By Phyllis Hanlon
Originally published in ASCP's Skin Deep, August/September 2006.
Bubbling with excitement, your ten o’clock appointment announces her just-confirmed pregnancy. While you share in her joy, you also hope to maintain or even strengthen your relationship with her at a time many ordinary skin treatments aren’t suitable.
While there are some don’ts in caring for a pregnant client, there are many things you can do to help mom feel relaxed and pretty while she rides the hormonal roller coaster.
Start With the Basics
Pregnant woman have a very sensitive sense of smell. Even a pleasant scent can cause discomfort, headache, or nausea. Go easy on the fragrance sprays, potpourri, incense, and open product containers in your workplace.
As her pregnancy advances to the second and third trimesters, your client may find certain physical positions challenging. After the first trimester, use a semireclined position. Use a pregnancy wedge (a special pillow) or as many as four regular pillows to support mother’s back and have her knees bolstered also. This way the growing baby is not resting on the abdominal aorta and inferior vena cava, which may cause fluid to accumulate in the lower extremities.
Diane Davies, a licensed cosmetologist and esthetician from Woodstock, Connecticut, offers her pregnant clients water immediately after a facial to flush metabolic wastes freed from tissue out of the system. Another tip for a client in the later stages of pregnancy is to limit treatments to thirty minutes or less as she copes with frequent trips to the restroom.
Thorough is Better
Do a thorough health intake and ask your client to update you on any medical, skin, or allergy changes at each visit, including through the breastfeeding period. Your expertise on products and treatments during pregnancy is an added customer service, although it’s certainly wise to request that your client have her physician approve any treatments that seem questionable.
Facials: Banishing Blahs
Facials can help a pregnant woman feel better about her changing physical appearance and foster a positive attitude. Davies says there is no one-size-fits-all facial for this client, but the usual rules about skin typing still hold.
Anifa Cazimoski, licensed esthetician at Faces Plus in Wayne, New Jersey, recommends a facial every six to eight
weeks during pregnancy to rebalance and moisturize the skin.
For home care, she advises a simple routine of cleansing, toning, and gentle exfoliation.
During the first trimester, a woman’s body produces more androgenic hormones—those with male-type properties—according to Barbara Dehn, RN, MS, NP, of Women Physicians OB/GYN Medical Group in Mountain View, California. “This could mean an increase in acne on the face, chest, and back, which may correlate with an adolescent history. Or it may be a brand-new onset,” she says.
As pregnancy progresses, oil production usually increases, although sometimes dryness may occur along with scaling and itching. In severe cases, an itchy rash may develop that necessitates intervention by a dermatologist.
The developing fetus is susceptible to adverse effects from harsh chemicals, particularly in the first trimester, according to Julia Tatum Hunter, MD, of Beverly Hills, California. “Cosmetics, makeup, and other skin care creams and lotions contain ingredients that can be transdermally absorbed,” she says. “They are deposited in fat and absorbed into the bloodstream, circulating to the fetus.”
According to Joshua Fox, MD, founder and director of Advanced Dermatology in New York, glycolic and salicylic acid should be avoided, since even small amounts could negatively affect the baby. “Any type of acid tends to penetrate the skin,” he says. “Most of these agents have not been well studied. It’s best to be conservative.” Fox warns against chemical peels during pregnancy, due to the alpha hydroxy and salicylic acids used in these preparations. Additionally, vitamin A, retinols, teratogenic agents, and even antihistamines can be harmful to a developing fetus, Fox says. Any doubts about a product that isn’t specified as safe during pregnancy deserve a call to the manufacturer or a change of plans.
Essential oils can soothe many of the discomforts of pregnancy, and there are a few applications an esthetician untrained in aromatherapy can safely use. Stick to therapeutic-grade essential oils in small amounts. For example, use a small amount of lavender or mandarin in a mist (six drops per one ounce of water), added to a steamer (one drop), or in scenting facial towels (one drop added to the hot towel cabinet).
Among the essential oils that should be avoided by the unschooled practitioner are basil, camphor, cedarwood, cinnamon bark, hyssop, jasmine, myrrh, pennyroyal, peppermint, rosemary, sassafras, sage, thyme, savory, and wintergreen.
Be sure to check product labels for any essential oils that might be blended into common products. Most often it is camphor oil.
Under the Sun
While sun protection is a high priority with skin care professionals, prudence is necessary when recommending a sunscreen to pregnant clients. Check with the manufacturer to ensure these easily absorbable products are appropriate during pregnancy.
“Your immunity decreases during pregnancy,” Fox says. He explains overexposure to the sun suppresses the body’s ability to produce antibodies, which may cause an allergic reaction manifesting as hives, rashes, facial swelling, or, in rare cases, breathing difficulties.
These warnings, in conjunction with standard sunshine precautions, may tempt a woman to use self-tanning products. Although no evidence exists to discredit these products, Fox frowns on their use during pregnancy.
Elaine Sterling, assistant director of education at the International School of Skin and Nailcare (ISSN) in Atlanta, emphasizes little evidence exists on the safety of certain procedures and products for pregnant clientele. “Obviously, you can’t perform tests on this population,” she says. “There is not enough proven data on how microdermabrasion and chemical peels affect the fetus.” Sterling rejects light therapy, which can penetrate bones, and cautions against body wraps as they raise a woman’s temperature, which runs counter to medical recommendations. The use of galvanic and high-frequency machines is not recommended since these therapies push product into the skin.
Spread the Joy
Offering mother-to-be gift packages on your own or by teaming up with other practitioners, such as massage therapists, can be a win-win-win, while providing a thoughtful, easy-to-buy shower gift friends and family will enjoy giving. Gift certificates are one option, or work with a florist to create a gift basket with a coupon or certificate tucked inside. It’s also a nice way to get your name in front of baby-shower guests and remind them beautiful skin isn’t just for babies.