Pregnant women need to know that anything they put in or on their bodies can affect their baby’s well-being. This goes for food, supplements, alcohol, cigarette smoke, and caffeine, as well as the lotions and creams they rub onto their skin. Basically everything a pregnant or nursing woman comes in contact with is of concern.
Some topical ingredients will get absorbed into the bloodstream, and dermatologists as well as OB/GYNs alike may warn you about certain prescription medications and potent ingredients to avoid. According to Beverly Hills Dermatologist Zein Obagi, MD, pregnant women should avoid applying any form of retinoids, including Avage, Differin, Renova, tretinoin, retinols, retinyl palmitate, Tazorac and any other variations. “Some pediatricians even recommend waiting at least 30 days after you discontinue use of retinoids to conceive. Pregnant women should not use hydroquinone for skin lightening and melasma.” He added that Tetracycline has been shown to cross the placenta, which can cause staining of the baby’s teeth and affect the way the skeleton develops so it should be avoided as well.
In general, salicylic acid peels are on the no fly list too. If in doubt about any product you are using, consult your obstetrician and/or dermatologist. If you have been using something that is not advisable, ask your doctor or pharmacist for a suitable alternative that is safe to use during pregnancy and breastfeeding.
According to New York Dermatologist Dr. Francesca Fusco, “When my pregnant patients ask me what is ‘safe’ to use while pregnant or breast feeding, I always advise them to check labels, and clear it with their OB or pediatrician (if breast feeding).”
Her go to list of products includes oils. “Almond is my favorite. Weleda Stretch Mark Massage Oil helps smooth tight skin and prevent stretch marks and smooth stretching skin as your stomach expands. It nourishes, smooths and maintains great hydration.” She also recommends products that are ideal for pregnant skin. “I look for products that are allergy-tested and free of parabens, fragrance, and harsh chemicals, and perfect for even the most sensitive skin. The First Aid Beauty line hits the mark on all the above. Their cult favorite Ultra Repair Cream, and best-selling Facial Cleanser and Daily Face Cream are wonderful. Many pregnant women get itchy due to changes in hormones and the Ultra Repair Cream is thoroughly soothing. I tell patients to keep one jar in a cool place and when the ‘pruritus of pregnancy’ strikes, slather don’t scratch!”
Fusco also recommends maintaining your hair and scalp. “A healthy scalp is the foundation for beautiful hair during any season Clear Scalp and Hair Beauty Therapy Mask with cactus is a deeply intensive hydrating mask that nourishes and gives hair resilience.”
As any mother knows, pregnancy can be a wild hormonal ride resulting in acne and even melasma, sometimes called the “mask of pregnancy.” Florida Dermatologist Dr. Heather Woolery-Lloyd says there are definitely topical options, even antibiotic ones, for treating unwanted acne while pregnant. “Topical antibiotics such as clindamycin and erythromycin fall into pregnancy category B, which means there are no proven risks in humans. Topical antibiotics can be safely used in pregnancy,” she says.
On the other hand, oral use of antibiotics may carry more risk and some studies show a weak association with certain birth defects. “Using oral antibiotics during pregnancy should be discussed with your physician and should be used when the benefits outweigh the risks,” Woolery-Lloyd advises.
She also recommends certain ingredients derived from natural substances for acne treatment. “Azelaic acid, derived from cereal grains, comes in a topical gel and cream formulas. This acne medication is also pregnancy category B,” she said.
Other natural ingredients that have been proven to be helpful in some acne studies and are safe to use during pregnancy are tea tree oil, a natural antibiotic; green tea, a popular natural antioxidant and anti-inflammatory; and lactic acid, which occurs naturally in our bodies. “Specific Beauty Exfoliating Cleansing Cloths offer gentle exfoliation and have aloe and green tea for skin brightening,” says Woolery-Lloyd.
According to Wooldery-Lloyd, benzoyl peroxide, sulfur-based therapies, and glycolic, acid do not fall into FDA pregnancy category A or B, but most dermatologists feel comfortable prescribing these treatments, as no adverse affects during pregnancy have been reported. However, most dermatologists avoid glycolic acid peels during pregnancy.
When it comes to treating hyperpigmentation or melasma, Woolery-Lloyd says to save the big guns like hydroquinone for after baby arrives. Brightening ingredients that are safe to use during pregnancy include licorice extract, green tea, lactic acid, and niacinimide (vitamin B3).
As you can see, there is some controversy regarding what exactly is safe to use during pregnancy. “In general if is important to recognize that studies are not commonly done on pregnant women, which unfortunately leaves us in the dark with regard to product safety issues,” says New York Dermatologist Janet Prystowsky. “The products that I consider safe to use during pregnancy include: mineral oil, Vaseline, Aquaphor, Pond’s Cold Cream, sunscreen with only minerals in it such as Aveeno Mineralguard SPF 50.” Her go to for acne treatment during pregnancy includes benzoyl peroxide, glycolic acid pads, and azeleic acid in prescription medications Finacea® and Azelex®. Also for acne, she likes Blu-U light. “For eczema, Aveeno baby eczema cream is fantastic and phototherapy (not tanning parlors) is safe. Small amounts of over the counter hydrocortisone for itches appears to be safe, but in general steroids should be avoided unless under a physician’s supervision,” she said.
Products and ingredients to avoid during pregnancy, according to Prystowsky, also include sunscreens that may be absorbed into the body, cosmeceuticals with peptides, salicylic acid, Rogaine® for hair loss, hydroquinone, and BOTOX®, though it has been used safely to treat pregnant women with migraines.
While breast feeding, topical retinoids may be added back and A+D ointment, typically used for diaper rash, works wonders on cracked and sore nipples between feedings. “Otherwise, while nursing I would continue the rest of the pregnancy restrictions because of concerns that products may get into the milk and have an untoward effect on the baby,” she says.
With all of the things to worry about during pregnancy, keep your skincare regimen simple. Basic moisturizers and mineral based sunscreen will go far in maintaining that mother-to-be glow. After your child is weaned, discuss a new regimen with a qualified skin care professional.