Question:

I’m 25 weeks pregnant and woke up this morning with nice pink cheeks that feel a little sore, sort of burning. I was outside yesterday, but it was cool and there was no sun. It does not feel like a sun/wind burn but they are pink and tender. Is this common throughout pregnancy? Could it be related to something else?

Answer:

There are a number of possibilities that might account for bright red cheeks:

  • The small blood vessels and capillaries can multiply during pregnancy as many blood vessels get larger to accommodate a larger blood volume. Many women can see spider vessels and increased general redness on the face or even the palms of their hands. Occasional facial flushing is related to the hormonal changes of pregnancy.
  • Rosacea typically causes facial erythema or redness or acne-like eruptions. It usually happens on the cheeks but can also happen on the nose, chin and forehead. This is more common in women than men.
  • A form of acne can be aggravated by hormonal changes during pregnancy.
  • Lupus erythematosus is characterized by a butterfly rash on the face. This is one of a group of mixed connective tissue diseases that typically occur more frequently in women than men. The skin changes associated with lupus may include non-specific cheek redness.
  • Contact dermatitis or a photo contact dermatitis. Irritant contact dermatitis is actually an extremely common skin eruption seen in women. An allergic contact dermatitis would result from an exposure. There are several exposures that can result in this kind of allergic dermatitis.
  • Slapped cheek disease or fifth’s disease can cause facial redness. You have probably already had this disease as most of us are exposed to this virus during childhood. This syndrome is also known as erythema infectiosum. The virus is a concern if it is a first exposure in the first 20 weeks of pregnancy and at present you are at 25 weeks. An early exposure could possibly result in miscarriage or an adverse event to the fetus. A blood test can test whether you are immune or not.

Finally, the red cheeks may simply be part of a normal pregnancy. Either way, see your doctor for a discussion as to what might be causing this.

Originally published in 2011.