Acne Treatment: What’s Safe During Pregnancy and Breastfeeding?

                                             

While bringing a precious little one into the world is a joyous occasion, there are also the not-so-joyous effects of those pregnancy hormones, including acne. During the first few weeks of pregnancy, there is a rise in progesterone and other androgens that can increase oil production and formation of acne.  For many women, acne improves in the second trimester and onward, but for others (myself included!) breakouts can persist throughout pregnancy and into the postpartum period. While several traditional acne treatments are contraindicated during pregnancy, thankfully there are several safe treatment options available to help you get that pregnancy glow.

Over-the-counter topicals and washes

·      Alpha-hydroxy acid (eg. Glycolic acid) containing peels, washes, and creams

o   These are essentially fruit acids

·      Benzoyl peroxide washes and creams (eg. Panoxyl wash)

Topical prescriptions

·      Azelaic acid (Finacea) gel or foam

o   This may also be helpful for that pesky pigmentation (melasma) that occurs during pregnancy.

·      Clindamycin or Erythromycin topical lotion, gel, or solution

o   Topical antibiotics that help reduce the amount of acne-producing bacteria on the skin

Oral Antibiotics

While we typically try to avoid oral medications during pregnancy if possible, there are a few safe options if acne continues to worsen despite topical treatments.

·      Azithromycin

·      Erythromycin

·      Cephalexin

Light Therapy

Blue light therapy or photodynamic therapy is an in-office therapeutic option for acne, which involves shining a blue light on the face for several minutes at regular intervals. This is often not covered by insurance but provides a safe option during pregnancy.

 What isn’t safe?

Acne medications such as isotretinoin (Accutane), doxycycline, minocycline, and spironolactone are absolutely contraindicated during pregnancy due to a risk of birth defects. While absorption is likely quite low, topical retinoids, including tretinoin, adapalene, retinol, and tazarotene are also not recommended. As several of these medications can come in combination prescription drugs and over-the-counter creams, make sure to check the ingredients on your prescriptions and moisturizers to avoid these. Additionally, products containing salicylic acid and sodium sulfacetamide are discouraged, both of which can be found in over-the-counter acne products.

The recommendations while breastfeeding are typically similar to those during pregnancy, but when in doubt, please consult your doctor first.

If you are one of the many of us that struggle with acne during and after pregnancy, we would love to help you get on a safe and effective regimen!