Pregnancy-safe skincare: what to stop, what to keep
Which skincare ingredients to stop in pregnancy and breastfeeding, which to ask about first, what is usually fine, and how to handle acne, melasma and itching.
Written by the Glowpedia team · not yet reviewed by our dermatologist
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Pregnancy changes skin, with acne, dark patches, dryness and itching all common, right when you are told to stop part of your routine. The list of ingredients to avoid is shorter than many apps suggest, and your own doctor or midwife has the final word.
Quick answer: Stop all retinoids (retinol, retinal, adapalene, tretinoin, tazarotene and isotretinoin) and hydroquinone, and ask your doctor before using salicylic acid above 2% or benzoyl peroxide. A gentle cleanser, a moisturizer and a mineral sunscreen are a safe base. Ask your doctor or midwife about your whole routine, including acne medicines.
Ingredients to stop during pregnancy
The American Academy of Dermatology (AAD) lists these as ingredients and medicines to avoid:
| Ingredient | Why it matters |
|---|---|
| Retinoids, including prescription isotretinoin, tretinoin and tazarotene, and over-the-counter retinol and adapalene | Oral retinoids are known to cause birth defects. Topical ones are absorbed less, but there are reports of problems, so doctors advise avoiding them. |
| Hydroquinone, a skin-lightening ingredient | Doctors advise avoiding it during pregnancy. |
| Oral tetracycline-type antibiotics (tetracycline, doxycycline, minocycline) | These can affect a baby's developing bones and teeth. |
| Spironolactone and finasteride | Medicines sometimes used for acne or hair loss, and not for use in pregnancy. |
| 5-fluorouracil | A prescription skin cream. |
If you are pregnant or breastfeeding, ask your doctor before using any retinoid. Mayo Clinic gives the same advice for retinol. A product that says "retinol alternative" is not automatically safe, so read the ingredient list.
Ingredients to ask your doctor about first
The AAD suggests using these sparingly, after talking to your dermatologist:
- Salicylic acid above 2%, such as in peels. Low-strength cleansers are often considered acceptable, so ask.
- Benzoyl peroxide.
- Some essential oils, such as rosemary, basil, jasmine and sage.
- Phthalates, parabens, phenol and triclosan, which can show up in fragranced products and some cosmetics.
When in doubt, choose fewer products and fragrance-free ones.
What is usually considered fine?
The ingredients below are not on the avoid lists of the sources used here. Many doctors consider them low concern, but safety data in pregnancy is limited for cosmetics, so check with your doctor:
- Azelaic acid for breakouts and uneven tone
- Niacinamide for oil and tone
- Hyaluronic acid, glycerin and ceramides for hydration
- Vitamin C and glycolic acid. An AAD dermatologist suggests vitamin C in the morning and glycolic acid in the evening to help with skin color changes. Glycolic acid is an AHA and can make skin more sensitive to the sun, so use sunscreen every day.
- Mineral sunscreen with zinc oxide or titanium dioxide
Bakuchiol, a plant ingredient sold as a gentle retinol alternative, has not been studied much in pregnancy. Some sources call it safe, but ask your doctor before relying on it.
A simple pregnancy routine
Morning: gentle cleanser, moisturizer, then mineral sunscreen with SPF 30 or higher.
Evening: gentle cleanser, treatment of your choice (see the next section), then moisturizer.
The AAD suggests cleansing up to twice a day and after sweating, using fragrance-free products without harsh alcohols or sulfates. Pregnancy skin is often more sensitive, so add one new product at a time.
Common pregnancy skin concerns
Acne
Hormone changes can cause breakouts, including in people who never had them before. A gentle cleanser and a lightweight moisturizer are a good start. Azelaic acid is often suggested, and your doctor may recommend other options. Avoid oral antibiotics from the tetracycline family and retinoids. See breakouts and acne-prone skin for more.
Melasma ("mask of pregnancy")
Melasma causes brown or gray-brown patches on the face. Sun and visible light can make it worse. The AAD recommends a broad-spectrum, water-resistant sunscreen with SPF 30 or higher, and a tinted version may help protect against visible light. It also advises waiting until after delivery to treat melasma, since it may improve or even go away after birth. See melasma.
Stretch marks
Genetics play the biggest role, and no cream has been proven to prevent stretch marks. Moisturizing can help skin feel more comfortable and less itchy. See stretch marks.
Dry and itchy skin
Use a fragrance-free moisturizer, keep showers short and warm, and avoid hot water. Severe itching, especially on the palms and soles, needs a quick check. This can be a sign of a liver condition called cholestasis of pregnancy.
Hair treatments
Ask your doctor or midwife about hair dye and chemical hair treatments. Some smoothing treatments release formaldehyde fumes. If you do have your hair colored or treated, choose a well-ventilated space.
Breastfeeding
Most of the same rules apply, so avoid retinoids unless your doctor says otherwise. Avoid putting products on the nipple or breast area before feeding, because a baby could swallow them.
How to read a label
- Check the ingredient list, not the front of the pack. A "pregnancy safe" label does not mean that every ingredient is right for you.
- Look for retinol, retinal, retinyl palmitate, adapalene, tretinoin and tazarotene.
- Fewer ingredients usually means fewer surprises.
- Tell your obstetrician and dermatologist about all the skin medicines you use, including prescription ones.
When to see a doctor
- Intense itching, especially on the palms and soles or at night, even without a rash. The NHS says to contact your maternity unit urgently for this.
- A sudden widespread rash, blistering, or swelling of the face or lips.
- Severe acne, or acne with pain and scarring.
- A mole that changes shape, color or size.
- You used a retinoid or another ingredient on the avoid list before you knew you were pregnant. Stop it and tell your doctor, who can explain what it means for you.
FAQ
Is bakuchiol safe in pregnancy?
There is limited safety data. Some sources describe it as safe, but ask your doctor first.
Can I use chemical sunscreen?
Mineral sunscreens with zinc oxide or titanium dioxide are usually the first choice, because they sit on the surface and tend to irritate less. Ask your doctor about other types.
I used retinol before I knew I was pregnant. What now?
Stop using it and tell your doctor or midwife. Try not to worry; they can explain what it means for you.
Can I use vitamin C?
It is not on the AAD avoid lists, and an AAD dermatologist suggests it in a morning routine. Check your own routine with your doctor.
Can I get facials or peels?
Ask first. Some peels use strong acids, and many professionals avoid them in pregnancy.
Sources
- Dermatologist-approved pregnancy skin care (American Academy of Dermatology)
- Melasma: Diagnosis and treatment (American Academy of Dermatology)
- Itching and intrahepatic cholestasis of pregnancy (NHS)
- Wrinkle creams: Your guide to younger looking skin (Mayo Clinic)