Dr Margit Polcz- Dermatologist, mum to twins Asta and Guy. Canadian born, Australian living.
After her early morning work commitments I could always spot Margit (Dr Polcz) from a distance multitasking her twin stroller (that is bigger than her!) whilst balancing a round of coffees, looking effortlessly healthy and with glowing skin of course! For me this simply sums up Margit- Super Woman!
Born and raised in Toronto, Margit completed her first degree in cell biology at McGill University, Montreal in 2006 before moving to Brisbane, Australia. Influenced by her wonderful family doctor growing up Margit went on to complete her GP training in Brisbane where she met and fell in love with her husband, Dave. Dermatology was love at first sight for Margit and the opportunity to specialize brought Margit and Dave to Sydney in 2015 where Margit continues to practice. The biggest shock of her life was being told she was pregnant with twins, Guy and Asta who were born in January 2019. Since the birth of her babies Margit now enjoys audiobooks and bush walks with some slow but very cute walkers.
During pregnancy and post pregnancy we undergo incredible physical and psychological changes. These changes vary due to the hormonal fluctuations that are needed to grow and nourish our baby. Whilst these fluctuations often affect the skin with expectant changes like stretch marks, it can also cause other unexpected temporary and more permanent changes.
To learn more about these changes, Margit kindly took the time to share her expert knowledge and personal experience on skin health and care in pregnancy and the postpartum.
What is your philosophy on healthy skin during pregnancy and Motherhood?
The skin is your largest body organ, and as is the case with all of our systems, maintaining a healthy lifestyle is important. However during those early baby days, sleep, diet and exercise often go out the window. If you are able to wash your face at night, and put on sunscreen in the morning then that’s pretty good for those first months!
During the pregnancy itself I figured ‘embrace the changes’, but do what you can to prevent issues. Pregnancy felt as though Mother Nature took over and I was just along for the ride. I was lucky as my own skin conditions, eczema and acne cleared up during pregnancy and post partum, although the opposite can happen.
What are some of the most common skin changes women might see when pregnant and/or postpartum?
We can expect:
- Some pre-existing skin conditions will get better, some worse. Of the most common conditions, acne more typically improves but may flare for some, rosacea on the other hand tends to flare.
- Increase in pigmentation – including melasma (facial mask-like pigmentation)
- Stretch of the skin- stretch marks will affect approximately 90% of women
- Increased hair – the welcome and not so much
- Vascular Changes- blood vessels/Increased blood flow to the skin. Dilated blood vessels called spider angiomas may appear. I had one on my lip that disappeared a few months after birth. Ankle swelling and varicose veins are other common vascular changes.
How can women manage these conditions?
- Avoid new products -Ideally this is not the time to introduce new products if you have sensitive skin. Conditions like rosacea and eczema may flare in pregnancy.
- Sun protection – 70% of us will develop melasma, so sun protection is important. Blue light from devices as well as indoor/outdoor lighting may also play a role so physical blocking sunscreens (titanium dioxide, zinc oxide) or products that include blue light filter are good options.
- Moisturise with your favourite cream based moisturizer – helps to maintain the barrier function and hydration of the skin, minimising flares of inflammatory conditions such as eczema, psoriasis, rosacea. Despite their popularity, oils are not as hydrating as ointments and creams.
- Stretch mark gel- unfortunately the majority of women are likely to get these. In a rigorous review of available products, none could be assuredly recommended. Topical silicon gel is potentially helpful and post pregnancy treatments such as laser may be helpful if they are problematic.
- Compression stockings- use daily (put them on first thing after your shower in the morning) and take them off for sleep, so long as you don’t have any circulation issues. Reduces swelling, vein protrusion and that heavy leg feeling.
What topical ingredients should women avoid when pregnant and/or breastfeeding?
It is ok to continue your cleanser, moisturiser and sunscreen. If your skin condition is flaring there are a number of treatments still available for example Light therapies, however it is best to discuss these with your doctor, as everything is a balance of risk/benefit.
The table below list common topical preparations that are generally considered safe to continue and some of those to avoid.
If you are unsure, Mothersafe is also a great resource for specific product questions.
| Considered Safe | Avoid |
| Azelaic Acid | Hydraquinone |
| Vitamin C | Retinoids ( Differin, Renova, Retin A, Tretinoin) |
| Niacinamide & Vitamin B | |
| Sunscreen, both physical and chemical | |
| Salycilic Acid 2% or less | |
| Hyaluronic Acid |
What do you recommend for mums who wish to help reduce scarring at the caesarean section site?
