One of the main cosmetic concerns we have when we are pregnant is the appearance of spots (or chloasma) on the face. Although they arise due to natural causes, the best thing we can do is always prevent them. For this purpose, the best ally in our cosmetic routine is a good sunscreen, especially if it has a formula that includes anti-aging and anti-stain ingredients.
Why do spots appear during pregnancy?
Chloasma or melasma, also known as 'pregnancy spot' or 'pill spot', are brown spots that appear on the face, especially on the moustache, cheekbones and forehead.
These can be more or less intense depending on the time of exposure to the sun and are caused by hormonal changes typical of pregnancy, since there is an increase in the level of progesterone and estrogens that affect the production of melanin (the natural pigment that gives color to the skin to protect it from solar radiation).
For this reason, it is vital to sunbathe with caution and use a broad-spectrum sunscreen, even if we are not going to be directly exposed to the sun. Fortunately, on the market we can find formulas that help us prevent and even correct spots if we already have them.
During pregnancy, hormones that are naturally produced in the body stimulate melanocytes (the melanin-producing cells located in the basal layer of the epidermis) to produce more melanin. Melanin is the pigment that, in excess, forms the spot.
Although hyperpigmentation caused during pregnancy usually disappears during the first year after the birth of the baby, there are cases in which it can persist for longer. The best thing in any case is good prevention and the best way is to protect ourselves from the sun.
What should be taken into account?
When choosing a sunscreen or any other cosmetic product for pregnant women's skin, it is especially important to read the label and the list of ingredients (the so-called INCI, International Nomenclature of Cosmetic Ingredients).
In this regard, it is worth remembering that the order in which the substances are listed is important: the first ones have a higher percentage, while the last ones are present only in small quantities.
1. UVA and UVB radiation
The sun's rays are not all the same. UVB rays are responsible for erythema, redness (and in more severe cases, sunburn), but they do not penetrate deeply into our skin. UVA rays, on the other hand, do not cause superficial problems, but are more harmful because they can damage the DNA of cells, leading to premature aging and skin tumors.
Therefore, you should always choose a broad-spectrum sunscreen that is effective against both UVB and UVA radiation.
2. Sun protection factor (SPF)
The SPF indicates the product's level of protection against the sun's rays: the higher the SPF, the greater the protection. During pregnancy, a minimum SPF of 30 is recommended, although many dermatologists recommend 50 or more to better protect the skin from the appearance of sun spots (and to prevent existing ones from getting worse).
In this regard, it is important to note that UVB rays increase with increasing altitude (for example, at 1800 meters above sea level we have +30%, which rises to +35% at 2100 meters). Therefore, in the mountains it is important to use a higher sun filter.
3. Physical filters and chemical filters
Physical filters (also called mineral or inorganic filters) are natural substances that, being opaque, form a kind of protective screen on the skin and prevent the sun's rays from reaching it. These include, for example, zinc oxide (INCI: zinc oxide), an ingredient often found in creams for baby's red bottom.
Chemical filters, on the other hand, absorb the energy emitted by the sun's rays and release it in the form of heat. Unlike physical filters, they do not remain on the surface, but are absorbed by the skin. In some cases, they can also penetrate the body, with health effects that researchers are still trying to clearly establish.
For these reasons, it is preferable to use sunscreens with physical filters during pregnancy and breastfeeding.
4. Water resistance
A good sunscreen should be water resistant or very water resistant, meaning it should remain effective on wet skin for 40 or 80 minutes, respectively.
5. Perfumes
Dermatologists recommend choosing sun protection products without added fragrances (fragrance-free). The reason is that these ingredients can be irritating and sensitize the skin to the sun (photosensitivity and photoallergy).
6. Petroleum
Petrolatum (INCI: mineral oil, petrolatum, paraffinum liquidum, microcrystalline wax) are substances derived from petroleum refining. They can be irritating and comedogenic, meaning they clog the skin's pores, making it difficult to breathe and promoting the formation of spots and blackheads.
Given the increased sensitivity of the skin and increased sebum production during pregnancy, it would be best to avoid sunscreens containing petroleum jelly.
7. Insect repellents
Some sunscreens are combined with mosquito repellents for double protection against the sun and insect bites. These products are not recommended, whether you are pregnant or not, as they slow down the evaporation of the repellent and increase its absorption through the skin.
