Safe skin care during pregnancy

Are there skin products that I should avoid during pregnancy?

Most pregnant women know that what they put in their bodies can affect the well-being of their growing baby. But you may not have considered that what you put on your body can affect you and your baby, too.

While most commonly used products are completely safe, there are a handful of ingredients experts say it's best to avoid. Below, see our guide to what to look out for when shopping the beauty aisle. And if you plan to breastfeed, continue following the guidelines below until you stop nursing.

Retinoids

These powerful substances are found in some antiaging moisturizers and treatments for acne, pigment disorders, and plaque psoriasis. Retinoids (also known as tretinoins) are a type of vitamin A that speeds up cell division (quickening your skin's renewal) and prevents skin collagen from breaking down.

But retinoids are one of the skin-care ingredients that experts recommend that pregnant women stay away from. Some studies have shown that taking high doses of vitamin A during pregnancy can be harmful to an unborn child. And oral retinoids, such as isotretinoin (a prescription acne treatment previously sold under the brand name Accutane), are known to cause birth defects.

If you've been using a skin cream that contains a retinoid, don't panic. Retinoids that you put on your skin have not been shown to cause problems in pregnant women. Doctors are just being extra cautious in recommending that you avoid them.

Avoid products with these ingredients:
Avage, Fabior, Tazorac (tazarotene)
Avita (tretinoin)
Differin (adapelene)
Panretin (alitretinoin)
Retin-A, Renova (tretinoin)
Retinoic acid
Retinol
Retinyl linoleate
Retinyl palmitate
Targretin gel (bexarotene)

Hydroxy Acids

Hydroxy acids such as beta hydroxy acid (BHA) and alpha hydroxy acid (AHA) are found in products to treat certain skin disorders, including acne, skin inflammation, and redness. They're also found in a number of cleansers, toners, and exfoliants touted to reduce the signs of aging.

Salicylic acid is the most common BHA you'll find listed as an ingredient and the only BHA that has been studied in pregnancy. High doses of the acid in its oral form (it's an ingredient in aspirin) have been shown in studies to cause birth defects and various pregnancy complications. Other BHAs have not been studied in pregnancy.

Very little of a BHA would be absorbed into the skin when it's applied topically. But because oral salicylic acid is not safe during pregnancy, doctors also recommend avoiding excessive or frequent use of skin products containing BHAs.

Small amounts applied to the skin – such as a salicylic acid-containing toner used once or twice a day – are considered safe.

But the concern is stronger about face and body peels containing salicylic acid. Always check with your doctor before having a peel treatment. Better yet, if you must have a peel, have it done professionally at your dermatologist's office. A dermatologist will know how to do it safely during pregnancy.

If you do use a BHA product, use it with sun protection since BHA can cause sensitivity to sunlight.

The two most common alpha hydroxy acids (AHAs) in cosmetic products are glycolic acid and lactic acid. AHAs have not been studied in pregnancy, but because only small amounts are absorbed into the skin, they are considered low risk when used in skin treatments. Still, to be safe, it's a good idea to use them only in small amounts.

Products containing these ingredients should only be used in small amounts:
Alpha hydroxy acid (AHA)
Azelaic acid
Benzoyl peroxide
Beta hydroxy acids (BHA)
Beta hydroxybutanoic acid
Betaine salicylate
Citric acid
Dicarbonous acid
Glycolic acid
Hydroacetic acid
Hydroxyacetic acid
Hydroxycaproic acid
Lactic acid
Salicylic acid
Trethocanic acid
Tropic acid
2-hydroxyethanoic acid

Acne products

Many women have breakouts in the first trimester because of changing estrogen levels, even if they've always had clear skin. If you're dealing with pregnancy-induced acne, a dermatologist can likely give you a safe topical antibiotic.

But if you prefer to avoid yet another doctor appointment, you can use a facial wash that contains no more than 2 percent salicylic acid (look for the percentage on the product label). This small amount is considered safe. (See above.)

If you want to be doubly sure, ask your obstetrician or midwife exactly how much would be safe for you to use. As for what to avoid when it comes to treating acne, stay away from leave-on acne lotions, gels, and creams, as well as at-home peels, which can contain salicylic acid or retinoids. And, again, steer clear of the oral form of the retinoid Accutane.

