The Chemist Beauty Insider

Safe Skincare During Pregnancy: What You Need to Know – A Must-Read Guide

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The Chemist Beauty Insider
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Pregnancy is an exciting journey, but it can also be a rollercoaster for your skin. Suddenly, you’re dealing with unexpected breakouts, strange pigmentation, or that lovely pregnancy glow everyone talks about. With so much advice out there, figuring out which skincare products are safe during pregnancy can be incredibly challenging.

During pregnancy, the skin can become more sensitive, and certain ingredients in skincare products may pose risks. Analyzing these ingredients is no easy task. Many products contain complex compounds, and understanding their potential effects, especially during pregnancy, requires careful research. Some ingredients, like teratogens, could impact your little one’s development, making it crucial to choose wisely.

But no worries, moms-to-be! I’m here with a guide that’s thorough, well-researched, and backed by science. Drawing on the latest studies and expert recommendations, this guide will help you maintain happy, healthy skin while ensuring everything you use is safe for your baby.

Let’s begin, shall we?

Understanding Skin Changes in Pregnancy

Pregnancy is a transformative period in a woman’s life, bringing with it numerous physiological changes, including those affecting the skin. Hormonal shifts, increased blood volume, and other physiological changes can lead to a variety of skin conditions. Understanding these changes is the first step toward building a pregnancy-safe skincare routine.

Hormonal Changes and Their Impact on Skin

During pregnancy, the body produces higher levels of hormones like estrogen and progesterone. These hormones play a crucial role in maintaining the pregnancy but can also affect the skin in several ways. Below is a list of common skin conditions:

1. Hyperpigmentation

Melasma 

Melasma, known as the “mask of pregnancy,” causes dark, blotchy spots on your face, particularly the cheeks, forehead, and upper lip [26]. Blame it on hormonal surges during pregnancy, when estrogen and progesterone stimulate melanin formation, resulting in hyperpigmentation. This condition affects 15% to 50% of pregnant women [3] and is more common in those with darker skin tones [24]. It usually emerges in the second or third trimester [3].  While melasma typically fades within a year after delivery with treatment, there is a small chance (6%) that it will go away on its own. However, up to 30% of women may develop some lingering pigmentation [21].

pregnant woman with linea negra

Linea Nigra

Linea nigra is a hyperpigmented line that typically appears on the abdomen of pregnant women during the second trimester. This vertical line usually extends from the pubic bone to the belly button and sometimes up to the chest [26][40]. It is caused by hormonal changes that increase melanin production, similar to other forms of hyperpigmentation during pregnancy. While linea nigra typically fades after pregnancy in many women, as observed in clinical studies, there can be cases where the hyperpigmentation does not spontaneously resolve and remains persistent. 

2. Acne

During pregnancy, your body’s hormones are on a wild ride, especially androgens, which increase oil production and lead to acne. This can result in inflamed pimples and sometimes cystic lesions on your face, chest, and back, particularly during the first and second trimesters. Up to 43% of people experience acne during pregnancy, according to cross-sectional and survey studies. The good news? These breakouts often clear up after pregnancy as your hormone levels stabilize. However, for some women, these unwanted guests might linger a bit longer, even postpartum.

3. Stretch Marks (Striae Gravidarum)

They have been shown to affect 50% to 90% of pregnant women [6] and commonly occur during their first pregnancy. These marks are caused by the tearing of the dermis, the middle layer of the skin, due to rapid stretching and growth. While these marks can look different for everyone, they often fade after pregnancy but may not disappear completely.

4. Increased Sensitivity

pregnant woman with sensitive skin

As your body works hard to support your growing baby, it goes through some wild changes. With increased blood flow, your skin becomes more sensitive and prone to irritation. Surges of estrogen and progesterone make your skin even more reactive. Plus, your immune system takes a turn, making your skin more susceptible to inflammation. Suddenly, the products you love might cause irritation, and you could experience rashes or flare-ups of conditions like eczema. This heightened sensitivity can lead to discomfort and distress, impacting the overall quality of life [40].

5. Spider Veins

Spider veins, small red or purple clusters of veins visible under the skin, are common during pregnancy. They are caused by increased blood volume and hormonal changes, particularly estrogen, which lead to the dilation and visibility of superficial veins. These veins typically appear on the legs and sometimes on the face. Affecting about 40% of pregnant women, spider veins often develop during the second trimester when blood volume peaks [30]. While they can be unsightly, they usually fade away within a few months after delivery as hormone levels and blood volume return to normal.

6. Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)

This common skin condition brings intensely itchy, red, and raised spots and patches, usually starting on your belly and often spreading to your thighs, buttocks, and arms. While the exact cause remains a mystery, it’s thought to be linked to rapid skin stretching and those wild hormonal changes [36][10]. Affecting about 1 in 160 pregnancies, PUPPP typically shows up during a first pregnancy.  Fortunately, this condition usually resolves on its own shortly after delivery, as hormone levels stabilize and the skin begins to recover.

Identifying Pregnancy-Safe Ingredients

Understanding the skin changes that occur during pregnancy, as discussed in the previous section, is only half the battle. The next crucial step is managing these conditions effectively and safely. Many expectant mothers turn to various skincare products, ointments, and treatments to address these issues. However, it’s essential to be mindful of the ingredients in these products, as some can pose risks to your developing baby. 

Good thing a regulatory body like the US Food and Drug Administration (FDA) set the standards for safe skincare ingredients. According to the FDA, some ingredients are classified as cosmetics, while others are considered drugs based on what they do. It’s crucial to know the difference because the FDA pregnancy categories only apply to pharmaceuticals.

Cosmetics vs. Drugs:

  • Cosmetics are designed to cleanse, beautify, or alter the appearance without affecting the body’s structure or functions. Think of your regular moisturizers, cleansers, and makeup.
  • Drugs, on the other hand, are intended to diagnose, cure, mitigate, treat, or prevent disease. They actively alter the body’s functions.

There are certain skincare ingredients can cross the line from cosmetic to drug based on their claims and effects. For example:

Sunscreens

Ingredients like avobenzone or zinc oxide are classified as drugs because they protect the skin from UV radiation, preventing sunburn and skin cancer.

Anti-Acne Treatments

Ingredients such as benzoyl peroxide or salicylic acid treat acne, making them drugs due to their role in altering the skin’s condition.

Anti-Aging Products

Some ingredients, like retinoids, can be classified as drugs if they claim to change the skin’s structure or function, such as reducing wrinkles or boosting collagen production.

FDA’s Pregnancy Categories

The FDA classifies drugs into pregnancy categories to indicate their safety for use during pregnancy[11]:

  • Category A: Safe in pregnancy; controlled studies show no risk.
  • Category B: No evidence of risk in humans; animal studies may show risk.
  • Category C: Risk cannot be ruled out; human studies lacking.
  • Category D: Positive evidence of risk; benefits may outweigh risks.
  • Category X: Contraindicated in pregnancy; risks outweigh benefits.

Understanding these distinctions and the FDA categories can help you make informed decisions about the skincare products you use during pregnancy, ensuring they are safe for both you and your baby. But even with these guidelines, finding thorough safety data can be like finding a needle in a haystack. Plus, some topical meds haven’t been approved and labeled according to this system.

Skincare Ingredients to Avoid During Pregnancy

Here’s a list of common skincare ingredients to avoid during pregnancy, along with safer alternatives.

❌ Hydroquinone

Application

Hydroquinone is commonly used for lightening dark patches of skin, such as those caused by melasma, to achieve a more even skin tone.

Mechanism of Action

Hydroquinone works by inhibiting melanin production, which lightens the skin. It can penetrate the skin barrier and enter systemic circulation.

Why Avoid It

Hydroquinone is highly absorbable through the skin, which poses significant risks during pregnancy. The US FDA classifies hydroquinone as a Category C substance, meaning that while there are no well-controlled studies in pregnant women, animal studies have shown a risk to the fetus. This implies that the potential benefits of the drug may outweigh the risks in certain situations, but it is generally advised to avoid hydroquinone during pregnancy due to these potential risks.

Label Identification

Hydroquinone

Recommendations

Use products with vitamin C, niacinamide, liposomal aloe vera, turmeric acid, and glycolic acid [1] to safely brighten the skin and manage pigmentation. These alternatives are safer during pregnancy and provide effective results in reducing dark spots and achieving an even skin tone.

❌ Topical Retinoids

Application

Topical retinoids like tretinoin (Retin-A) and adapalene are commonly used to treat acne, improve skin texture, and reduce signs of aging.

Mechanism of Action

Topical retinoids cause the presence of all-trans retinoic acid and 13-cis retinoic acid in the body. While the all-trans form helps improve skin [8] , the 13-cis form can be dangerous for a developing baby during pregnancy [37].

Why Avoid It

Studies have shown that retinoids, including tretinoin, can cause teratogenic effects, interfering with fetal development. The FDA classifies Tretinoin  and Adapalene as Category C for pregnancy, indicating that risk cannot be ruled out, while Tazarotene and Isotretinoin are classified as Category X, indicating extreme contraindication during pregnancy.

