Everything You Need To Know About Skincare During Pregnancy
With so many ingredients and chemicals packed into such small bottles and tubes, there is a lot of concern for pregnant and breastfeeding women around the safety of beauty and skincare products. While some ingredients are harmless, others carry potential risks or, even worse, are linked to birth defects.
FDA Drug Classifications
The United States Food and Drug Administration (FDA) has created a specific drug classification system for pregnant women. Drugs are labeled on a six-point scale:
- Category A: No risk in controlled human studies
- Category B: No risk in other studies
- Category C: Risk not ruled out
- Category D: Positive evidence of risk
- Category X: Contraindicated in pregnancy
Typically, categories A and B are deemed safe for pregnant women, whereas the others should be avoided. The issue with the scale, however, is that it is meant for oral medication — not necessarily topicals. “It doesn't take into consideration if you apply it topically,” says Jason Emer, MD, a West Hollywood-based board certified dermatologist, of the FDA classification. “In my opinion, as a medical professional, I don't think that you're getting the same level of internal absorption by applying a little bit topically onto your skin as you would if you're taking it orally and using it as a pill.”
Dr. Emer uses isotretinoin, the active ingredient in Accutane (i.e. the oral medication used to treat acne), as an example. Taken orally, Accutane is in category X, which means it is contraindicated in pregnancy because it causes fetal harm. “That's why all the other retinols and vitamin A are bunched in that category,” he says.
Skincare Ingredients to Avoid During Pregnancy
Given the overall lack of regulation in the beauty industry, there can be a lot of uncertainty surrounding skincare regimens during pregnancy. Following the FDA guidelines is the simplest (and safest) route, but Dr. Emer notes that it tends to be conservative given that it does not take topical forms into account.
If you’ve read our guide to cosmetic procedures to avoid during gestation and postpartum, you’ll find that there is a similar lack of research in skincare. “The majority of over-the-counter products have a lot of basic chemicals, but there isn't really research,” Dr. Emer says.
Even so, there are certain ingredients that are generally paused during pregnancy. “Retinols, hydroquinone, and acne medications that are over-the-counter like benzoyl peroxide and salicylic acid should all be avoided in pregnant and nursing moms,” says Morgan Rabach, MD, a board certified dermatologist and co-found of LM Medical in New York City.
Below is a list of some of the most common ingredients to avoid:
While hormonal acne is a common skin concern during pregnancy, benzoyl peroxide falls under category C and is, therefore, not recommended for use during pregnancy.
We’re the first ones to tell you that you need to wear sunscreen all day, every day, but it might be best to switch to physical (mineral) sunscreens during gestation. “Chemical sunscreens, like oxybenzone and avobenzone, are hormone disruptors,” Dr. Emer explains. “People feel that if they are absorbed topically, they would affect the hormones that babies need to grow.”
The bronzing agent in many spray and self tanners, dihydroxyacetone (DHA) is to be avoided during pregnancy. “There are certain self-tanners now that don't have DHA and are a little bit more healthy for the skin,” Dr. Emer says. One such example? The Chemistry Brand Glow Oil.
Found in some nail polishes and hair-straightening treatments, the chemical has been linked to certain types of cancer and nervous system conditions. If possible, it’s best of all women — not just pregnant ones — to avoid products with formaldehyde.
While the skin-lightening agent is used to treat dark spots and melasma (two skin conditions that are common during pregnancy), hydroquinone should be avoided during pregnancy. While no research has been done looking at the impact of the ingredient on a fetus, studies have shown as much as 45 percent of the medication is absorbed into the skin after topical application
As Dr. Emer explains, vitamin A derivatives are generally avoided during pregnancy because of the links between oral isotretinoin and birth defects. Tazarotene and isotretinoin are classified category X, though most other retinoids find themselves in category C — meaning there isn’t enough research.
Salicylic acid is a derivative of aspirin (a.k.a. willow bark extract). “People say not to take aspirin during pregnancy, but that's orally,” Dr. Emer says. While it’s unlikely to cause harm if used topically, studies have suggested that taking salicylic acid orally in the late stages of pregnancy may increase the risk for intracranial bleeding in the fetus.
Skincare Ingredients That Are Safe For Pregnancy
So, what skincare is safe for moms to be and new mothers? “Pregnant and nursing moms can use skincare products that contain hyaluronic acid, peptides, growth factors, and [mineral] sunscreens,” Dr. Rabach says. Below are a few of our favorites:
Part of category B, the antimicrobial and anti-inflammatory ingredient is safe for women who are pregnant and breastfeeding. “It’s derived from a wheat plant and is good for addressing texture and pigmentation,” Dr. Rabach shares.
Known as a natural alternative to retinol, Dr. Emer recommends products from the AnteAGE MD line because it contains stem cells, vitamin C, hyaluronic acid, and — you guessed it — bakuchiol. “It’s derived from an Indian plant and is equivalent to, if not better, than retinol,” he shares. “It’s actually been shown to be really good for darker skin types and those that get melasma and pigmentation.”
Hyaluronic Acid (HA)
Dr. Rabach is a fan of this ultra-hydrating, naturally occurring compound that can hold 1,000 times its weight in water.
“There is some specific research on rosehip oil being used as an alternative to retinol because it has a lot of beta carotene vitamin C in it,” Dr. Emer shares. Packed with molecules that are small enough to penetrate the skin, the botanical extract improves moisture and collagen levels, while reducing fine lines and wrinkles.
While there is a lot that is unknown about the safety of skincare ingredients during pregnancy and breastfeeding, most skin experts recommend following the pregnancy drug classification from the FDA. All the while, there are still plenty of active ingredients that can treat everything from acne to melasma. Consulting with a board certified dermatologist and learning how to read the label will ensure the best and safest treatment plan for your skin concerns.