Many people develop acne while pregnant, and while it can be frustrating, most cases resolve after pregnancy hormones settle down.
There are ways to treat severe symptoms, however, but it is essential to talk to your physician first. Treating acne in pregnancy is complicated by the fact that many standard acne treatments can harm a developing foetus.
As a general rule, if you are pregnant or breastfeeding you should avoid taking any medications you don’t absolutely need. This is especially true of any medications known to increase the risk of birth defects when taken in pregnancy. Unfortunately, many prescription and over-the-counter acne treatments have a high risk of causing such problems. In this article we will look at medications that are unsafe for treating acne in pregnancy, and then look at safer options for pregnancy acne.
Problems of treating acne in pregnancy – Isotretinoin
Isotretinoin (Accutane) is a popular treatment for severe acne. Indeed, this oral medication has dramatically altered how acne is managed. However, isotretinoin is unsafe for use during pregnancy as it can cause serious birth defects.
Anyone prescribed isotretinoin is typically required to register as part of a risk-management program intended to prevent pregnancy and birth defects. This may involve a requirement to use at least two forms of birth control, with an oral contraceptive regimen or intrauterine device (IUD) in place before isotretinoin treatment begins.
Even when you stop taking the drug, you should continue using at least two methods of birth control for a month or more. Pregnancy tests are typically carried out before, during, and after treatment with isotretinoin.
Other drugs to avoid when treating acne in pregnancy
Oral tetracyclines should also be avoided in pregnancy. These drugs (which include antibiotics tetracycline, doxycycline and minocycline) can lead to tooth discoloration and can inhibit bone growth in the developing foetus.
Anti-androgens flutamide and spironolactone, as well as estrogen, are also typically avoided in pregnancy. If you are taking any of these hormone medications and want to try to conceive, talk to your physician first.
Topical tretinoin (Retin-A), along with adapalene (Differin) and tazarotene (Tazorac), are also contraindicated in pregnancy. These topical agents may still pose a risk of birth defects even though absorption through the skin is low. You should also avoid these products if you are breastfeeding.
Finally, some physicians suggest avoiding the use of topical salicylic acid (the active ingredient in aspirin) while pregnant. This chemical is found in numerous over the counter products for acne relief.
So… how can you treat acne in pregnancy?
Not many products have been rigorously studied for their safety and efficacy for treating acne in pregnancy. As such, it is essential to talk to your physician before using any acne treatment, topical or otherwise.
Acne treatments that may be OK for use in pregnancy include topical creams containing erythromycin (Erygel), clindamycin (Cleocin T, Clindagel, others) and azelaic acid (Azelex, Finacea). These products are only available on prescription.
Products containing benzoyl peroxide or glycolic acid are sometimes recommended for use in pregnancy. These over the counter products are given the green light by some because of their low absorption rate; only 5% or so of the active ingredient is absorbed through the skin. No problems have been reported so far with the use of benzoyl peroxide in pregnancy, and the low absorption means a low likelihood of increased risk of birth defects. However, there remains little research on the use of this drug.
Self-care options for pregnancy acne
Acne affects around 50% of people in pregnancy and usually clears up after pregnancy. It is most common in the first trimester. During those few months, where fluctuating hormones may trigger acne, it is a good idea to be diligent about skin hygiene.
To help prevent and treat acne in pregnancy, gently and carefully wash acne-prone areas with a mild cleanser and lukewarm water, morning and night. You may also wish to gently wash acne-prone areas after working up a sweat. Don’t be tempted to wash more as this can irritate the skin and stimulate oil-producing glands, making the skin more vulnerable to breakouts and infection.
Choose a cleanser that is free from oil, alcohol, and abrasive substances. If you use a washcloth, change it every day, or consider using biodegradable, disposable cleansing pads instead.
You might not connect your shampoo or hair to facial acne, but these are intimately linked. If your hair falls onto your face you may absent-mindedly brush it away several times a day. Repeated contact between your hand and your face or hair can transfer germs that lead to acne breakouts. Consider keeping your hair off your face and shampoo your hair daily if it is oily. Avoid the use of oily hair products near your hairline.
As with cleansing products, try to avoid oil-based cosmetics if you are suffering from acne in pregnancy. Water-based, noncomedogenic or nonacnegenic products are better options. These have a lower chance of blocking pores, but you should still remove them before going to bed.
And, finally, treating acne in pregnancy also means taking steps minimise the risk of it spreading! So, no picking, scratching, or squeezing of spots. Not only can this spread infection and make acne worse, it can also lead to scar formation.