The No-Go Skincare Ingredients During Pregnancy And Their Safe Swaps

Many of my mama patients ask me what is safe to use on their skin during pregnancy or when trying to conceive. Here is my list of the No-Go’s in pregnancy and safe swaps.

Retinoids/Retinols: 

Pros: These ingredients can be found over the counter as retinol, retinyl palmitate, retinaldehyde, and retinoic acid. Prescription strength products such as adapalene, tretinoin, trifarotene, tazarotene, and oral isotretinoin are prescribed by your board-certified dermatologist. These medications treat acne but also increase collagen production and are a great nightly topical in your skincare regimen to soften and prevent fine lines and wrinkles.

Cons: Retinoids/retinols are one of the most widely studied topicals and there is much data to demonstrate efficacy. They are derived from Vitamin A; an essential vitamin for fetal eye growth, skeletal growth and the growing baby’s immune system. However, the Vitamin A in retinoids/retinols can easily be transferred from mother to baby via the placenta in a far larger amount than needed, making it a NO-GO during pregnancy. Studies have shown a direct correlation between retinoid use and malformations affecting prenatal and postnatal growth.  However, topical retinoids are considered safe during nursing, so speak to your dermatologist once you deliver!

Pregnancy Swap! Azelaic Acid, Vitamin C and peptides, as well as Alpha-hydroxy acids like glycolic, lactic, mandelic and malic.

Hydroquinone: 

Pros: This ingredient is fantastic alone or in combination with other skin lightening ingredients for melasma (aka the mask of pregnancy) and hyperpigmentation caused by the sun.  

Cons: Hydroquinone has optimal absorption into the skin and thus is considered a NO-GO during pregnancy and nursing. Research done on reproductive animal studies have shown adverse effects to the fetus. Due to limited research on controlled studies in the human population, it is best to avoid this ingredient while pregnant. Once you are ready to start hydroquinone after pregnancy, especially for melasma, talk to your board-certified dermatologist for all treatment options. I currently use a terrific  formula of compounded hydroquinone, Vitamin C, and kojic acid for my mama patients post pregnancy and nursing.

Pregnancy Swap! Sunscreen, Vitamin C, Alpha hydroxy acids, azelaic acid, and niacinamide.

High – Dose Salicylic acid 

This ingredient is terrific for removing dead skin cells from our pores and is used for certain types of acne. At low doses, 2%, or less, this ingredient is safe during pregnancy when limited to smaller skin areas. 

Talk to your board- certified dermatologist with questions or concerns if this is part of your current skincare regimen, we are here to help you!

Pregnancy Swap! Alpha hydroxy acid such as glycolic acid, benzoyl peroxide, as well as clindamycin and erythromycin, which can be prescribed by a physician. 

Sunscreen

Sunscreen is the most important skin cancer prevention and anti-aging product in your skincare regimen. There are two types of sunscreen. Chemical sunscreens include active ingredients such as oxybenzone, avobenzone, avobenzone, octinoxate octisalate, octocrylene, and homosalate. Mineral sunscreens include zinc oxide and/or titanium dioxide. There is limited animal research on the effect of low dose chemical sunscreen in pregnancy, which can act as an endocrine modulator. It has been found in breast milk in more than one study.  I recommend mineral sunscreen during pregnancy and nursing. In fact, the American Academy of Dermatology solely recommends mineral sunscreen to babies 6 months and above.   Please see my thoughts below if you are still uncertain.

Pregnancy Swap! Mineral sunscreen, sunglasses, seeking shade, and sun-protective clothing.

Essential Oils

Due to the fluctuation of hormones and changes in skin structure during pregnancy and even through fertility treatments, it is very important to limit any potential allergens.   Plant based, organic products and essential oils are highly allergenic at this time. I tell my mama patients to choose the “safe synthetic “path with products that are free of fragrance and dye.  A great resource for understanding more about contact allergens is the American Contact Dermatitis Society of which I am a proud member of (https://www.contactderm.org/). 

Pregnancy Swap! Lady Polpo products and brands that are free of fragrance and dye. Check with your board-certified dermatologist for safe and effective recommendations.

Botulinum toxin

Pros: Common names include Botox, Dysport, Jeuveau, Xeomin, and Daxxify.  These products are excellent for fine lines and wrinkles of the forehead, crows feet, and the 11 lines, as well as any area that a board-certified dermatologist is trained to treat. 

I absolutely love botulinum toxin and my patients look and feel fantastic after this treatment option. 

Cons: There is not enough data to demonstrate safety during pregnancy. Wait and get injected after the baby is born!  Hyaluronic acid fillers also fall into this category as there is not enough data to support use currently.

Pregnancy Swap! Peptides, hyaluronic acid which plumps the skin, and glycerin.

A Few Gems…

Our skin is highly sensitive during pregnancy, fertility treatments, and nursing due to the fluctuation of hormones and changes in skin structure. Kojic acid is effective for hyperpigmentation, but it has increased allergenic potential.

Pregnancy Safe? If you choose to use kojic acid, please do a spot test first and talk with your board-certified dermatologist.

Although topical tranexamic acid is a newer effective treatment for melasma/facial hyperpigmentation, it is traditionally used by IV or orally for prevention and management of antepartum and postpartum hemorrhage (bleeding). 

Pregnancy Safe? I do not recommend during pregnancy topically, as there is not enough safety data. 

Bakuchiol is an anti-ageing retinoid alternative that is naturally derived from the Psoralea corylifolia plant in India and is traditionally used in Ayurvedic medicine. Research has shown that it is effective in addressing fine lines and wrinkles and is less irritating than the retinoid family. However, there are no safety studies in pregnant women and thus it is not recommended. If you like to go the more natural route or have sensitive skin, consider this in your anti-ageing regimen post-delivery.  

Benzoyl peroxide is a common treatment for acne and works by killing and preventing growth of the bacteria associated with acne (Propionibacterium acnes) as well as helping pores shed dead skin cells. Studies have demonstrated that stronger doses do not correlate with greater efficacy and may be more of an irritant. Remember our skin is more sensitive at this time.  

Pregnancy Safe? Choose doses that are 5% or lower in strength and in combination with clindamycin – a great acne treatment that is safe in pregnancy that your dermatologist can prescribe for you.

A word on sunscreen - It is most important to wear sunscreen daily. If you are hesitant about switching to a mineral sunscreen due to the white caste of mineral sunscreen – talk to your dermatologist.  The most widely studied ingredient is oxybenzone which has been removed from many chemical sunscreens in the past few years.  Additionally, tinted mineral sunscreen is an excellent alternative with no white caste. Recent data has shown that the ingredient iron oxide, which produces the tint, is effective against HEV (high-energy visible) light that is emitted from our computers, iPad, phones, and may also help to prevent premature ageing.