Label Identification

Tretinoin/Retinoic Acid, Adapalene, Tazarotene

Recommendations

To manage acne and aging concerns during pregnancy, consider using products with bakuchiol, a plant-based alternative that offers similar benefits without the associated risks. Other safe options include products with niacinamide or azelaic acid [9], which can help manage acne and improve skin texture.

❌ Parabens

Application

Parabens are synthetic preservatives widely used in personal care products like cosmetics, lotions, shampoos, and deodorants to extend their shelf life [5].

Mechanism of Action

Parabens are absorbed through the skin and detected in urine, breast milk, and tissues. They can disrupt hormone function by mimicking estrogen [5].

Why Avoid It

Emerging research suggests potential health risks associated with parabens, particularly during pregnancy. Prenatal exposure may be linked to increased birth weight, altered thyroid function, increased risk of preterm birth, and potential contributions to childhood obesity and metabolic disorders [15].

Label Identification

Watch for common parabens on product labels, including methylparaben, ethylparaben, propylparaben, and butylparaben.

Recommendations

Minimize exposure to parabens by selecting paraben-free personal care products. Look for alternatives using natural preservatives like phenoxyethanol [15].

❌ Phthalates

Application

Phthalates are commonly used as plasticizers and solvents in cosmetics, such as nail polishes, hair sprays, and fragrances, to enhance flexibility and longevity [25].

Mechanism of Action

Phthalates are absorbed through the skin and inhaled from products, leading to their presence in blood, urine, and tissues. They can disrupt the endocrine system by interfering with hormone receptors and synthesis. [38].

Why Avoid It

Research has raised concerns about potential health risks associated with phthalates, particularly during pregnancy. Prenatal exposure may be linked to disruption of hormone function [38], developmental and reproductive toxicity [34], and potential neurodevelopmental issues [17].

Label Identification

According to the FDA, consumers can check product labels to see if phthalates are listed as ingredients, although the specific fragrance ingredients may not be disclosed (FDA, 2021). Look for common phthalates on product labels, including dibutyl phthalate (DBP), diethyl phthalate (DEP), and dimethyl phthalate (DMP).

Recommendations

Due to potential risks, especially for pregnant women, it is advisable to limit exposure to phthalates by choosing phthalate-free personal care products. 

❌ Oxybenzone

Application

Oxybenzone is a widely used chemical UV filter in sunscreens, lotions, and other personal care products. Its primary function is to absorb UV radiation and thereby prevent skin damage from sun exposure.

Mechanism of Action

Oxybenzone absorbs UV light, preventing skin damage, but its chemical structure allows it to mimic hormones in the body, potentially disrupting normal endocrine function.

Why Avoid It

The European Commission’s Scientific Committee on Consumer Safety (SCCS) has been studying this and found some hints that oxybenzone might affect hormones, but the evidence isn’t solid yet. This means more research is needed to really understand the risks, especially for pregnant women.Potential risks include birth defects, low birth weight[32], and Hirschsprung’s disease.

Label Identification

To identify oxybenzone in sunscreen and other products, look for it listed under ingredients as “Oxybenzone” or sometimes by its chemical name “Benzophenone-3.”

Recommendations

Opt for sunscreens that use mineral filters such as zinc oxide or titanium dioxide. If you have specific concerns about sunscreen use during pregnancy, consult with your healthcare provider.

❌ Salicylic Acid

Application

Salicylic acid is commonly used as an exfoliating agent in acne treatments, helping to unclog pores and reduce inflammation.

Mechanism of Action

Salicylic acid works as a keratolytic agent, helping to shed the outer layer of skin, unclogging pores and preventing acne formation.

Why Avoid It

Salicylic acid is classified as a Category C substance by the US FDA. While there are no well-controlled studies on topical use during pregnancy, systemic administration in animal studies has shown risks of fetal malformations.The SCCS (Scientific Committee on Consumer Safety) has also noted that there are limited data on the potential teratogenicity (ability to cause developmental abnormalities) of salicylic acid, and the available data suggest a potential teratogenic effect.Therefore, the SCCS considers that the use of salicylic acid in cosmetic products by pregnant women should be avoided, especially during the first trimester of pregnancy, unless the anticipated benefit outweighs the potential risk.

Label Identification

Salicylic Acid

Recommendations

For acne treatment during pregnancy, consider using alternatives like azelaic acid or glycolic acid. These are safer options and can help manage acne effectively while minimizing risks. Always consult with a healthcare professional before use.

