Skincare During Pregnancy | As Seen in Women’s Health

Pregnancy skin care is a hot topic and while Dr. Bowles shares general recommendations in this article, most things have never been tested in pregnancy therefore we don’t definitively know their effects on a baby. We recommend consulting your dermatologist or obstetrician (OB) before using any products in pregnancy.

Read along while Dr. Alexandra Bowles shares her insights from her Women’s Health feature on how your skin can be affected during pregnancy.

1. How exactly does a woman’s skin change during pregnancy? What are some things to keep an eye on or conditions that can occur? I know everyone is different, but generally, is pregnant skin more susceptible to anything in particular or in need of anything extra to stay healthy?

During pregnancy, a woman’s skin goes through more changes than you think. This is due to several factors, including, hormonal changes, an increase in blood volume, and other physiological factors. Lots of women experience oilier skin, leading to acne, while others may notice melasma or a dark line down the abdomen called linea nigra. Stretch marks also may develop as the belly grows, and some women may see an increase in spider veins or experience dry, itchy skin. Medical conditions like PUPPP, a rash characterized by itchy bumps, or cholestasis, a serious condition that causes intense itching, can also occur and warrants an immediate trip to the OBGYN.

To keep skin healthy, staying hydrated, using fragrance-free moisturizers, applying sunscreen, and practicing gentle cleansing are key. A balanced diet rich in vitamins and antioxidants can also support skin health. It’s essential for pregnant women to consult with a dermatologist if they experience severe skin changes and to be mindful of avoiding certain ingredients, like retinoids, during this time.

I know certain skincare products and active ingredients can be unsafe during pregnancy. For each of the following, can you explain why each is not recommended for use during pregnancy? Retinol/Tazorac/Accutane, Salicylic acid, Chemical sunscreen, Benzoyl peroxide, Hydroquinone, Essential oils.

Consider steering clear of the following products if you are pregnant or planning to become pregnant. Pregnancy skin care is a hot topic and while we have recommendations, most things have never been tested in pregnancy therefore we don’t definitively know their effects on a baby. Retinol and retinoids, a form of vitamin A, can lead to catastrophic birth defects, especially in the early months. Both Tazorac (a topical retinoid) and Accutane/isotretinoin (oral retinoid) are very powerful acne treatments that can lead to serious birth defects, so these are absolutely medications to avoid!

Salicylic acid can affect fetal development, so it’s best to avoid strong formulas like this. Even some chemical sunscreens could disrupt hormone levels and have reproductive toxicity concerns. Benzoyl peroxide might irritate your skin and do more harm than good. We really don’t even know enough about its effects during pregnancy, so it’s better to be safe. Hydroquinone, an ingredient known to lighten the skin, can get absorbed into the bloodstream and may harm your baby. Many essential oils can also cause unwanted reactions or even stimulate contractions. Again, these ingredients have not been studied in pregnancy, so if there is ever a question it is best to consult your dermatologist before using new products in pregnancy. 

3. I’ve also heard that hair dye can be bad during pregnancy. Do you have any watch outs or recommendations here? Are any products in this category appropriate to use?

Hair dye could cause some potential concerns during pregnancy, though it’s usually pretty safe if you take some precautions and do your research. A lot of women actually wait until the second trimester to dye their hair since that’s when the baby’s major organs are developing. If you want to be extra cautious, consider using a semi-permanent or ammonia-free dye. When it comes to hair techniques, highlights or balayage are a great option since no dye is actually touching your scalp. If you decide to go see a stylist, you can even ask for gentle and chemical-free products. 

4. Is there anything else product or ingredient-wise not listed above that should be avoided?

Certain oral medications should not be used in pregnancy. An example would be someone taking oral spironolactone for acne before conception. This should be stopped when you are expecting. Truly, the list of pregnancy-safe ingredients is short and the ‘do not use’ list is vast. Make sure you are checking with your OBGYN when questioning any particular skincare/medication/foods.

5. During pregnancy, what treatments and procedures should be avoided and why (ex. Botox, fillers, chemical peels, lasers, etc.)?

 Botox and fillers contain toxins that could possibly affect the fetus, so I recommend avoiding them altogether. Chemical peels are also unsafe, as they use strong acids that can really irritate the skin and eventually may get absorbed into your system. Laser treatments can lead to an increase in pigmentation and skin sensitivity, and there’s not enough research on this to determine if it’s safe during pregnancy, therefore we typically do not recommend this. Plus, steer clear of tanning beds since they expose you to harmful UV rays and can lead to overheating as well as increase skin cancer risks later in life.

Some essential oils can also trigger contractions or allergic reactions, so it’s best to avoid those unless you’ve checked with your healthcare provider. Lastly, electrolysis and laser hair removal might not be recommended because pregnancy hormones can disrupt your skin and hair growth. Always check with your doctor before trying any cosmetic treatments during pregnancy to make sure everything’s safe!

6. Are there any safe skincare treatments for pregnancy?

There are actually a lot of safe skincare treatments you can enjoy during pregnancy. Keeping your skin hydrated is the first step. Make sure you are using a gentle and fragrance-free moisturizer to avoid any irritation. Also, gentle and mild cleansers are a great option, and definitely don’t forget a mineral sunscreen. To focus on hydration, choose a face mask with ingredients like aloe vera or honey–these can help rejuvenate your skin. Natural oils like coconut or jojoba oil are great for moisturizing. Lots of spas offer pregnancy-safe facials, so be sure to let your esthetician know you’re expecting! 

7. Generally speaking, I’ve read the following skincare ingredients are safe for use during pregnancy. Glycolic acid and bakuchiol, azelaic acid, vitamin c/niacinamide, and mineral sunscreen. Does your research corroborate this, and if so, do you have any specific product recommendations in each category below that you like or would advise patients it’s safe to use?

This is correct! Glycolic acid, azelaic acid, vitamin C, niacinamide, and mineral sunscreen are generally considered to be safe to use during pregnancy. Bakuchiol is commonly used as an alternative to retinol, however, there have been no studies on bakuchiol and pregnancy, so it is best to avoid it. Prescription azelaic acid is also typically considered safe to use. Lastly, for expecting mothers who want a vitamin C in their routine, Phloretin and CE Ferulic are great options noted as pregnancy-safe by Skinceuticals. 

8. Is there anything else you recommend to pregnant women in your practice? If so, where would they use it, and what benefits does it offer?

I recommend gentle skincare, focusing on hydration and mineral sunscreen. After, add in a few fun treatments to make you feel refreshed and bright! Three options my pregnant patients love are diamond glow facials, oxygen facials, and dermaplaning. Each of these are safe and effective treatments to make your skin shine!