How to Treat Acne During Pregnancy

Taking Medication Safely

Avoid high-dose or long-exposure treatments. The recommendations below are based on normal dosages only. No matter which product you choose, be aware of the following: It's best to talk to a doctor or dermatologist before taking any medication while pregnant. This is especially true if you are already taking other medication. Use only as recommended. Most products are intended for daily or twice-daily use only. Don't use two or more products with the same active ingredients. Some ingredients used to treat acne are also in other skin care products. Avoid face or body peels, which increase the amount of drug absorbed.

Try topical glycolic acid. Glycolic acids and other alpha hydroxy acids (AHAs) are considered safe to use topically while pregnant. Very little of the drug is absorbed through the skin. Topical treatments are drugs that go directly onto your skin: lotions, gels, facial washes, etc. Oral treatments (pills) carry much higher risk. Do not take oral acne treatments during pregnancy unless directed by a doctor.

Consider topical azelaic acid. The US FDA places azelaic acid in pregnancy category B. This means there is no known risk, but the drug has not been studied on pregnant people. It is considered safe when used as directed. This drug requires a prescription in some regions, including the US. This drug is commonly sold as Finacea.

Request a prescription for topical antibacterials. Acne is often associated with excessive skin bacteria. Topical antibacterials (antibiotics) can help treat this condition. Clindamycin and erythromycin, two of the most common options, are both in pregnancy category B. They are considered safe to use during pregnancy. You'll need a prescription in most regions. If you do find an over-the-counter drug, confirm the other active ingredients are safe as well. These drugs are often combined with higher-risk ingredients.

Treat salicylic acid and BHAs with caution. Salicylic acid and other beta hydroxy acids (BHAs) are in FDA pregnancy category C. This means the FDA has not ruled out risk to the fetus. That said, some doctors consider these drugs safe in topical form, at no more than 2% concentration. Salicylic acid is often confused with aspirin (acetylsalicylic acid), which has complex effects on pregnancy. The two chemicals are closely related, but not identical. Ask your doctor about each one separately.

Ask a doctor about benzoyl peroxide. This is another drug in pregnancy category C. Risk cannot be ruled out without more studies. However, the drug only passes through skin in small amounts, and the body metabolizes it quickly. Your doctor can help you judge the risk and choose a low-dosage product.

Avoid high-risk treatments. The following acne treatments are not recommended during pregnancy: Isotretinoin (Accutane) may cause birth defects or miscarriage. Tetracycline may affect bone and tooth development in the fetus. Tretinoin (Retin-A, Renova), adapalene (Differin), tazorac (tazarotene) and other retinoids may cause birth defects. The evidence is unclear, but it's still best to avoid these. This group includes most ingredients with "retin" in the name. Hormonal therapy can cause major developmental changes to the fetus.

Basic Acne Treatment

Wash the affected area gently. Wash with lukewarm water twice a day, once in the morning and once in the evening. Wipe gently using your bare hands only until your skin is free of excessive oil. Pat dry with a towel instead of rubbing. Despite popular belief, acne is not caused by dirt. Scrubbing hard, using hot water, or washing more than twice a day can make your acne worse by irritating your skin. Wash again if you gets uncomfortably sweaty. Sweat may make acne worse.

Stop touching your face. Many people touch their face without thinking, which can trigger a breakout. Try to keep your hands at your side. If you have oily hair, wash and condition frequently, and keep it out of your face. The physical irritation of your skin causes the breakout, not bacteria from your fingers. Keeping your hands clean won't solve the problem.

Reevaluate your makeup. Some makeup products help prevent acne, and others encourage it. Because skin is particularly susceptible during pregnancy, cosmetic products that did not bother you before can cause acne now. Stick to makeup labeled "non-comedogenic." This is less likely to clog pores. You may want to talk to your doctor about safe cosmetic use during pregnancy. In the United States, the FDA takes pregnancy into consideration when evaluating cosmetics. Not all countries have this level of protection.

Learn about acne and diet. Although people often blame acne on diet, the connection is shaky. A healthy diet for you and your baby is much more important than an "acne diet" that might not even work. Notably, some anti-acne diets cut fat (with only slight evidence). This is a bad idea while pregnant. Aim to get roughly 25–35 percent of your calories from fat.

Take zinc supplements. Oral zinc supplements seem to help acne, even though zinc lotions probably do not. 15 mg of zinc per day (including from food) is recommended during pregnancy, and may even slightly reduce the risk of complications. Stop taking zinc supplements once you start breastfeeding.

Make natural skin treatments. These are generally not as effective as medication, but the examples here have no risk of harming the baby. These come in two types: To exfoliate clogged pores, add honey to superfine sugar or ground oatmeal, scrub gently, and rinse off. Use sparingly to avoid irritation or drying. To soothe irritated skin, massage gently with a plain carrier oil (such as argan oil or olive oil).

Be careful with essential oils. Some essential oils can be dangerous during pregnancy, including sage, jasmine, and many others. Different types of essential oil, including eucalyptus and citrus oils, are most likely safe but have not been thoroughly tested. If you decide to use them anyway, take these precautions: Never use them in the first trimester. Confirm that the oil you chose is safe by asking a doctor or other trusted source. Mix one drop into at least 1 tsp (5mL) of a carrier oil. Use sparingly. Daily use carries a higher risk.