Are alpha-hydroxy acids (AHAs) and beta-hydroxy acids (BHAs) safe to use during lactation?

Safety of Alpha-Hydroxy Acids (AHAs) and Beta-Hydroxy Acids (BHAs) During Lactation

Alpha-hydroxy acids (AHAs) and beta-hydroxy acids (BHAs) are generally considered safe for use during lactation as they have minimal systemic absorption and are unlikely to affect breast milk or harm the nursing infant.

Understanding AHAs and BHAs in Skincare

• AHAs (such as glycolic acid and lactic acid) and BHAs (primarily salicylic acid) are organic acids commonly used in skincare products for exfoliation and treatment of various skin conditions 1
• These acids work through different mechanisms: AHAs exfoliate in hydrophilic areas while BHAs work in lipophilic areas 2
• They are frequently used for treating acne, reducing fine lines, and improving skin texture 3

Safety Profile During Lactation

• Topically applied AHAs and BHAs have limited systemic absorption, making them unlikely to enter breast milk in significant quantities 4
• Beta-lactam antibiotics (which are structurally different from BHAs) are considered safe during lactation, suggesting that many topical treatments with limited absorption are generally safe 4
• The minimal systemic absorption of topical AHAs and BHAs means they pose little risk to the nursing infant 4

Specific Considerations for Different Acids

Alpha-Hydroxy Acids (AHAs)

• Glycolic acid and lactic acid are the most commonly used and effective AHAs in skincare 5
• L(+) lactic acid appears to be less irritating than other AHAs, which may be preferable for sensitive skin during the postpartum period 5
• Higher concentrations (>12%) of AHAs may have more significant dermal effects and should be used with caution 3

Beta-Hydroxy Acid (BHA)

• Salicylic acid (the primary BHA used in skincare) at typical cosmetic concentrations (2-4%) has not been shown to cause adverse effects when used topically during lactation 6
• Unlike oral salicylates, topical salicylic acid has minimal systemic absorption when used as directed 4

Practical Recommendations

• Start with lower concentrations of AHAs (5-10%) or BHAs (1-2%) to minimize potential skin irritation 3
• Apply products to limited areas initially to test skin sensitivity, which may be different during the postpartum period 1
• Use sunscreen diligently when using AHA products, as they may increase photosensitivity 6, 1
• Avoid applying these products directly on the breast or nipple area to prevent potential ingestion by the infant during breastfeeding 4

Important Precautions

• Wash hands thoroughly after applying AHA or BHA products before handling the infant or breast-feeding 4
• If using multiple skincare products containing acids, be cautious about the total concentration to avoid excessive irritation 1
• Discontinue use if skin irritation, burning, or other adverse reactions occur 1
• For women with specific skin conditions requiring higher concentrations of these acids, consultation with a dermatologist is recommended 4

Monitoring and Follow-up

• Monitor the infant for any unusual symptoms if using these products regularly 4
• Be aware that skin sensitivity may change during the postpartum and lactation periods 1
• Consider the timing of application (e.g., immediately after breastfeeding) to minimize potential transfer 4