CAP CLASSROOM: THE PREGNANCY PROTOCOL

It's clear that we rely on Kristina Holey as our most trusted and thorough source for all matters related to the skin. So when we found out she was pregnant (congratulations!) we of course reached out and asked the questions that we knew all of you would want answers to: what happens to the skin during pregnancy, what can you do to support your body best, how do hormones effect this process and what practices can be relied upon during these magical nine months. And she delivered. Drawing from her experience of working with hundreds of women while pregnant and post-partum, her observations are abundant and thorough, but she's also sharing her own experience eight months into her path to motherhood. If you know anyone who's in the space of giving birth, or if you are yourself, consider Kristina's insights the voice of a caring friend. One who happens to know a lot about the intricacies of the skin, the biome and how best to support your largest organ during this time of growth and transformation for optimal health. We call it the motherload of wise, practical skin wisdom.

First off, congratulations on your pregnancy! Now that you're getting close to your due date, can you share your first thoughts when finding out you were pregnant in regards to the health of the skin?

Thanks! :) When I first found out I was pregnant I was really excited to get to experience it all first hand. I have worked with so many clients throughout their pregnancies and postpartum, helping them troubleshoot symptoms and support their skin. I was really curious to know how my body would respond and what I would learn. There is something kind of liberating and freeing about pregnancy; just knowing that there is this intricate process happening inside you without much participation from your mind and all you can really do is observe. It feels so complex with so many variables that for someone like me, who likes to analyze all processes and be involved, it has in a sense felt like a break. 

 

Can you explain what happens to the body when pregnant? And how do these shifts affect your skin?

So much! 

There are huge shifts in hormones and immune function, an increasing demand of micronutrients, and also dramatic changes to your microbiome all during 9 months! I like to visualize the word EXCESS when thinking about what happens during pregnancy. 

For the skin in particular, (generally speaking here as all bodies are different!), ALL of these changes can impact skin function, and mostly for the better in fact.  

Typically, during the initial surge of hormones in the first weeks of pregnancy breakouts are the most common symptom, on the face, neck, chest, even if you never get breakouts. Also allergies and congestion etc. (of course all of that is linked) can all be heightened so more inflammatory and immune related skin symptoms such as eczema or psoriasis can flare up. I have more or less always seen this resolve at some point mid second trimester as hormone production changes, and histamine levels and inflammation decrease.  

By the end of pregnancy your microbiome is really depleted therefore, there is so much vulnerability for manifesting unwanted skin symptoms (and internal symptoms). However, due to the *glorious* fact that inflammation tends to be low at this time, people tend to stay clear of breakouts, eczema, etc.  

There are also massive shifts in the oral microbiome/oral mucosa (swollen gums, pregnancy gingivitis and increased risk of cavities from acid reflux). All which would undoubtedly disrupt the skin's balance if inflammation levels and immune system function were in normal, non-pregnant range and function. 

Pregnancy glow we hear about often is really from all the extra blood. I loved seeing that firsthand as I always have worked on blood building and blood deficiency. There's really nothing like a nice robust blood system when it comes the skin!

There are some changes which impact the skin of the body also, not just the face- skin tags (so much estrogen!), PUPP (pruritic urticarial papules and plaques of pregnancy,) stretch marks, more freckles, Bier spots, and more!  Most of which, luckily and hopefully, resolve postpartum. 

My takeaway of all that happens to the skin during pregnancy is that this period can be seen as a break for most people to simply enjoy their skin and focus on other things (like preparing for baby!).

 

What from the MV + KH line would you recommend to someone pregnant?

While Pregnant:

To be honest I don't think a single product touched my skin during the first 4 months. But, this has been my routine when I am able and I will continue postpartum (or hope to). 

AM

Balancing Hypotonic (the most important!)

Soothing b3 SerumC therapy 

Barrier Lipid Complex

SPF

 

PM

Pure EO Free Cleanser (honestly I cleanse maybe 1/week)

Balancing Hypotonic

Soothing b3 Serum

Barrier Restore Serum

Barrier Lipid Complex

In this routine you are supporting all aspects of the skin system and it should feel really good. Even though your skin can feel plump and full during pregnancy, that shifts (sometimes dramatically) postpartum. So trying to nourish and support while you can, will make a big difference in what you experience postpartum/while breastfeeding. 

With so many changes happening during pregnancy, what have you focused on to support yourself physically and emotionally?

Well that's an interesting question. 

I have always been a super curious person about my own body and found satisfaction in knowing what is causing symptoms and what my tools are to resolve them (breathing, exercise, diet, sleep, supplements, etc). Not in a way to necessarily "control" (as of course we cannot control the body) but to instead support it. 

I also love to be active: hike, run, swim, move all day long. I love feeling the extremes of emotions and life and I love food! However, while pregnant all of this has completely gone out the window. 

In the first trimester, I felt like I had no idea how to take care of myself and had lost most of all my tools. I was really struggling with any movement at all, food was largely an impossible subject, my brain was mush and even meditation felt just too hard. 

