While preparing for the birth of your child is an overwhelmingly joyous occasion, being pregnant does come with more than a handful of inconveniences, including having to give up certain foods (sushi, cold-cuts, wine) and activities (high-intensity and high-impact workouts). Pregnant women also have to be careful about what they put on their skin, as products containing potent acne-fighting ingredients — like prescription retinoids, over-the-counter retinols, hydroquinone, benzoyl peroxide, and salicylic acid, to name a few — are not safe during pregnancy.
This, understandably, can come as bad news to moms-to-be with acne and other skin conditions that pregnancy can often make even worse. What’s more, some of these ingredients should still be avoided even after giving birth — especially if you’re breastfeeding, since topicals like retinoids can be absorbed into the skin then excreted into breast milk, or simply transferred to a baby’s skin upon contact. But the data on lactating mothers is limited, so it can be confusing to know exactly what is or isn’t safe to use while breastfeeding.
To help you navigate what is already a stressful time, we spoke to eight dermatologists about what ingredients to absolutely avoid during pregnancy (and breastfeeding), alternative ingredients to look for, and the best products expectant mothers can use to tackle problems like acne, dry skin, dark spots, and more. But before using any, Dr. Jennifer MacGregor of Union Square Dermatology says that, regardless of your skin issue, it’s best practice to “get a recommendation from your dermatologist and check with your OB before trying to conceive, or as soon as you find out you are pregnant.” The same goes for once the baby has arrived: If you have any questions about the safety of any product, speak to your doctor and pediatrician.
Best non-retinoid products to treat acne
Unfortunately, retinoids (and retinols), the Vitamin A–derived holy-grail ingredient that works wonders on both acne and fine lines by promoting skin-cell turnover, are considered unsafe to use during pregnancy. “Those molecules have pretty good data showing that they can affect embryo development in the first trimester,” says Dr. Abigail Waldman of Mohs and Dermatologic Center at Brigham and Women’s Hospital. “Even though most of the studies were done when the medication is taken orally, we believe that it is absolutely contraindicated to use any cream or lotion with those ingredients at least during the first trimester. But I generally say avoid it during all of pregnancy.” For breastfeeding moms, the data is less clear, but the dermatologists we spoke to generally agree that it’s best to avoid oral or topical retinoids and retinols during lactation, too. According to Waldman, “There are no data studying it in lactating mothers and in breast milk, so it’s kind of one of those unknowns. I generally recommend not using it when breastfeeding.”
So how should pregnant women address acne if many go-to products contain retinoids and salicylic acids (another ingredient to avoid during pregnancy)? All eight of our experts recommend using azelaic acid, a topical also used to treat rosacea, that works by killing bacteria found in pores and decreasing the body’s production of keratin. Dr. Michelle Park of Washington Square Dermatology says azelaic acid makes a fantastic substitute for retinols. “It’s my favorite topical acne treatment to use during pregnancy and breastfeeding,” she says. “It helps clear redness and acne, as well as decrease pigment production, so it helps with the dark marks that acne can leave behind.” MacGregor agrees, noting that “azelaic acid has a subtle brightening effect.” Although typically prescribed by doctors (under the name Finacea, for example), azelaic acid can be found over the counter, including in this creamy formula from The Ordinary that came specifically recommended by Park.
In addition to azelaic acid, New York City–based dermatologist Dr. Cybele Fishman says that pregnant women can use “topical erythromycin (prescription) and all over-the-counter topical sulfur, zinc, and niacinamide treatments.” From the latter category of over-the-counter products, Fishman recommends the sulfur-based acne medication, Acnomel, as well as The Ordinary’s niacinamide and zinc blemish treatment. (Park; Dr. Nava Greenfield of Brooklyn’s Schweiger Dermatology Group; and Dr. Yoon-Soo Cindy Bae, a clinical assistant professor at New York University who also works at the Laser and Skin Surgery Center of New York, also agree that sulfur-based products are safe to use to treat acne while pregnant or breastfeeding.)
Good news: Strat’s favorite pimple patches from Cosrx are also dermatologist-approved for use while pregnant and breastfeeding.
As is the two-step patch from Acropass — as long as you take care to make one important change when it comes to using it, according to Park. The first part of the Acropass patch (which Rio also recommends) includes sanitizing the blemish with a swab soaked in salicylic acid, so she advises skipping that part and using regular alcohol instead. But otherwise, our experts say the product is safe — including its microneedles (in general, microneedling is considered safe during pregnancy, but other procedures like Botox and fillers are not).
