Having a child on the way will change a lot of things about a mother’s life and body. While pregnancy is usually associated with the glow of motherhood, the truth is, not all women undergo pleasant transformations. And one of these unexpected and unwelcome changes include acne.
How pregnancy affects the skin
The skin as an organ is largely affected by changes in hormones, immunity status, nutrition, and blood flow. Pregnancy upends all these factors, so you can expect changes in how your skin typically behaves--but it is difficult to predict exactly how and when these changes will occur in any given mother-to-be.
Unfortunately, the list of skin conditions that tend to get better during pregnancy is shorter than the list of skin conditions that tend to get worse. Significant fluctuations in hormonal levels drive many of the physical and behavioral changes in pregnant women. Some manifestations that can be seen on the skin include the appearance of dark patches on the face, heightened prominence of blood vessels, increased oiliness, itchiness, swelling, redness, and even the formation of pustules in different parts of the body.
It is important to note that there are skin disorders that occur only during pregnancy. Though these are lumped together under the umbrella term “specific dermatoses of pregnancy”, these diseases manifest in different ways. Some of them may be easy to mistake for acne, but the treatment is very different. This is why it is important to see your OB-gynecologist to help diagnose any major skin changes during this time.
Factors contributing to acne during pregnancy
The association between pregnancy and acne is a complicated one because not everyone goes through the same experience. You can be clear-faced prior to conception then suddenly break out in the next nine months. You can have that beautiful pregnancy glow for the first trimester and then suffer through intermittent breakouts until you give birth. Or you can be one of those lucky girls who go through their pregnancy zit-free.
It’s hard to tell exactly how your skin will react, but chances are, the reason you’re reading this article in the first place is because you are already experiencing pregnancy acne. In that case, we feel for you!
Acne is caused by a multitude of factors, and the complexity is only heightened by having a baby in your belly. Pregnancy acne is associated with increased amounts of androgens that drive up sebum production. Hormones that regulate how much you sleep, when you want to eat, and how you feel, all have an effect on your skin’s nutrition and wellness.
Pregnancy is also tied in with changes in your immune system. To carry a child to term, your body must quell any physiological process that will reject the growing fetus. This includes shifts in the levels of different white blood cells in your body and changes in inflammatory response. Acne is an inflammatory skin condition, so any change in your immune system will likely influence breakouts.
But it’s not just changes within your body that can predispose you to acne. Pregnancy changes your habits and routines. Sleeping patterns and energy levels will change. You may not be able to do the same things you did before pregnancy that keeps your acne at bay. Pregnant women have to avoid certain foods, certain physical activities, and certain products to keep the baby safe.
How to take care of your skin during pregnancy
What makes pregnancy acne more difficult to deal with is not necessarily because it’s more severe, but because your choices for treatment are much more limited. You might have to change your existing acne routine during your pregnancy, and possibly even during the time you are breastfeeding.
Off-limits
Retinoids are put on a pedestal for their amazing acne-fighting abilities, but these are an absolute no-no for pregnant women. Public enemy number one is oral isotretinoin, which has a 20% risk of spontaneous abortion and 18-28% risk of congenital malformations. Another product to avoid is topical tazarotene, which, despite its method of administration, can still be absorbed in high enough concentrations in the mother’s bloodstream to cause teratogenic effects on the child.
Studies show that topical retinoids such as adapalene and tretinoin are poorly absorbed systemically, making it less likely to affect the baby. However, it is best to err on the side of caution. There are other products that are just effective and safer for your growing child.
Low-risk
Benzoyl peroxide, salicylic acid and azelaic acid are well-known topical acne treatments that help limit bacterial proliferation, break apart pore-blocking debris, curb inflammation, and help with acne marks. Since these are absorbed in very small amounts in the bloodstream, it is unlikely to exert a harmful effect on the fetus.
Zinc supplements have been known to help fight against acne-associated bacteria, minimize inflammation, and decrease oiliness. These have not been associated with adverse effects on pregnant women, especially in the low doses usually prescribed for them.
Clindamycin and erythromycin are antibacterials that are considered safe to use on pregnant women, although these are usually combined with other products such as benzoyl peroxide or used for a short time to minimize the risk of antibiotic resistance. These come in oral and topical formulations, but it may be less risky to use it directly on the skin to avoid it from getting absorbed in high amounts.
While these products are considered low risk, not that research on these products’ effect on human pregnancy is limited. As such, it is still best to consult with both your OB-gynecologist and your dermatologist on what is the safest treatment for you.
Conclusion
There are a lot of big changes happening in your body when you are supporting the growth of another human inside you. On some days, these changes will leave you looking at the mirror in dismay. You may feel embarrassed to admit you’re worried about how you look, but keeping your baby safe and taking care of your appearance need not be mutually exclusive concepts.
So if your acne is exacerbated during pregnancy, it is not wrong to want to solve it. With proper guidance from your OB-gynecologist and your dermatologist, you can safely and effectively improve your skin condition as you wait for your baby to arrive.
This content is for general information only and is not a substitute for medical advice.
Resources:
Bozzo, P., Chua-Gocheco, A., & Einarson, A. (2011). Safety of skin care products during pregnancy. Canadian family physician Medecin de famille canadien, 57(6), 665–667.
Chien, A. L., Qi, J., Rainer, B., Sachs, D. L., & Helfrich, Y. R. (2016). Treatment of Acne in Pregnancy. Journal of the American Board of Family Medicine : JABFM, 29(2), 254–262. https://doi.org/10.3122/jabfm.2016.02.150165
Vora, R. V., Gupta, R., Mehta, M. J., Chaudhari, A. H., Pilani, A. P., & Patel, N. (2014). Pregnancy and skin. Journal of family medicine and primary care, 3(4), 318–324. https://doi.org/10.4103/2249-4863.148099
Sladden MJ, Harman KE. What Is the Chance of a Normal Pregnancy in a Woman Whose Fetus Has Been Exposed to Isotretinoin? Arch Dermatol. 2007;143(9):1187–1188. doi:10.1001/archderm.143.9.1187
Tunzi, M., & Gray, G. R. (2007). Common skin conditions during pregnancy. American family physician, 75(2), 211–218.
