself in increased pigmentation of the white crease, the areolae of the nipples, the skin of the umbilicus, the armpit pits, the genital area and a blue-violet colouring of the vulvar mucous membranes. An increase in the skin's sensitivity to sunlight manifests itself in the discolouration of freckles and pigmented spots and often the formation, especially in the face, of so-called 'pregnancy osteoma' - irregular yellowish to dark brown spots ('butterfly', 'glasses', 'moustache'). The pigmented nevi often enlarge and become noticeably darker, and it is not uncommon for new nevi to form. There is an increased tendency for malignant transformation of pigmented nevi (nevi that are markedly enlarged or exposed to irritation should be removed).

Medforum: What are the most common dermatoses occurring in pregnant women that require absolute diagnosis and treatment?

Dr A. Damasiewicz-Bodzek: There are skin diseases occurring only during pregnancy, directly related to it, specific to this period. These are the so-called dermatoses of pregnancy. Most of them, despite their often protracted and subjectively troublesome course (accompanying pruritus), do not pose a threat to the mother or the foetus. Antihistamines and external preparations with soothing, anti-inflammatory and antipruritic effects are usually used in the treatment of these conditions. However, there are (fortunately rarely) gestational dermatoses with a severe course and a serious prognosis for both mother and foetus. These require intensive and specialised therapeutic management. These mainly include impetigo, herpes zoster of pregnancy and progesterone autoimmune dermatitis of pregnancy.

Medforum: Should all skin diseases be treated during pregnancy?

Dr A. Damasiewicz-Bodzek: Of course, but under the care of a specialist. The dermatologist will select medications that are safe for the period of pregnancy (if oral preparations are necessary) and will propose appropriate local treatment (in many cases, effective external therapy is sufficient and the risk of its impact on the foetus is negligible if the area of treated lesions is small).

Many skin lesions are infectious and it would be downright dangerous to leave them untreated. There are, of course, dermatological drugs that are absolutely prohibited during pregnancy. Furthermore, there are drugs for which pregnancy should not be carried out even up to two years after the end of therapy. Therefore, patients who suffer from chronic skin diseases requiring specialised treatment should inform their dermatologist about their procreative plans and obtain the relevant information on how to safely become pregnant.

Medforum: Does pregnancy significantly affect the course of skin diseases?

Dr A. Damasiewicz-Bodzek: In many cases yes, and in different ways. In some diseases, the period of pregnancy has a beneficial effect, alleviating the symptoms (acne, alopecia areata, vitiligo, many cases of psoriasis), in others the opposite (some cases of psoriasis, collagenosis). Very often, diseases whose symptoms improve during pregnancy again worsen after childbirth.

Medforum: Is there any skin care model to prevent the unpleasant consequences of pregnancy (stretch marks, not very elastic skin)?

Dr A. Damasiewicz-Bodzek: As I have already mentioned, it is important to remember proper, healthy nutrition and supplementation with vitamins recommended for pregnant women. The skin, especially during pregnancy, requires adequate hydration. Showering to stimulate the blood circulation in the skin is beneficial. After each bath, do not forget to massage a moisturising lotion or milk into the slightly damp skin. Of course, those areas of the skin that are subject to the most tension require special attention. A gentle daily massage using specially designed preparations will prevent the formation of cosmetically unattractive stretch marks. However, it is important to remember that these treatments need to begin before stretch marks appear, so the skin in this area needs to be prepared for the hard times ahead. If we do this regularly, our skin will become more elastic and stretchy, and will therefore be able to survive pregnancy without stretch marks, and will be better toned and return to its good shape sooner after giving birth.

Medforum: Thank you for the interview.

Dr A. Damasiewicz-Bodzek: Thank you very much.