Host of skin changes plague pregnant patients. (Obstetricians Should Know Possibilities).

PALM BEACH, FLA. -- Hair loss, hyperpigmentation, striae, and other pregnancy-related physiologic changes may be of little consequence to physicians, but they generate considerable patient concern, dermatologist Kenneth Tomecki said.

Women who notice their hair thinning or falling out in clumps shortly after delivery, for example, need to be reassured that telogen effluvium is a common but self-resolving response to the build-up of hair during pregnancy. While hair loss is particularly distressing, however, it is just one in a range of common skin changes with which obstetricians need to be familiar, Dr. Tomecki commented at the annual meeting of District V of the American College of Obstetricians and Gynecologists.

Hirsutism, which about half of all pregnant women develop, is another. The coarse, male-type hair" they acquire generally remains after pregnancy and may require electrolysis or treatment with a hair removal product, said Dr. Tomecki of the Cleveland Clinic Foundation.

Virtually all obstetrical patients exhibit some form of hyperpigmentation, typically on the breasts, nipples, and areolae. It also affects the face and often occurs on the genitals and anus, "but any area of the body is a potential site," Dr. Tomecki reported. About three out of four obstetrical patients develop melasma, a macular hyperpigmentation that presents as facial blotches, but those who acquire the raccoon-like "mask of pregnancy" are apt to find it most upsetting. The pigmentary changes generally fade, but persistent cases may require treatment with tretinoin or a topical cortisone, he said.

Vascular/hematologic changes are common, too. About two-thirds of pregnant women develop vascular "spiders" that usually disappear after ...