The Dos And Don'ts

All that talk about the pregnancy glow makes a clear complexion sound like an automatic perk of expecting. But that may be more wishful thinking than fact -- acne can flare up, and you'll want to know what you can -- and can't -- use to help control it.

Woman applying acne medicatoin

For the estimated 40 to 50 percent of adult women who still deal with occasional breakouts, chances are your skin problems will continue through your pregnancy -- with the added catch that a lot of the pills and creams you've used to zap your zits in the past are now strictly off-limits.

What to avoid?

Figuring out which products to avoid can be difficult, though -- and scary. For Nicole Larsen, of St. George, Utah, it took a couple weeks to register that the cream her dermatologist had prescribed might not be okay once she was expecting. She explained, "A few weeks after I got pregnant, I thought, 'Should I be using this?' I called my dermatologist and he said it was okay, but I saw on a website that maybe it wasn't. Out of caution, I basically stopped using anything but normal face soap. I didn't want to do anything that would hurt the baby."

Getting things under control

Being pregnant doesn't necessarily mean grinning and bearing it, though. Cindy Lamerson, MD, a clinical assistant professor at the University of Nevada in Reno, says acne in pregnancy is actually fairly common, but it can be controlled. How? Carefully. Even dermatologists don't always agree about what's safe to use while you're expecting.

Benzoyl peroxide, for instance, the active ingredient in several over-the-counter creams, gets the okay from some doctors -- but don’t pick some up just yet. The Food and Drug Administration labels it a Class C drug, which means that there isn't enough info to give it a green light, and professional opinions are mixed. In a nutshell, they just don't know if it’s safe for pregnant women to use.

When it comes down to the health of you and your child, dermatologists would rather be safe than sorry. And, as Dr. Reed points out, "Most women feel they would not want to take a chance with their babies."

What you shouldn't use

When it comes to acne medications, a few -- like Accutane -- throw up major red flags. The popular vitamin A-based retinoid is taken in pill form over a months-long course of treatment and has caused such severe birth defects that patients must sign a release form affirming that they'll use two forms of birth control while they're taking it.

Although no other drugs have side effects as frightening as Accutane's, which is labeled a Class X drug by the FDA, Dr. Reed advises pregnant women to swear off anything in the retinoid family, including topical creams and gels like Retin-A, Differin, and Tazorac. "The amounts of topical drugs that are absorbed are very small. Nevertheless, problems in the fetus have been reported with use of Retin-A early in pregnancy, and since Differin and Tazorac are related chemically, they're placed in the same class."

You should also avoid oral antibiotics like tetracycline, doxycycline, and minocycline, which, Dr. Lamerson says, have been shown to permanently stain babies' teeth.

What to try

You can try to manage acne issues before resorting to medication. Use a mild cleanser and wash your face once or twice a day. If your hair tends to be oily, wash it frequently as well, and keep it back from your face. Avoid resting your face in your hands, and choose oil-free cosmetics if you use them.

The bottom line is that medication (including over-the-counter acne scrubs, creams or other treatments) should not be your first option when treating acne -- and always discuss any treatment or medication with your obstetrician as well as your dermatologist.

According to WebMD, Erythromycin is often the drug of choice for pregnancy acne. Azelaic acid is another option that some doctors feel comfortable prescribing.

Finding a skin-care routine or an acne medication that works for you can be a pain while you're pregnant, but it's worth it to be careful for the sake of your baby -- and so you can safely get that pregnancy glow for yourself.

More on pregnancy

Tips to help itchy pregnancy skin
What's my line? All about the linea nigra
Skin changes during pregnancy


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