There’s this idea that during pregnancy, you’ll have a certain glow . . . and then there’s reality, which is not always aligned with that idealized version. Sure, your nails and hair may be thicker — and some people will have a subtle radiance — but something more unfortunate might crop up as well: acne.
Whether you have been handling blemishes big and small for some time, or if you’ve always had picture-perfect skin until pregnancy, the hormonal changes that take place during these nine months can kick pimples into high gear. However, you can’t simply use the same spot treatments you might have used before you got pregnant. Like your diet, your caffeine intake, and your exercise routine, your acne treatment is just another thing you’ll need to tweak for 40 weeks. Here’s what you need to know to get on the road to clearer skin.
Products containing a retinoid or retinol — derivatives of vitamin A — are not on the safe list during pregnancy, says Boston-based, board-certified dermatologist Dr. Papri Sarkar. This is because research has shown that certain versions of the substance can harm a developing fetus. While it’s primarily oral versions of this ingredient (such as isotretinoin) that are the most dangerous, most dermatologists tell patients to steer clear of all these ingredients, from Rx to OTC.
[Editor's note: Retinol shouldn't be used by those who are pregnant, considering getting pregnant, or nursing. Please consult with your doctor before use.]
Also, if you rely on oral antibiotics in the tetracycline family for acne (including doxycycline and minocycline), you will not be able to take them during pregnancy, since they can cause discoloration of a fetus’s developing teeth and inhibit bone growth. There are other oral and topical antibiotics your dermatologist might suggest you try during pregnancy, says Dr. Tiffany J. Libby, a fellow dermatologist in New York City. Work with your dermatologist and your OB-GYN to see what options would be best for you.
Ingredients you can rely on during this time include glycolic acid and azelaic acid, says Libby, who likes Glytone® Brightening Complex ($74) (which actually combines both acids) and Skinceuticals® Glycolic 10 Renew Overnight ($80). Salicylic acid used to be thought of as a no-no, but the latest recommendations give any OTC product with the ingredient the green light during pregnancy, according to the American Academy of Dermatology. We’re fans of Paula’s Choice® 2% BHA Liquid Exfoliant ($30), which clears out pores while soothing skin with green tea.
Other safe ingredients to consider in the blemish battle: benzoyl peroxide (in limited amounts), charcoal, vitamin C, and clay. For moderate acne and oily skin, Sarkar recommends using clay masks one to two times per week and benzoyl peroxide as a spot treatment. Try the Target® Up and UpTM; Acne Spot Treatment ($4), which has 2.5 percent benzoyl peroxide in it. Sarkar also likes the Mad Hippie® Vitamin C Serum ($27) and the PaiTM; Copaiba Deep Cleanse AHA Mask ($60) which contains glycolic acid.
[Editor’s note: Be sure to talk to your doctor if you have any questions or concerns about products or ingredients.]
You spend many hours in bed — either asleep or, as the pregnancy continues, tossing and turning — so it’s important that you make sure that your pillow is pristine. “We know oil, dirt, and bacteria can contribute to acne breakouts,” says Libby, “so it is wise to minimize contact of these factors with our skin. Since pillowcases can accumulate oil and dirt, washing them regularly, at least one to two times weekly, is helpful.” For a boost in defense against bacteria, opt for an antimicrobial pillowcase like the Skin Laundry® Sleepcycle® Pillowcase ($30), which features silver ions to help repel germs.
People often get blackheads in their ears, including during pregnancy-induced acne, says Sarkar, who jokes, “Thank god women have the reward of getting a baby at the end of all of this, right?” A likely culprit: Dirt, oil, and bacteria that lingers on our screens and headphones. Make sure you regularly give them a once-over with an alcohol-based wipe.
While you’re at it: hands off your face, says Sarkar. If you’ve got a spot you just can’t leave alone, consider covering it with a small acne-fighting patch. Having that sticker over the area will remind you to keep your fingers away.
Dr. Libby says that glycolic peels can control acne during pregnancy, as well as help with hyperpigmentation. Other treatments likemicroneedling and cryofacials are also thumbs-up, as are most laser treatments. (The only hitch: some of the numbing solutions may not be safe for baby, so check with your doctor.)
Unfortunately, because of hormonal fluctuations, acne often worsens during pregnancy, says Libby. “If you are using medications to treat acne and planning to, or become, pregnant, I recommend consulting with your board-certified dermatologist for a skincare regimen that is both safe and effective for you,” she adds.
Breakouts can range from small comedones (whiteheads or blackheads) to full-fledged cystic acne, explains Sarkar. That said, the good news is that once your pregnancy is over, your skin should pretty much go back to the way it was, Sarkar notes.
Hopefully, with these tips, you’ll be able to quell any confidence-undermining blemishes, but don’t be afraid to see a dermatologist if you’re feeling less-than-stellar about your skin during pregnancy. Just because you’re creating life doesn’t mean your hormonal breakouts have to negatively affect yours.
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