If necessary, it is recommended to choose two different products and apply the sunscreen about 20 minutes before the mosquito repellent (never the other way around).
8. Expiration date
Sunscreens do not have a real expiration date, but rather a so-called PAO (Period After Opening) date, which indicates how long the product can be used after it has been opened.
The PAO is represented on the packaging as an open can containing a number, usually between 9 and 12 months. Once the recommended use limit is exceeded, sunscreens no longer offer safe and effective protection, exposing the skin to the risk of redness, irritation and blemishes.
“Risky” ingredients
In recent years, some substances commonly used in cosmetics and sunscreens have attracted the attention of research, raising questions about their safety for pregnant women.
1. Oxybenzone
Oxybenzone (INCI: oxybenzone) is a chemical filter that is being investigated for its possible hormonal effects.
As a precaution, sunscreens containing oxybenzone are not recommended during pregnancy or in children.
There are also environmental considerations: oxybenzone appears to be potentially harmful to sea anemones and contribute to the bleaching of marine corals.
In 2020, the U.S. Food and Drug Administration (FDA) placed oxybenzone under surveillance along with other chemical filters: avobenzone, octocrylene, homosalate, octisalate, and octinoxate.
Pending the results of these investigations, caution is advised when using sunscreens containing the above-mentioned filters during pregnancy.
2. Parabens
Parabens are used as preservatives in skin care products. Recognizing these ingredients in the INCI is quite easy because they end with the suffix “-paraben” (such as methylparaben, ethylparaben, etc.).
A 2000 study of pregnant women found that these substances can interfere with the hormonal mechanisms that regulate fetal growth, increasing the risk of obesity.
3. Nanoparticles
Ingredients in the form of nanoparticles (INCI: nano + name of ingredient), due to their very small size, can penetrate the body, with long-term effects yet to be clarified.
So when it comes to sunscreens, it might make sense to favor “non-nano” ingredients during pregnancy.
In any case, if you have any doubts about the safety of the ingredients contained in sunscreens or any other cosmetic product, it is always advisable to consult a doctor.
How to choose a sunscreen during pregnancy?
Choose a photostable and broad spectrum sun filter against the 4 radiations (UVB, UVA, Visible and Infrared).
Choose one that contains a physical or chemical filter and also a biological filter. A biological filter is an antioxidant that will neutralize and repair sun damage.
Choose one that is suited to the activity you are going to do. It's not that you need a different sunscreen for every activity, that would be crazy, but perhaps for everyday use you prefer one that has a bit of color and for walking another that is sweat-resistant and doesn't sting your eyes.
Finally, and although it may seem obvious, texture is going to be very important when choosing a sunscreen, especially if we have suffered changes in our skin during pregnancy. If you have combination skin and are bothered by shine, you will appreciate oil-free textures, but if, on the other hand, you have dry skin, you will need one with extra hydration.
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How to use it correctly?
You should follow the same rules as when you were not pregnant.
Read the product instructions carefully.
Apply the cream about 20-30 minutes before exposure and every 2 hours afterwards (even in cloudy weather).
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Reapply after swimming or sweating heavily, even if the label says “water resistant.”
To maintain the product's characteristics intact, do not expose the packaging to direct sunlight and, if possible, store it in a protected place.
Italian Association of Dermatology and Cosmetology (AIDECO). Frequently asked questions.
American Academy of Dermatology (AAD) Association. How to choose a sunscreen.
American Academy of Dermatology (AAD) Association. Is sunscreen safe?
American Academy of Dermatology (AAD) Association. How to decipher sunscreen labels.
Vuckovic D, Tinoco AI, Ling L et al. Conversion of oxybenzone sunscreen to phototoxic glucoside conjugates by sea anemones and corals. The science. 2022 May 6;376(6593):644-648). doi:1126/science.abn2600
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Matta MK, Florian J, Zusterzeel R, et al. Effect of Sunscreen Application on Plasma Concentration of Sunscreen Active Ingredients: A Randomized Clinical Trial. JAMA. 2020;323(3):256–267. doi:10.1001/jama.2019.20747
Philippat C, Botton J, Calafat AM, Ye X, Charles MA, Slama R; EDEN Study Group. Prenatal exposure to phenols and growth in children. Epidemiology. 2014 Sep;25(5):625-35. doi: 10.1097/EDE .00000000000132. PMID: 25061923; PMCID: PMC4724208.
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