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157: Pregnancy Skin Changes Explained: Stretch Marks, Hyperpigmentation, Varicose Veins & Itchy Rashes

April 29, 2026 · 15 min

Show notes

Certified nurse midwife Roxanne explains common skin changes in pregnancy caused by hormonal shifts, increased blood volume, and a growing belly, including hyperpigmentation (melasma, linea nigra), vascular changes (spider veins, varicose veins), and stretch marks. She shares practical tips like daily SPF and sun protection for darkening, and compression socks, avoiding prolonged standing/crossing legs, walking, and massage to support circulation. For stretch marks, she notes there’s no evidence that creams prevent them during pregnancy and retinoids aren’t recommended until postpartum; causes are multifactorial (genetics, collagen, hydration, baby size/weight gain). Roxanne also reviews pregnancy itching and rashes: PUPPP (third trimester, spares belly button), atopic eruption (first/second trimester, widespread), and more concerning conditions needing evaluation—ICP (itching palms/soles), pemphigoid gestationis (starts at belly button; risks for baby), and rare pustular psoriasis with systemic symptoms—advising viewers to contact their provider for assessment and treatment options.


Watch our video about ICP here: https://youtu.be/uzZz2KuZDAU


00:00 Welcome and Introductions

01:01 Why Skin Changes Happen

01:44 Hyperpigmentation and Melasma

02:40 Spider and Varicose Veins

03:48 Stretch Marks Truths

06:18 Common Changes Recap

07:15 Itching and PUPPP Rash

08:57 Atopic Eruption Explained

09:53 Red Flags and Serious Rashes

13:45 Final Recap and Next Steps



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