The only thing I could do really was sleep, breathe and try to find the fascination in how wild it all really is to grow another human and thank my body for all the work it is/has been doing. 

I did start to feel more myself around week 15 and movement, eating, etc was again possible, but still all so different! Each day has been so unique and it's been a great learning lesson to drop routines, expectations, to start each day with an attitude of "ok, we will see how it goes today and keep adjusting as necessary."   

I am super fortunate to live in nature and work from home as that tends to really keep my stress levels down. We have really beautiful clean ocean air, our own water source and lots of trees, so short walks in the woods and swims in the ocean have basically been my only consistent source of support. I've really just tried to make things as absolutely simple as possible. 

 

So many have concerns about stretch marks after pregnancy, are there other conditions that you think are important in addressing as well? And on that note, do you have a protocol for stretch marks?

Stretch marks are a concern for sure as your body really stretches SO much. However (I write in more detail here) I can say that if you are over 30 your chances of getting them are quite low (again everyone is unique and different- speaking on experience of working with many women through their pregnancies and from what makes sense to me based on science). 

If you are going to get them, that is unfortunately, out of your control and no cream will really prevent them. 

That being said, applying oils and balms to your growing body can feel so good and be a nice part of a self care routine. Dry skin on the limbs is another common symptom of pregnancy so I have found the following to be really helpful: 

Mix a few cups of brown sugar (or any sugar) in a mason jar. 

Squeeze one full lemon over the sugar

Pour oil over to cover the sugar (any oil will do: olive, jojoba, sunflower seed, argan, etc). 

Keep this in the shower and use it as a body scrub a few times a week or as needed. 

Then rinse off and after you towel dry apply oil to damp, warm skin. 

My favorite is sunflower seed (cosmetic grade) as it absorbs really quickly and evenly. I buy my bulk oils from Mountain Rose Herbs but you could really use any body oil that you love here: In Fiore, Everyday Oil, Wonder Valley, etc. Personally, I can't handle any scents/fragrance as I feel just too heightened/sensitive but I can imagine any of those would be nice if you can tolerate.  

I also like to follow this oil application with a balm to really seal it in. Nucifera is my favorite for this. 

 

It seems that many pregnant women are older these days, do you think that mature skin expresses in a different way during pregnancy?

Well, as I mentioned above you likely have less risk of stretch marks when older- so that's very positive! 

Other than that it's hard to say as so much impacts the skin; our genetics, our history, our stress levels, our hormones, diet, weight, environment, product usage, etc. I think that independent of our age, the assortment of changes you will feel in pregnancy are pretty unique to each person.   

What about postpartum? Should the routine change? What is the best way to support the skin during this time?

See above- If anything you will need more support postpartum. 

The loss of blood, big drop in hormones, immune stimulation, resulting microbiome deficiencies, and increasing nutritional depletion from breastfeeding all might impact skin function. 

The above regimen will target each component of the skin that is needing support. 

Many people  have increased hyperpigmentation during pregnancy and that tends to resolve within a year postpartum, but vitamin C can really help. 

Also, once no longer breastfeeding, RETINOL

Just a note that I have heard from most of my clients at some point postpartum about their sudden loss in elasticity, collagen and feeling like their skin has no vitality. This is so so common, and for good reason, and try to trust that if you nourish your body, rest and support your skin with healthy products you will recover and feel yourself again very soon.

 

What else has helped you during this time? Anyone or anything you've turned to to guide you that you'd like to share?

My community! Staying close with friends, family and my partner has been huge. Just being able to talk to them about what I am experiencing and hearing their own stories has felt so supportive. Pregnancy can feel a little isolating and lonely because you are going through these massive shifts all alone and everything is unique to your body. Being mindful of not going too internal and holding everything in has been a big learning lesson for me.  Consciously making sure I am expressing myself to my partner by sharing my experience regularly, regardless if its positive or negative, has helped us stay close throughout this entire process. I also ask for help all day long. I am used to doing things on my own so this is a big shift, but when you can't lift things, or have no energy, turn to others for support! This is not the time to push yourself or deny really, really important limitations. 

The medical system around pregnancy was pretty shocking to me and I found the system of check-ups and tests provoked a lot of anxiety and fear. As someone who is not used to going to the doctor often, this part of the process was really uncomfortable. Luckily, are many amazing midwifes and OB's out there, so once I pieced together the right team of medical providers for me, everything felt better. I believe it is important to speak up for yourself if something doesn't feel good and keep interviewing OBs/midwives until you find your match. 

Lastly, I am in support of keeping pregnancy simple. Your body is equipped with the tools it needs and there really isn't that much we need to actually do. Try to eat as best you can (but don't stress about it when you can't), take your prenatal, and sleep as best you can. It seems that pregnancy has turned into a big (profitable and somewhat elitist) industry and we are constantly bombarded with things to buy, people to hire, or ways to make it better- but in reality we don't need that much. Try not to compare to others (which trust me I understand can be difficult!) and trust in the magic of your body! 

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