Nosebleeds? Hair Loss? Maybe You Are Pregnant!

Red palms. Hair loss. Shortness of breath. Nosebleeds. Discolored skin patches and swollen ankles. Even heart murmurs! All unwanted, but potentially normal changes in pregnancy. During the nine months that a baby is growing inside, the rapid hormonal changes cause a lot of external changes as well. In fact, pregnancy often mimics more serious systemic diseases, like liver cirrhosis or heart disease. Let's discuss a few of these and why they occur.

Estrogen, progesterone and other hormone levels rise markedly during pregnancy. This can cause diffuse or blotchy redness of the palms. Occurring in over half of pregnant women, these changes are identical to those seen in liver cirrhosis. Vascular spiders, red bumps with tiny vessels branching out, occur in two-thirds of Caucasians and 10% of African Americans during pregnancy. These changes typically regress after delivery. Melasma ("the mask of pregnancy") consists of dark brown patches on the forehead, cheeks, nose and upper lip. Seen more commonly in brunettes than blondes, these changes fade after delivery but may never disappear completely.

Scalp hair goes through a growth phase (lasting several years) followed by a resting or telogen phase. After about 3 months of telogen, an old hair strand is lost and a new one grows to replace it. Normally about 20% of hair strands are in telogen at any time; in late pregnancy this falls to 10%, resulting in very thick, full hair. After delivery, the number of hairs entering telogen increases to about 30%. So it is normal, albeit upsetting, to see a marked increase in hair loss around 3 months after delivery. Fortunately, normal regrowth of hair is complete within 6-12 months.

Pregnant women often suffer from nosebleeds and nasal stuffiness. Blood flow and mucus production increase in the nasal passages; thus, the complaint of a chronic "cold" throughout pregnancy. Frequently this is not true illness and the temptation to continually use nasal decongestant sprays should be avoided, as they can cause abnormal thinning of the nasal lining.

by Scott G. Williams, MD, FACOG, of SSM St. Charles Clinic Medical Group, O’Fallon, MO.