We often do not know if treatments are safe during pregnancy – because it hasn’t been tested on pregnant women. No ethics board allow testing on a pregnant woman (understandably so), and no mom will want to take a treatment that might cause harm to their baby (even if the risk is minimal). So, most data on safety comes from studies that look at historical cases where the treatments were used in pregnant women and if the baby was affected or not.
The no-no’s
Roacutane/Orotane (isotretinoin) – the medication often taken for acne, causes abnormalities in a forming fetus. You must be on oral contraception before taking this treatment, and you must let your dermatologist know if there was an accidental pregnancy. This treatment does not affect your fertility (your chances of becoming pregnant in the future) and can be stopped one month before conceiving.
Topical vitamin A’s (tretinoin/retinol/Retin-A/differin, ect)– are category C in pregnancy and are best to avoid. It is generally not ‘worth it’ to take a risk for this. Maybe double-check your skin routine to check if there is no vitamin A in your products. Fortunately, there are alternative treatments that can substitute this.
Hydroquinone – a skin lightening treatment should not be used due to high systemic absorption after topical use.
Spironolactone/finasteride/certain antibiotics – These tend to also not be safe in pregnancy. Best to chat to your dermatologist/gynecologist about alternatives.
Botox – although the evidence of harm is contradictory – is best avoided.
What is safe?
Sunscreen – you can continue using your sunscreen.
If you want to be ultra-safe, you can switch to a mineral-based sunscreen.
Azelaic acid – a topical treatment that helps for acne, rosacea, and pigmentation can safely be used in pregnancy.
Benzoyl peroxide – is common in acne treatments and can be safely used.
Niacinamide – supports your barrier and improves various skin conditions. It’s okay to include this in your routine.
Topical vitamin C – Safe and sound to have on board, this antioxidant helps protect you from the sun and can lighten pigmentation.
Hyaluronic acid – common in hydrating face creams, can be safely used in your skincare.
What you might need in pregnancy
Keep an eye on your moles – Melanoma is one of the most common cancers during pregnancy. Being pregnant doesn’t seem to increase the risk. It’s just that this skin cancer develops during a woman’s child-bearing years. Today, more women between the ages of 20 and 40 are getting melanoma. It is safe to test for melanoma during pregnancy, and you should not delay an examination if you notice a changing or new mole.
Stretch marks – here, prevention is better than cure.
There are multiple ‘miracle stretch mark creams’ out there, but the research shows that it’s more the action of massaging your growing tummy that makes the difference. So, get a good moisturizer – free from nonsense – and massage the ever-increasing baby bump twice a day. Doing this will allow the skin to become more supple gently. If you already have stretch marks – depending on what kind of stretch mark it is, there are treatment options.
Other – The immune cells in your skin change in pregnancy, and you might experience worsening of a known skin condition or a new rash. Chat to your dermatologist about how these can be safely addressed.
Reference:
DOI 10.1016/j.jaad.2013.09.010
