• Dawn Naylor BS, RN, MSN, ACNP

Skincare During Pregnancy: Scientific Facts

Updated: Jan 4


How to keep your skin looking good during pregnancy & while breastfeeding


This is a comprehensive blog; however, this is your baby we are talking about right? I am presenting scientific-based information (references are at bottom of the page).


In order to discuss which products are safe to use during pregnancy, you must understand how the FDA categorizes drugs/products for pregnancy as listed by the Department of Public Health and Human Services:


Category A: (safe) Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).


Category B: (safe) Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.


Category C: (not safe) Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.


Category D: (not safe) There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.


Category X: (not safe) Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in the use of the drug in pregnant women clearly outweigh potential benefits.


According to the Mayo Clinic pregnancy due to hormonal fluctuations can lead to a number of changes in your skin. These include changes in pigment, acne, varicose veins, and stretch marks. Girlfriend, it’s easier to prevent these problems than to have me fix them later on. Unfortunately ladies you CANNOT get neuromodulators (botox/dysport/xeomin) or fillers during pregnancy. Reason why is that it hasn't been studied.


Pigmentation Changes

The area around your nipples, inner thighs, genitals, and neck might darken. You might notice a dark line from your navel to your pubic bone (linea nigra). The biggest concern for most involves the risk of chloasma/melasma which are dark patches on your face that may remain permanent. Avoid sun exposure, which can worsen chloasma/melasma. Since UV exposure can worsen melasma, sunscreen SPF 30 or higher that blocks UVA/UVB rays is a must. Choose physical sunscreens that contain titanium dioxide and zinc oxide. Avoid chemical sunscreens containing oxybenzone. I do not recommend any laser treatments or chemical peels during pregnancy. Preventing pigment problems with sunscreen is key!!!Bakuchiol may be an option to decrease pigment during pregnancy instead of retinol.


What is it?

Bakuchiol is an antioxidant that comes from seeds of the corylifolia plant, found mostly in India. Traditionally, it has been used for rashes, redness, and healing cuts, and more recently, it has started popping up in skincare products as an option for people who can’t use retinol and retinoids. Again, I always recommend checking the ingredients in your products on the Environmental Working Group (EWG) and with your medical provider.



Acne

Acne during pregnancy is a concern for many. To counter acne, wash with a gentle cleanser. Shampoo regularly, don't pick blemishes, and be careful about what touches your skin. Wear clean masks, change your pillow cases often, use mineral makeup (check ingredients) and don't share face products. Alpha Hydroxy Acid’s (AHA’s) including mandelic acid, lactic acid, and glycolic acid are deemed safe during pregnancy and nursing. They may be helpful in the treatment of acne and pigment concerns.


Mandelic acid is the largest alpha hydroxy acid, so it penetrates the skin slowly and doesn't cause irritation as much as the other AHA’s. Topical erythromycin a (category B) and sulfur are also considered pregnancy safe.


The American College of Obstetrics and Gynecology (ACOG) endorses glycolic and azelaic acid as safe to treat acne during pregnancy, in addition to topical benzoyl peroxide and topical low dose salicylic acid (a Beta Hydroxy Acid-BHA). Another product that works well in sensitive skin is Bakuchiol as noted above. Stay tuned for a separate blog discussing AHA's and BHA's (what are they and how are they helpful).


Varicose Veins

You might develop enlarged veins in your legs (varicose veins) due to your uterus exerting greater pressure on these veins. Hormonal changes during pregnancy also might play a role.


Varicose veins that develop during pregnancy generally improve without medical treatment three to 12 months after delivery.


Here are some tips to prevent these unsightly veins:

  • Avoid sitting/standing in same position for long periods of time.

  • Avoid wearing high heels. It is better to wear lower-heel or flat shoes as this works your calf muscles, fostering healthy circulation.

  • Get regular