The surge of hormones that pregnancy brings can manifest itself on the skin in a variety of ways. A major one, says New York dermatologist Dr. Macrene Alexiades, is melasma, the hyperpigmentation known more ominously as the mask of pregnancy. “What makes it the biggest problem is the fact that it’s intractable, so it typically doesn’t go away after you give birth. You’re limited in the ingredients that are safe to use to treat it during pregnancy,” she explains. Increased dryness, which can result in more overall sensitivity, is another issue, says Dr. Shereene Idriss of Union Square Laser Dermatology. “And the increased blood volume that pregnancy brings, along with an increase in estrogen levels, can also result in more redness,” adds Idriss. And, of course, there’s acne. Considering how hormonally driven acne can be and the drastic changes happening in your hormonal milieu during pregnancy, it’s a less surprising—although no less annoying—skin side effect. “I never had acne growing up, and when I got pregnant I suddenly had breakouts,” shares Vicky Tsai, founder of Tatcha (the entire line is formulated to be pregnancy safe). But here’s one upside: “People who typically have very bad acne before pregnancy tend to clear up,” says Alexiades.