Acne and pigmentaton: what treatments are safe during pregnancy

Fiona Clark

What can you do about acne or pigmented skin when you’re pregnant? The experts explain.

Pregnant women are faced with a long list of what they can’t do when they’re pregnant, but if you have acne outbreaks or pigmentation issues the big question is – what can you do?

“Good question, and a difficult one as during pregnancy women are asked to avoid a lot of the products” dermatologist Dr Simon Zokaie says.

Dr Paul Charlson, president of the British College of Aesthetic Medicine (BCAM) says the reason behind this is not necessarily because the ingredients in skin care products or treatments are dangerous (although some are definitely off limits), but because most aren’t specifically tested on pregnant women so there is no way to say that they are 100% safe. So doctors err on the side of caution just in case there could be some effect on the developing baby.


What’s off the table?

The ones that are definitely out are:

  • retinol products (vitamin A) – orally or topically
  • most antibiotics
  • hydroquinone for skin lightening
  • any invasive skin treatments or cosmetic procedures, and that includes threadlifts, fillers and anti-wrinkle injections like botox,
  • high strength, professional grade chemical peels.

The reason some ingredients or products are off limits during pregnancy is that they may be absorbed via the skin into the blood stream and may possibly affect the baby. But in some cases the amount of an active ingredient that is absorbed through the “is tiny”, Dr Charlson say.

This means there are still some options available depending on how they’re used and what your doctor is happy for you to use or try. (Always speak to your own GP!)


What could be on the table?

The options are limited there are a few that may help – depending on how they’re used:acne-pigmentation-what's safe-during-pregnancy-harley-street-emporium

  1. LED Therapy: Dr Zokaie says this is safe during pregnancy. It may be useful for both acne and rosacea as well as pigmentation issues. Red light helps fight the bacteria associated with acne and inflammation while blue light may be of benefit for sun damaged or pigmented skin.
  2. Topical erythromycin. Dr Charlson says some doctors may prescribe this antibiotic for short term use on the skin for some skin infections.
  3. Glycolic acid – is great for unclogging pores and brightening the skin. It is best to avoid acid high strength products, so if you’re using the 10% concentrations or above, scale back to a milder product. A lactic acid product, which is milder, may be a better option if your skin has become more reactive, or avoid acids altogether and switch to an enzymatic cleanser such as ZENii’s Chamomile & Papaya Cleanser  or a simple Micellar water.
  4. Vitamin C serums. Vitamin C serums  can help brighten the skin and play a role in reducing pigmentation as well. This should be fine to use unless your skin has become more reactive – if so, swap to one with a lower concentration or a time release formulation, or stop using it until after the baby has arrived and your skin has settled down. Vitamin C products can irritate acne prone skin so it may be best to avoid if you are getting outbreaks.
  5. Hyaluronic acid – this plumps and hydrates. Again this should be fine to use as it is found naturally in your own skin. It is fine for people with acne if it is in a non-comedogenic product. A serum may be best if you are having outbreaks.
  6. Sunscreen – this is a must for pigmented skin and melasma. For melasma, sometimes known as the mask of pregnancy, dermatologist Dr Nick Lowe suggests “both during and after pregnancy patients [should] use a broad-spectrum sun protection daily. I would advise against using sunscreens containing oxybenzone.” He adds: “There’s no point in commencing any other treatment unless you are prepared to apply moisturiser with sunscreen every day as even low levels of UVA coming through windows can darken melasma.” (See his article on pregnancy and post pregnancy treatments here)


One that is a little more controversial is salicylic acid.

There are two school of thought on this. It is a Beta Hydroxy Acid (BHA) which is useful in reducing inflammation and fighting the bacteria associated with acne. It is, however, related to aspirin. Aspirin in its oral form is not advised (unless medically required) during pregnancy because it ‘thins’ the blood and increased the risk of bleeding.  But Dr Charlson says in a concentration of 2% or less it is considered safe for topical use during pregnancy. Always consult your doctor first.


Recommended skin care ranges

If your skin is red and inflamed with acne or rosacea Dr Zokaie recommends using a quality skin care product that calm the skin can make a difference. He recommends the Alumier MD Hydracalm skin care range which can only be purchased through professional clinics.

Dr Unnati Desai, a GP with a diploma in dermatology, agrees. She says it’s best to avoid chemicals like parabens and phthalates if possible.

Many of the professional/clinic only products are formulated without these so-called ‘nasties’ and she recommends the Tebiskin range, with the exception of its retinol-based products while pregnant and breastfeeding.

She says the Cera-boost, UV Sooth moisturiser and Sooth-clean cleanser are ideal for irritated, red and inflamed skin and dry skin. (Take the Skin Care Test to find out more about these products and which ones are right for you.)


If you have skin care concerns while you are pregnant, always see your doctor. You can find a number of dermatologists and GPs in our doctor’s section who can help.

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