What are the recommendations for skin care during pregnancy?

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From the Guidelines

Pregnant women should prioritize skincare routines that avoid harmful ingredients and focus on safe alternatives, such as azelaic acid and topical clindamycin for acne management, to minimize risks to the developing baby. When considering skincare during pregnancy, it's essential to weigh the potential benefits and risks of various ingredients. According to the most recent guidelines, topical azelaic acid, benzoyl peroxide (BP), erythromycin, and clindamycin are considered safe for use during pregnancy due to limited expected systemic absorption 1. However, salicylic acid should be used with caution, limiting the area of exposure and duration of therapy to minimize potential risks.

Key considerations for skincare during pregnancy include:

  • Avoiding retinoids, high-dose salicylic acid, hydroquinone, and certain essential oils
  • Using safe ingredients like glycerin, hyaluronic acid, and vitamin C
  • Managing acne with azelaic acid (15-20%) and topical clindamycin
  • Addressing common pregnancy skin issues like melasma with broad-spectrum SPF 50 sunscreen, wide-brimmed hats, and gentle brightening ingredients like niacinamide
  • Preventing stretch marks with consistent moisturizing using products containing centella asiatica or cocoa butter

It's crucial to consult healthcare providers before using any new skincare products during pregnancy, as individual circumstances may vary and medical advice should always be prioritized 1. By prioritizing safe skincare practices and avoiding harmful ingredients, pregnant women can minimize risks to their developing baby while maintaining healthy and glowing skin.

From the FDA Drug Label

Tretinoin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. The FDA drug label does not provide specific recommendations for skin care during pregnancy, but it does mention that tretinoin should be used with caution.

  • The label states that there are no adequate and well-controlled studies in pregnant women.
  • It advises that tretinoin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus 2.

From the Research

Skin Care Recommendations During Pregnancy

  • Topical azelaic acid or benzoyl peroxide can be recommended as baseline therapy for acne during pregnancy 3
  • A combination of topical erythromycin or clindamycin with benzoyl peroxide is recommended for inflammatory acne 3
  • Oral erythromycin or cephalexin is generally considered safe for moderate to severe inflammatory acne when used for a few weeks 3
  • A short course of oral prednisolone may be useful for treating fulminant nodular cystic acne after the first trimester 3
  • Oral retinoids are teratogenic and absolutely contraindicated for women who are pregnant or considering pregnancy 3

Safety Profile of Topical Products

  • Most pregnant women develop skin changes, including physiological or hormonal changes, worsening of preexisting skin conditions, or the appearance of new dermatoses during pregnancy 4
  • There are some alternatives to prevent and treat skin lesions during pregnancy, but most treatments are recommended to be used after delivery 4
  • The most current and comprehensive information about the efficacy and safety profile of topical products in pregnancy are necessary 4

Ceramide Containing Skincare

  • Ceramide containing moisturizers may help maintain the protective skin barrier and soothe with long-term moisturizing benefits in neonates and infants 5, 6
  • Skincare for neonates and infants should be safe, effective, and fragrance-free as well as sensitizing agent-free 5, 6
  • Gentle cleansers and moisturizers containing barrier lipids help maintain the protective skin barrier and soothe the skin with long-term moisturizing benefits when applied from birth onwards 6

Treatment of Melasma

  • The combination of glycolic acid and hydroquinone or kojic acid can be used for the treatment of melasma and related conditions 7
  • Both glycolic acid/kojic acid and glycolic acid/hydroquinone topical skin care products are highly effective in reducing the pigment in melasma patients 7

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Treatment of Acne in Pregnancy.

Journal of the American Board of Family Medicine : JABFM, 2016

Research

Skin Changes and Safety Profile of Topical Products During Pregnancy.

The Journal of clinical and aesthetic dermatology, 2022

Research

The combination of glycolic acid and hydroquinone or kojic acid for the treatment of melasma and related conditions.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 1996

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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