Starting IVF? Here Are the Ways It Might Impact Your Skin

While fertility drugs can cause an array of known side effects, something that is not discussed as often is the impact they may have on your skin. When Kaitlyn Shrove, a 35-year-old professional in Buffalo, NY, started a dose of Clomid for timed IUI fertility treatments, she was prepared for the mood swings, hot flashes, and nausea. What she had not expected was the slew of other symptoms that hit her two rounds into her prescription regimen: weight gain, headaches, hair loss, and flaky skin. “I've noticed my overall skin is more dry and itchy,” she says. “I’ve drunk extra water, used extra moisturizer, and changed my diet which has helped slightly, but it's still there.”

Amy Klein, author of the infertility advice book, The Trying Game, is also no stranger to the disruption of fertility drugs, noting that it took her “four years, ten doctors, nine rounds of IVF, and four miscarriages” to have her now five-year-old daughter. During that time, Klein was on a variety of fertility medications, many of which caused her skin to act up. “The main one, follistim, increases egg production and caused redness of my skin,” she explains. In addition to experiencing some skin irritation from the injections, she was also prescribed the steroid prednisone to reduce inflammation and risk of miscarriage, “which causes moon face – a puffy face that made me look pregnant even when I wasn't.”

One of the upsides of pregnancy is that famous 'glow'...some women also experience it during IVF treatments from the hormones used to stimulate ovulation.

“Any type of hormonal treatment can affect the skin in a negative way,” says Dr. Peterson Pierre. If you are thinking about undergoing fertility treatments, here are the things you should know about the ways they may impact your complexion.

Acne Breakouts

One of the upsides of pregnancy is that famous “glow.” While estrogen claims responsibility for this luminous reaction, some women also experience it during IVF treatments from the hormones used to stimulate ovulation. But with the glow can come some not so pleasant responses to the influx of hormones prescribed during a fertility regimen. 

Dr. Anna Guanche says that progesterone, estrogen’s counterpart that is commonly used during IVF, can “make you break out, just like when you are on your period.” As for the estrogen and other hormones that give you the glow, post ovulation and egg harvesting, “there can be a let-down or withdrawal of the happy hormones.” All of these changes, says Dr. Guanche, can affect pigmentation, oil glands and hair follicles, perspiration and apocrine (scent) glands, and a myriad of other well-balanced systems in the body.

“The interaction of hormones in our bodies and the balance they play in skin health is complex,” says Dr. Jeffrey Fromowitz.  There is limited data, he notes, to predict exactly how someone on these medications will react, but it is fairly common to see some acne flaring up. According to Dr. Michele Green, a rule of thumb is “if you had a prior history of breaking out before the treatments, the odds are you will also experience acne breakout while undergoing treatments.” 

While not all products are safe to use during this time (IVF patients should follow the same guidelines as women who are pregnant or breastfeeding), there are effective and safe skincare ingredients that can help alleviate these issues. “Glycolic acid and sulfur washes, light treatments, and facials with safe products are fine during pregnancy,” Dr. Guanche says.

Injection Site Irritation

As many fertility drugs are injectables, Dr. Guanche says injection site issues make up the majority of the fertility medication side effects. While redness and bruising are the most common issues, she has also seen these injectable drugs cause occasional blood blisters. Cut down on these temporary flare-ups by making sure you are following the proper injection procedure. (Many fertility doctors provide educational videos and lessons to help with training.)

While the most common skin problems are caused by the daily shots, some women can also have an adverse reaction to the drug solution that contains the fertility medication. Dr. Lauren Bishop says one example is progesterone. “These injections are made with oil, and some women can have a sensitivity reaction to the sesame oil,” she says. “Women who experience redness and itching can try switching to a different base such as olive oil, which is less likely to cause local skin irritation.”

Skin Redness 

Dr. Lucky Sekhon says skin redness can occur from elevated estrogen levels, which can cause dilation of blood capillaries and flushing of the skin. “Redness and flushing may accompany the hot flashes, which can sometimes be experienced with medications such as Clomid or letrozole,” she explains.

“I recommend patients wear light cotton clothing and layers so that they can adjust their body temperature and minimize discomfort,” Dr. Sekhon says. “Flushing of the skin usually accompanies hot flashes. Hot flashes themselves can be reduced or prevented with medical treatments such as hormone replacement therapy and certain antidepressants and seizure medications.”

Additional Side Effects

It’s hard to predict which, if any, side effects you may experience as skin changes caused by hormonal fertility drugs can be varied. But in addition to injection site irritation and acne, Dr. Green says patients may also face: “dryness of the skin, hair loss, under eye bags and pigmentation, discoloration of the face and melasma, redness and rosacea flares.” The good news, according to Dr. Guanche, is that if you do experience skin reactions to fertility treatments, most will subside once the fertility treatment has passed. 

Once a fertility treatment or pregnancy has ended and skincare restrictions are no longer needed, Dr. Green treats patients’ lingering acne with chemical peels, bleaching creams with hydroquinones, and Cosmelan peels to help combat melasma. “Chemical peels can help increase skin cell turnover and treat the facial discoloration,” she says. Products like vitamin C serum (a powerful antioxidant for the skin) and retinols (an ingredient that is not safe for use during pregnancy) can also be effective at treating skin discoloration from the hormonal after-effects.

When to Be Concerned

According to Dr. Pierre, the majority of these skin-related issues are completely normal and should resolve once the hormonal treatments stop. “They can, however, persist throughout the subsequent pregnancy and into the postpartum period,” he says. Typically, there is no need to be alarmed if you do find your skin acting up.

“The side effects we worry about are skin infections, which would show signs of swelling, redness, pus production, fevers, and chills,” says Dr. Daniel Skora. These, he says, need to be addressed by a physician and likely will need antibiotics. Skora advises that before beginning fertility treatments, patients, especially those with sensitive skin, should speak with their dermatologist or physician about possible side effects.

Klein admittedly wasn’t thrilled to go through all of the skin changes that her fertility treatments brought on, but she says she would absolutely do it all over again. “In the scheme of all the side effects – weight gain, sleeplessness, nightmares, bruising – skin breakouts are a minor nuisance in the quest to have a baby.” Plus, there is one skin upside you can always count on: the famous glow.

Our Experts

Peterson Pierre, MD

Dermatologist and founder of the Pierre Skin Care Institute

Anna Guanche, MD

Dermatologist and dermatologic surgeon at the Bella Skin Institute

Michele Green, MD

Cosmetic dermatologist in New York City

Lucky Sekhon, MD

Fertility specialist and ob-gyn in New York City

Daniel Skora, MD

Reproductive endocrinologist and infertility specialist

Lauren Bishop, MD

Fertility specialist atColumbia University Fertility Center

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