From the Guidelines
During pregnancy, topical azelaic acid and benzoyl peroxide are considered safe acne treatments, with azelaic acid being category B in pregnancy and benzoyl peroxide having limited expected systemic absorption 1. When considering acne treatment during pregnancy, it's essential to prioritize the safety of both the mother and the fetus.
- Topical azelaic acid (15-20% formulations) can be used twice daily, as it is mildly effective as a comedolytic, antibacterial, and anti-inflammatory agent, and is category B in pregnancy 1.
- Benzoyl peroxide (2.5-5%) can be applied once or twice daily to affected areas, as it has limited expected systemic absorption and is considered safe for use during pregnancy 1.
- Oral medications like antibiotics (erythromycin or clindamycin) may be prescribed by healthcare providers in certain cases, but their use should be limited due to the risk of bacterial resistance and other antibiotic-associated complications 1. However, it's crucial to avoid retinoids (like tretinoin, adapalene, and isotretinoin), tetracycline antibiotics, and high-concentration salicylic acid products, as these can potentially harm fetal development. Pregnant women should also maintain a gentle skincare routine using mild, fragrance-free cleansers and non-comedogenic moisturizers. Always consult with your healthcare provider before starting any acne treatment during pregnancy, as individual circumstances may affect recommendations.
From the Research
Acne Medications Safe During Pregnancy
There are limited studies on the safety of acne medications during pregnancy. However, based on available evidence, here are some findings:
- Isotretinoin, a commonly used acne medication, has been shown to have teratogenic effects, particularly when taken systemically 2, 3.
- The use of isotretinoin during pregnancy is associated with a high risk of birth defects, including craniofacial, cardiovascular, thymic, and central nervous system malformations 3.
- However, a study found that local isotretinoin treatments may not be associated with an increased risk of birth defects 2.
- Topical tretinoin, another acne medication, has been found to have a low risk of birth defects when used during early pregnancy 4.
- A pregnancy-prevention program has been implemented to minimize pregnancies among women taking isotretinoin, which has been shown to be effective in reducing the number of pregnancies during therapy 5.
Safe Alternatives
Some safe alternatives to isotretinoin during pregnancy may include:
- Topical tretinoin, which has been found to have a low risk of birth defects 4.
- Other topical acne medications, such as benzoyl peroxide or salicylic acid, which have not been shown to have teratogenic effects.
- It is essential to consult a healthcare provider before taking any medication during pregnancy to discuss the potential risks and benefits.
Key Findings
Key findings from the studies include:
- The importance of avoiding pregnancy during isotretinoin therapy 2, 3, 5.
- The need for careful monitoring and follow-up during pregnancy to minimize the risk of birth defects 2, 3.
- The potential for local isotretinoin treatments to be safe during pregnancy, although more research is needed to confirm this finding 2.
- The low risk of birth defects associated with topical tretinoin use during early pregnancy 4.