Scarring is an active process, and a scar isn’t considered mature until a year or more post surgery.
Early: in the first 2 weeks, keep your wound dressing intact as advised by your surgeon/obstetrician. Avoid infection and minimize tension on the wound as these lead to poor scarring.
Later: after the scabbing has resolved, taping your scar (using a paper based or retention dressing tape) and/or using silicon based dressing may help minimise scarring. If you are developing a thickened hypertrophic or keloid scar you could also see your doctor to consider cortisol or later laser treatment which may help to improve the scar’s appearance. Consider using post partum supportive wear as it may help reduce the swelling, tension and stretch on your scar (this can also help reduce the discomfort)
What do we need to know when shopping for sunscreen? And what should we be practicing to keep our families safe from the sun?
Two out of three Australians will be diagnosed with a skin cancer by the time they are seventy. So my approach is: given I am likely to get a skin cancer unless I seriously protect myself, what protection should I use?
Broad spectrum, SPF 50+.
- ‘Broad spectrum’ includes UVA (responsible for aging and also skin cancer)
- SPF rating refers to UVB only, but 50+ in Australia is a must.
- Hats, sun protective clothing and seeking shade are a must.
Find the product you are most likely to use everyday. If you are looking for a single product, the tinted sunscreen or BB cream with a higher SPF may be better. Cosmetics generally contain below SPF 20+, so you may do better to find your daily product in the skin care aisle.
Sun protection is really important for kids, as this has an impact on the development of naevi (moles) that they are likely to develop and their future risk of skin cancer.
Babies- generally sunscreen is considered ok after 6 months. In babies under 6 months you can apply a minimal amount of sunscreen (to face and hands) when they cannot be adequately protected by shade and clothing alone. Use a broad spectrum 50 + SPF formulation with zinc oxide or titanium dioxide as they do well on baby’s sensitive skin.
Sprays are popular for kids but be mindful of the amount needed for good coverage. But any sunscreen you can actually get on your child is better than nothing! I just get a sensitive skin formulation and use for the entire family.
Postpartum hair loss varies from woman to woman, pregnancy to pregnancy. What is a normal amount of hair loss? And when should we seek further advice?
The average non-pregnant woman loses approximately 100 scalp hairs/day. Telogen effluvium is the name of the physiological hair shed we get beginning 2-4 months after birth, when a majority of our hairs switch from anagen growth phase to telogen rest phase. The hair falling out a few months later is actually the result of a new growing hair pushing the older hair out, so it’s good news when it starts to fall and ‘baby hairs’ or ‘fly aways’ are coming, so get your hairspray/gel/cream ready.
Some women notice hair fall for longer. If troubled by the appearance you can use camouflage products – electrostatic fibres (toppik etc) can help fill in some volume while your hair is growing in.
When to be concerned;
- patterned hair loss (front and top of scalp for women),
- bald circles with no hair, significant hair thinning rather than hair fall.
- If you have an underlying androgenic alopecia (patterned hair loss) then that may become more apparent after a telogen effluvium, and this may not necessarily improve.
See your doctor if you’re not sure. Hair loss is often a difficult problem for women.
A collective concern amongst the nursing and medical community is the overuse of ‘Dr Google.’ What public resources do you recommend for reading about all things skin, hair and nails?
Good resources from dermatologists are;
Australasian college of Dermatologists (ACD) A to Z,
https://www.dermcoll.edu.au/a-to-z-of-skin/
DermNet New Zealand
British association of dermatologists (BAD)
https://www.skinhealthinfo.org.uk/
What were your consistent ‘go- to’ products when pregnant and/or postpartum?
With sensitive skin I kept things the same for the most part. I use Cetaphil soap free wash and cream based moisturizer. I used a broad spectrum 50 +SPF BB cream daily (Roche Posay Uvidea). I also used Silicon gel daily (Stratamark) for my stomach for stretch mark prevention. Every morning, I wrestled on my pregnancy compression stockings (15-20mmHg, Preggers maternity pantyhose) with increasing difficulty as the twin pregnancy progressed!
Lastly, any words of wisdom you have learnt along the way?
You’re doing a good job.