Acne is very common during pregnancy due to the increased androgen hormone levels in your body that increase the production of more sebum. Sebum can clog pores and lead to bacteria, inflammation, and breakouts.
Managing acne while pregnant can be frustrating because you want to have the “pregnancy glow” that everyone talks about and you don’t want to expose your baby to anything that could be toxic.
Most ob/gyns will recommend using nothing and letting the acne clear up on its own. Call it vanity or whatever you like, but I struggled with having acne, AND gaining weight, AND being swollen. I felt like there had to be something I could do to help my acne, even if it just improved it a little.
It is more difficult to say if a medication is safe during pregnancy because there are few or no studies to tell us what happens when pregnant women use the medication. Most of our knowledge and recommendations come from animal studies and retrospective analysis of women that used these medications while pregnant and their pregnancy outcomes. However, only about 5% of the active medication applied to the skin is absorbed the body.
Pregnancy
Safe:
Topical medications that are considered safe during pregnancy are:
The American College of Obstetrics and Gynecology have stated that the use of over the counter medications such as:
Benzoyl peroxide, azaleic acid, topical salicylic acid, and glycolic acid are all safe to treat acne during pregnancy.
The American Academy of Dermatology states that using:
Topical antibiotics like clindamycin, the oral antibiotics cefadroxil, azithromycin, and clarithromycin are considered safe.
However, a few babies have had birth defects while the mother was taking these medications but there is no way to know if the medication caused the birth defect.
Laser and light treatment are considered safe during pregnancy.
Unsafe:
Medications that should be avoided during pregnancy are:
- Hormonal therapy– can block certain hormones to treat acne, but during pregnancy can lead to birth defects.
- Isotretinoin– May cause severe birth defects including intellectual disability, life-threatening heart and brain defects, along with other physical deformities.
- Oral antibiotics – tetracycline can cause discoloration of the fetus’s teeth if taken after 15 weeks of pregnancy. Other antibiotics to avoid include: doxycycline and minocycline.
- Topical retinoids– although topical retinoids are applied to and absorbed through the skin, and the amount of medication absorbed throughout the body is low, it is still recommended to avoid this drug.
- Tazortene– this medication treats psoriasis and acne and should not be taken during pregnancy.
- Dapsone– a newer topical acne medication is generally recommended to be to avoided during pregnancy due to the lack of research available about this medication and it’s long-term effects.
Breastfeeding
Safe:
Topical medications that are considered safe during breastfeeding are:
According to the LactMed database:
Benzoyl peroxide, azaleic acid, topical tretinoin, erythromycin, doxycycline are considered safe for short-term use.
No data is available for salicylic acid, however, due to the small absorption rate through skin it is considered safe during breastfeeding.
Dapsone can be used during breastfeeding but carries the risk of the infant developing hemolytic anemia especially those with a specific metabolic disorder known as G6PD. The manufacturer states it is safe to use while breastfeeding, but further studies are needed to determine long term-effects.
Drug-free treatments:
- Apple cider vinegar- using a mixture of 1:3 distilled water
- Baking soda
- Citrus fruit
- Honey
- Coconut oil
- Oatmeal and cucumber
- Tea tree oil
- Limit washing to twice a day
- Use a gentle, oil-free cleanser
- Change your pillowcases and towels frequently
- Avoid touching your face
References
Webmd. Acne During Pregnancy.
ACOG. Skin Conditions During Pregnancy
AAD. Is any acne treatment safe to use during pregnancy?
LactMed, A Toxmed Database. Drugs and Lactation Database.
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