Taking care of your skin is always important, but during pregnancy it is even more important. This is the opinion of Montserrat Fernández Guarino (Madrid, 46 years old), dermatologist at the Ramón y Cajal hospital in Madrid and director of Madriderma, a private clinic in Madrid. Fernández Guarino specializes in skin health during pregnancy and as such has just published mother’s skin (Círculo Rojo, 2025), a book that offers practical and safe advice for pregnant women who want to take care of themselves without risks and without falling into misinformation.
The volume provides tools that are easy to apply and focused on health, far from passing fads or unverified recommendations. The key, he assures, is to have reliable information and maintain a simple routine that protects without complications or excess. As the doctor explains, in the scientific field her discipline studies dermatoses – any alteration or disease that affects the skin, the largest organ of the human body – specific to pregnancy, although many women also turn to her for clear answers on the daily care of their skin and hair in this period. “The hormonal alteration causes changes in the structure, vascularization and sensitivity to the sun, as well as favoring the appearance of stretch marks and blemishes,” he explains. And she insists that, with the appropriate recommendations, “women can take care of themselves safely and effectively.”
ASK. What is the contribution of dermatology to pregnancy care?
ANSWER. Dermatology delves into the typical dermatoses of pregnancy which, although rare, are very specific. But above all it offers useful tools for taking care of skin and hair in daily life, and for treating aspects such as scars or perineal care after childbirth. Many women ask what products they can use, how to prevent stretch marks or what to do if they have acne or pigmentation spots. Dermatology can provide reliable answers to these doubts in such a delicate moment.
Q. How does your skin change during pregnancy?
R. Obviously. The skin is influenced by a hormonal cocktail that alters many functions. It changes vascularity and consistency, increases fluid retention and becomes more sensitive to the sun. Furthermore, progressive distension can cause itching and stretch marks, and previous pathologies such as dermatitis or psoriasis can improve or worsen. Pathologies such as melasma – the appearance of dark spots on the skin, especially on the face – or gestational acne also appear.
Q. And the hair?
R. Initially, many women notice that they have stronger, shinier and denser hair, due to the increase in estrogen. But after giving birth, with the decline in hormones, hair loss occurs, called telogen effluvium, which can be alarming, although in most cases it is reversible. In my book I explain how to recognize it, when to contact a specialist and which cosmetic treatments can be useful.
Q. What treatments can be useful to prevent hair loss in the postpartum period?
R. I would say that postpartum hair loss cannot be avoided. What can be done to help you have better quality and faster recovery. Before giving birth it is important to monitor iron levels: it helps oxygenation, proliferation and hair growth. And after giving birth, assume that this fall will happen, without worrying, and focus on maximum care from both inside and outside. From a general point of view, monitor your diet and use nutritional supplements if compatible with breastfeeding. On a specific level, good hydration of the scalp with delicate, non-irritating and preferably hydrating shampoos, and care of the hair fiber with specific masks and also hairdressing treatments, always adapted to the type of hair. All this does not prevent breakout, but ensures that its impact is less, that the hair stays looking better and that the hair recovery process is more bearable.
Q. Is there a relationship between the sex of the baby and changes in the pregnant woman’s skin?
R. It’s one of those questions we hear often. But there is actually no scientific evidence linking the sex of the baby to changes in the expectant mother’s skin. Sebum secretion during pregnancy, which can cause acne, responds to androgen levels, which increase regardless of whether you are male or female.
Q. What about stretch marks? Can they be prevented?
R. Not always. Genetic factors and previous connective tissue quality have a lot of influence. Also the amount of relaxation. But we can take care of our skin: adequate daily hydration helps keep it resistant and reduce the risk of breakage. Ingredients such as glycerol, ceramides, centella or hyaluronic acid are safe and effective. And, after giving birth, treatments like laser or radiofrequency can improve your appearance.
Q. What recommendations are there for preparing the perineum for vaginal birth?
R. With pelvic floor exercises, physiotherapy and massages with specific oils it is possible to make the area more flexible and facilitate dilation. This care also prevents tears and improves the birth experience, a fundamental aspect for living it with respect and care.
Q. To what extent can skin care become excessive during pregnancy?
R. Many times confusion arises: more products do not always mean better care. It is important to apply only what is strictly necessary, with safe products and avoid active ingredients that can damage or irritate. A simple routine is enough: skin cleansing, sunscreen and moisturizer. And keep in mind that behind many campaigns there are commercial interests that push people to buy more and more, with social pressures and a distorted idea of beauty.
Q. What advice do you have for taking care of facial skin during pregnancy?
R. First, check what ingredients are used. Retinoids, some depigmentants, or hydroquinone should be avoided. For the rest you can maintain a safe routine: mild acids in the evening, antioxidants such as vitamin C in the morning, always with sunscreen. And, above all, inform yourself well, judiciously and without obsessing.
