State-of-the art dermatology and plastic surgery allow us to seek treatments that offer instant gratification when we're not pregnant, but that doesn't always hold true when we're carrying another life inside of us.

Some fortunate women feel incredibly beautiful when they are pregnant, though many others feel awkward and unattractive. The reality is that pregnancy makes us look different. Pregnancy is characterized first and foremost by weight gain, but in addition, drastic hormonal fluctuations lead to physical changes in skin and hair that may affect appearance. On top of these changes, certain beauty routines, such as getting Botox® (botulinum toxin type A) injections or using topical Retin-A, are forbidden during pregnancy.

According to Dr. Jeanine Downie, a dermatologist and the director of Image Dermatology in Montclair, N.J., the three main dermatological problems during pregnancy are acne, eczema and melasma. "Plus, skin conditions that have been under control may flare," she says. Fortunately, acne, eczema and melasma can be addressed during pregnancy, but the options are limited.

For clients with acne, Dr. Downie recommends glycolic or salicyclic acid peels as frequently as once a month. Both improve skin texture and tone, help with very fine lines and are considered safe during pregnancy. Acne is a common concern, but pregnant women should always approach a dermatologist or plastic surgeon for treatment, because the vast majority of prescription and over-the-counter acne medications are contraindicated during pregnancy. Dr. Downie is adamant in not allowing her pregnant patients to use products with tretinoin, which is the active ingredient in Retin-A and Renova. In pre-clinical studies in mice, there was some evidence of fetal toxicity and birth defects in animals treated with tretinoins.

In addition, Dr. Downie advises that pregnant women should not use prescription drugs, Differin (adapalene) or Tarazac, or over-the-counter drugs, Benzoyl peroxide or ProActive. Certain topical steroid creams, such as Clindagel (clindamycin) or Erygel (arithromycin), are safe for acne and eczema, but again only with the guidance of a qualified physician.

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