Dealing with Acne During Pregnancy

The body goes through many changes during pregnancy and although we may think the days of having to deal with acne are long gone, it can once again rear its ugly head. The culprit-increased hormone levels can also cause hyper-pigmentation.

Before you try to zap those zits, it’s important to know what is safe to use and what isn’t. Some medications have been linked to complications during pregnancy and birth defects. It’s always best to consult your doctor before starting any kind of acne treatment.

In doing research for this posts, there were certain medications that all sources agreed were NOT safe. So let’s cover those first...

Medications to Avoid

Retinoids which includes:

  • Differin (Adapalene)
  • Retin-A, Renova (Tretinoin)
  • Retinoic Acid
  • Retinol
  • Retinyl Linoleate
  • Retinyl Palmitate
  • Tazorac, Avage (Tazarotene)


  • Accutane (Isotretinoin)
  • Tetracycline
  • Doxycycline
  • Minocycline

Hormonal Therapy

  • Estrogen
  • Flutamide
  • Spironolactone

I found differing opinions on Salicylic Acid or Beta Hydroxy Acid (BHA), which I would translate as avoid if possible. In its oral form, studies have shown it causes birth defects and various complications during pregnancy. However, dermatologist Sandra Marchese Johnson stated in an article posted on, “small amounts applied to the skin-such as a salicylic acid-containing toner used once or twice a day-are considered safe”. Remember, the longer it sits on your skin the more opportunity it has to seep into the bloodstream.

Benzoyl Peroxide is another ingredient I found conflicting opinions on. At it says that there’s been little research on the safety of its use during pregnancy, but problems have not been reported. At, it says products containing benzoyl peroxide appear to be safe. Dr. Brandith Irwin at recommends avoiding this medication during pregnancy. The bottom line, appears to be safe, however there are really no studies to back this general consensus.

You’ll want to be careful of any product you put on your skin, not just acne medications. Products like sunscreen and even skin care products in general can have many harmful chemicals in them. Be sure to read my post, “Top 10 Toxic Ingredients in Your Beauty Products” and “Sunscreen What You Need to Know”.

Medications for Rosacea

Metronidazole is prescribed for rosacea and studies done on animals did not show fetal damage, however it does cross the placental barrier. According to the FDA, it should not be used in the first trimester. See above for any acne medications (which may be prescribed for acne) that you stay away from.

Now let’s look at which treatments are considered safe to use during pregnancy…

Safe to Use

  • Erythromycin (Erygel)
  • Clindamycin (Cleocin T, Clindagel)
  • Azelaic Acid (Azelex, Finacea)

Safe for Hyperpigmentation

  • Kojic Acid
  • Mandelic Acid

Generally you want to avoid over cleansing because this can overstimulate the skin’s oil glands, use a gentle non-abrasive cleanser and don’t pick or pop your pimples. Of course, you can always come and see me for a facial and I’ll help to get your skin back on track.

Diamando Perivolaris

Hard Wax Expert, Wax Trainer/Educator