Acne During Pregnancy

Acne is common during pregnancy. In fact, more than one out of every two pregnant women can expect to develop acne. In some cases, the acne may be severe.

The primary cause of acne when you're pregnant is the increased hormone levels in the first trimester. The higher level increases the skin's production of natural oils. It's hard to predict who will develop pregnancy acne. You have a higher risk, though, if you have a history of acne or have acne flares at the start of your menstrual cycle. If you do not develop acne during the first trimester, it's unlikely you'll have breakouts that are out of the ordinary during the second or third trimesters.

Managing acne when you're pregnant can be tricky. That's because many prescription and over-the-counter treatments come with a high risk of birth defects. In general, you should avoid any medication that has even a remote chance of harming your baby.

Here is information about pregnancy acne that can help keep you and your unborn baby safe.

Dealing With Acne During Pregnancy

Pregnancy acne is a natural, cosmetic condition. It usually subsides when hormone levels return to normal. So the safest thing to do is to avoid any prescription acne medications or over-the-counter chemical spot treatments. Instead, you can rely on drug-free home remedies. But before starting any acne treatment when you're pregnant or planning to become pregnant, talk with your doctor about what's best -- and safest -- for you.

Unsafe Treatments for Pregnancy Acne

Isotretinoin is an oral medication that has revolutionized the way severe acne is treated. However, it's especially dangerous when you are pregnant. That's because the drug can affect a fetus and cause serious birth defects.

Any patient who takes isotretinoin, as well as any doctor who prescribes it, pharmacy that dispenses it, and wholesaler who distributes it, must enroll in a special program that's part of a risk-management program to prevent pregnancy and birth defects.

Because the risks are so high, women of childbearing age who take the drug need to be on two forms of birth control starting at least one month before they begin therapy. They also need to stay on two forms of birth control for at least one month after therapy ends. Also, women must have pregnancy tests before, during, and after treatment.

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Other prescription acne treatments that can cause birth defects include:

  • Hormone therapy. This includes the "female" hormone estrogen and the anti-androgens flutamide and spironolactone.
  • Oral tetracycyclines. These include antibiotics such as tetracycline, doxycycline and minocycline, which can inhibit bone growth and discolor permanent teeth.
  • Topical retinoids such as adapalene (Differin), tazarotene (Tazorac) and tretinoin (Retin-A). These products are similar to isotretinoin and should be avoided during pregnancy. Although studies show that the amount of these medications absorbed through the skin is low, there is a concern that they could pose an increased risk of birth defects. Products are required to carry a warning that states it is unknown if these medications can harm a developing fetus or a child that is being breastfed.

For the same reasons, some experts also recommend against using topical treatments containing salicylic acid. This is an ingredient found in many over-the-counter products.

Other Topical Acne Treatments and Pregnancy

Some experts recommend topical prescription products containing either erythromycin or azelaic acid. Other options include over-the-counter products that contain either benzoyl peroxide or glycolic acid. Only about 5% of the active medication applied to the skin is absorbed into the body. So it's believed that such medications would not pose an increased risk of birth defects.

But it is important to remember that many topical medications have not been adequately studied in pregnancy. So again, be sure to consult your doctor before you start any acne treatment.

Drug-Free Treatments for Pregnancy Acne

Pregnancy acne is a natural condition that usually resolves after childbirth. So, the safest course of action is good skin care. Here are some methods for coping with pregnancy acne that are drug-free:

  • Limit washing to two times per day and after heavy sweating.
  • When you do wash, use a gentle, oil-free, alcohol-free, and non-abrasive cleanser.
  • Use a washcloth (but change it every time you wash your face), cotton pad or sonic cleansing system.
  • After washing, rinse your skin with lukewarm water. Then gently pat dry and apply moisturizer.
  • Avoid over-cleansing. It can overstimulate the skin's oil glands.
  • Shampoo regularly. If you have oily skin, it's best to shampoo daily. Avoid oily hair mousse or pomade near the hairline.
  • Change your pillowcases frequently.
  • Keep your hands off your face because there are bacteria on the fingers.
  • Use earbuds. Don’t hold a cellphone against the face.

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Above all, avoid the temptation to squeeze or pop your pimples. This usually results in permanent acne scars. If you have clogged pores, get a professional facial.

WebMD Medical Reference Reviewed by Debra Jaliman, MD on January 13, 2016

Sources

SOURCES:

Organization of Teratology Information Specialists: "Topical Acne Treatments and Pregnancy." 

AcneNet: "Acne Medications Not for Use During Pregnancy."

American Academy of Dermatology: "Pregnancy and Breastfeeding" and "How to Wash Acne-Prone Skin."

American Pregnancy Association: "Acne Treatment During Pregnancy."

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