Avoid products with these ingredients:
Avage, Fabior, Tazorac (tazarotene)
Avita (tretinoin)
Differin (adapelene)
Panretin (alitretinoin)
Retin-A, Renova (tretinoin)
Retinoic acid
Retinol
Retinyl linoleate
Retinyl palmitate
Salicylic acid
Targretin gel (bexarotene)
Tretinoin

Hair removers & minimizers

Lotions that remove your hair chemically (depilatories) or that minimize hair between shaves sound like a dream come true when you can barely reach – not to mention see – your legs. The good news is that these products are considered safe, as long as you use them as directed.

If you've had an allergic skin reaction to hair minimizers or removal creams in the past, then you should avoid these products during pregnancy as well.

Also, some women's skin gets extra sensitive during pregnancy, so you may have a reaction to these ingredients even if you haven't before. Before slathering your whole leg, do a patch test on a small piece of skin behind your knee and wait 24 hours to see if you react.

These topical ingredients are considered low risk during pregnancy:
Calcium thioglycolate (depilatory)
Hydrolyzed soy protein (minimizer)
Potassium thioglycolate (depilatory)
Sanguisorba officinalis root extract (minimizer)
Sodium hydroxide (minimizer)

Sunscreens

Just because you're pregnant doesn't mean you can't hit the beach. But don't forget the sunscreen. Even sunscreens with ingredients that penetrate the skin are considered safe during pregnancy. However, as an extra precaution, you might opt for products that use titanium dioxide and zinc oxide – physical sunblocks that don't penetrate the skin.

(In addition to sunscreen, avoid the sun between 10 a.m. and 4 p.m.; wear a sun hat, sunglasses and sun-protective clothing; and reapply your sunscreen every two hours. And yes, even if you have dark skin you should wear sunscreen and follow these guidelines).

It’s best not to use a sunscreen containing the skin lightener hydroquinone. There is limited data on its safety during pregnancy, and most experts agree it’s best to avoid it.

These topical ingredients are considered low risk during pregnancy:
Avobenzone (Parsol 1789)
Benzophenone
Dioxybenzone
Octocrylene
Octyl methoxycinnamate (OMC)
Oxybenzone
Para-aminobenzoic acid (PABA)
Titanium dioxide
Zinc oxide

Makeup

You may not give a second thought to the kind of makeup you use, but even cosmetics are something to consider when pregnant.

Many makeup products are marked "noncomedogenic" or "nonacnegenic" – meaning they're oil-free and don't clog pores. These are safe and will not affect the health of your baby.

Avoid cosmetics that contain retinol. Salicylic acid is found in some makeup for acne-prone skin. While it's safe topically in small amounts (say to dab on a pimple or use in a face wash), it's better to avoid it in makeup (such as foundation) that may be absorbed by larger areas of your skin for long periods of time. 

If you want to be super careful during pregnancy, try some of the minerals-only makeup lines. These products use ingredients that primarily sit on top of the skin and don't cause irritation for most people.

Avoid products containing these ingredients:
Avage, Fabior, Tazorac (tazarotene)
Differin (adapelene)
Panretin (alitretinoin)
Retin-A, Renova (tretinoin)
Retinoic acid
Retinol
Retinyl linoleate
Retinyl palmitate
Targretin gel (bexarotene)
Tretinoin

Steroids

Steroid creams – such as over-the-counter hydrocortisone creams – are often used for minor skin irritations, inflammation, itches and rashes caused by contact dermatitis, mild eczema, rashes, psoriasis, soaps, detergents, cosmetics, jewelry, poison oak, poison ivy, poison sumac, and insect bites.

These topical steroids are considered safe to use during pregnancy. More potent steroid products are sometimes prescribed by dermatologists or primary care physicians, and most of these are safe as well. But do talk with your healthcare provider about the safety of any prescribed products, including topical prescriptions, before using them during pregnancy.

These ingredients are considered safe:
Alclometasone (Aclovate)
Desonide (Desonate, DesOwen)
Fluocinolone (Capex, Derma-smoothe)
Hydrocortisone (Aquanil HC)
Triamcinolone (Aristocort A, Kenalog)

The final word

If you have any concerns about a skin product, it's a good idea to discuss it with your healthcare provider. If you have used a product that contains a potentially harmful ingredient, don't panic. Simply stop using the product now and pick one with safer ingredients.

Note: This article was reviewed by Miriam Pomerantz, dermatologist at New York University Langone Medical Center; Michael Bummer, ob-gyn at Magee Women's Hospital of the University of Pittsburgh Medical Center; and Gerald Briggs, pharmacologist at Washington State University College of Pharmacy.