Best non-retinoid products for brightening dark spots
Vitamin C is an effective ingredient that can also take the place of retinoids when it comes to treating dark spots and general skin-tone issues while pregnant or breastfeeding, according to Waldman and Park. “Used in conjunction with sunscreen” — more on that below — “vitamin C not only has properties that boost collagen production and has a retinod-like effect, but also works as an antioxidant that helps fight sun damage,” Park explains. Of all the vitamin-C formulas out there, she told us she trusts one above the rest: “I always stick with Skinceuticals CE Ferulic acid for its efficacy, and the research they have put into their product.” Bae also recommends Skinceuticals’s vitamin C serum for hyperpigmentation, dark spots, and discoloration.
The Skinceuticals CE Ferulic may be prohibitively expensive if you’re trying to save money for all the other things you need for your newborn, but Park says that, “for about half the price, you can try Drunk Elephant’s Vitamin C.” She adds that “The Ordinary also has a low cost option,” too.
Best moisturizers for pregnant women
“If you’re looking for a moisturizer for the face, I would recommend products that contain hyaluronic acid, which is incredibly hydrating and will plump the skin,” says Park, who adds that “hyaluronic acid is a natural substance found in our body’s tissues that’s naturally there anyway, so it’s not like introducing a foreign chemical.” (Other acids, however — including some alpha hydroxy acids/AHAs and beta hydroxy acids/BHAs — should either be avoided or used sparingly, according to most of the pros we talked to.) Neutrogena’s gel-cream is Park’s (and, incidentally, our beauty hobbyist Buzz Bissinger’s) go-to pick for an affordable moisturizer that gets the job done. She says “it has a lot of benefits, including moisturizing and fighting fine lines,” adding that “it’s just an overall great moisturizer.”
When looking for a moisturizer while pregnant or breastfeeding, Greenfield — who is currently pregnant herself — cautions against using products that call themselves anti-aging, because that means they’ll likely contain either AHAs or BHAs. She also notes that, because “skin can become sensitive during pregnancy and very dry during breastfeeding, you may need to change what you use more often.” Right now, she’s switching between C’est Moi’s Gentle Moisture Lotion and Belli’s Healthy Glow Facial Hydrator, which contains vitamin C and is formulated specifically for pregnant and breastfeeding women.
For those who prefer a true cream to a hybrid one or a lotion, Park and Greenfield also recommend this gentle moisturizer by CeraVe — a brand that took the top spot in our list of the best body lotions for dry skin. Park adds that a cream like this “will keep more moisture in the skin than a lotion.”
AHAs and BHAs are both popular types of skin brighteners and exfoliants, but, according to MacGregor, “they disrupt the skin barrier and enhance penetration of other topicals, including untested substances.” She and another dermatologist we spoke to say its best to generally avoid AHAs and BHAs (which include salicylic acid) if pregnant or breastfeeding. But others, including Fishman and Dr. Shinjita Das at Massachusetts General Hospital, say there are some topical acids — including glycolic, lactic, malic, and mandelic acid — that are considered low-risk and okay to use (though Das warns to avoid letting a baby’s skin touch any areas where they may be applied). This face cream, recommended by Park, contains azelaic acid and glycolic acid, both of which, she says, will “help with acne but also to even out skin tone.”
Best serums for pregnant women with very dry skin
Those who can get extremely dry skin know that sometimes a moisturizer alone won’t deliver all the hydration you need. In instances when “a topical moisturizer isn’t cutting it, you can use a hydrating serum in conjunction with the moisturizer,” Park says. For quenching super thirsty skin while pregnant or breastfeeding, she recommends SkinCeuticals’s Hyaluronic Acid Intensifier or the Hydrating B5 Gel (which also contains hyaluronic acid).
For a more affordable serum with hyaluronic acid to use on extra dry skin during pregnancy or while breastfeeding, Park recommends The Ordinary’s HA with B5 (which Strategist beauty writer Rio Vera-Newton also swears by).
Best sunscreen for pregnant and nursing women
In addition to using the above products, the dermatologists we spoke with also noted that keeping out of direct sunlight — or regularly using a mineral sunscreen (or a moisturizer with SPF) if you’re exposed to it — will help keep skin issues at bay while pregnant or breastfeeding. In fact, Greenfield told us that “strict sun avoidance” is one of the most important things you can do to prevent hyperpigmentation, dark spots, and discoloration. That means wearing “protective clothing, a hat, and a broad spectrum mineral/physical sunscreen such as EltaMD Pure.” The brand is generally beloved by derms (it took the top spot in our list of best sunscreens for face), and MacGregor notes that EltaMD’s tinted sunscreens with SPF 41 or SPF 44 are a good option if you’re looking for one that functions more like a tinted moisturizer. Park, Nagler, and Waldman also stress using a mineral sunscreen (which typically contain zinc oxide and titanium dioxide as their main active ingredients) over a chemical one, as mineral formulations sit on the surface of skin to block UV rays, where chemical ones seep into skin and suck UV rays in before reflecting them.
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