Safe Skincare Ingredients During Pregnancy

✅ Hyaluronic Acid

Hyaluronic acid, a popular ingredient in skincare, has been thoroughly tested for safety across various animal studies. Remarkably, it showed no signs of toxicity, even with different methods of exposure. It’s not only gentle on the immune system but also doesn’t cause allergic reactions. Additionally, it poses no risks to reproduction or development and isn’t linked to genetic damage. These reassuring findings highlight why hyaluronic acid is a trusted component in many health and beauty products, making it a safe choice for everyday use [4].

✅ Glycolic Acid

Glycolic acid, a popular ingredient in skincare products for its exfoliating properties, has been thoroughly tested for safety. Animal studies show that high oral doses can cause developmental and maternal toxicity, but these effects were not observed at lower, non-toxic levels. When applied to the skin, glycolic acid does not cause systemic effects, though it can lead to irritation at the application site. It has not been linked to genetic damage or cancer, and does not significantly enhance the absorption of other chemical agents [13].

However, glycolic acid can increase skin sensitivity to UV radiation, emphasizing the importance of daily sun protection. To ensure safety, AHAs like glycolic acid should be used in cosmetics at concentrations of ≤10%, with a final product pH of ≥3.5, and with proper sun protection. These guidelines help make glycolic acid a safe choice for cosmetic use, including during pregnancy, when used as directed.

✅ Vitamin C

Vitamin C is widely recognized for its essential role in various biological functions, including collagen synthesis, wound healing, and immune support. When used topically, vitamin C is effective in improving skin conditions such as hyperpigmentation and melasma, making it a popular choice for addressing uneven skin tone.

Studies have demonstrated the safety of ascorbic acid and its related ingredients. Animal studies have shown no signs of adult-toxic, teratogenic, or fetotoxic effects from oral doses of ascorbic acid up to 1000 mg/kg body weight. Topical application of ascorbic acid does not cause systemic effects, making it a safe choice for cosmetic use during pregnancy. Topical application does not lead to systemic effects, and it is not associated with developmental or maternal toxicity. 

✅ Niacinamide and Niacin

Niacinamide, also known as nicotinamide, is a form of vitamin B3 that has gained significant popularity in skincare due to its versatile benefits, including anti-inflammatory, antioxidant, and skin-barrier strengthening properties. Collective findings from animal studies strongly suggest that niacinamide is safe for use during pregnancy. It does not exhibit developmental toxicity and may even confer protective effects against certain teratogens. While high doses of niacinamide appear to be safe, optimal protective effects are achieved at lower doses. Pregnant women considering niacinamide, whether through dietary supplements or topical applications, can be reassured by the substantial evidence supporting its safety [20]. However, as with any supplement or medication during pregnancy, it is always advisable to consult with a healthcare provider to ensure the best outcomes for both mother and baby.

✅ Titanium Dioxide

Titanium dioxide is a key ingredient in many sunscreens due to its ability to effectively block UV rays. toxicological data show no systemic effects, including reproductive or developmental toxicity, or carcinogenic effects following oral or dermal exposure. This safety profile is supported by evaluations from reputable health authorities such as the European Food Safety Authority (EFSA) and the US Food and Drug Administration (FDA)​ [19]. These comprehensive assessments affirm that titanium dioxide is safe for use in cosmetics, making it a reliable choice for pregnant women when used as directed.

✅ Zinc Oxide

Zinc oxide is a key ingredient in mineral sunscreens, providing broad-spectrum protection against UVA and UVB rays. Animal studies have shown that zinc oxide does not exhibit teratogenic effects (i.e., it does not cause developmental malformations) at varying doses.

Conclusion

Managing skincare during pregnancy can be overwhelming, but understanding how different ingredients affect your skin and your baby makes all the difference. By avoiding harmful substances like hydroquinone, topical retinoids, parabens, phthalates, oxybenzone, and salicylic acid, you can maintain a safe and effective skincare routine. Opting for safe alternatives such as hyaluronic acid, glycolic acid, vitamin C, niacinamide, titanium dioxide, and zinc oxide ensures that your skin stays healthy and radiant throughout your pregnancy journey.

Remember, the key to a worry-free skincare routine lies in informed choices. Always read labels, consult with healthcare providers, and prioritize ingredients that are backed by science for their safety and efficacy.

Skincare During Pregnancy: Expert Answers to Top FAQs

Q: Can I continue using my regular skincare products during pregnancy?

A: It’s important to review your regular skincare products during pregnancy as some ingredients may not be safe for your developing baby. Ingredients like hydroquinone, topical retinoids, parabens, phthalates, oxybenzone, and salicylic acid should be avoided. Opt for products that contain safe alternatives such as hyaluronic acid, glycolic acid, vitamin C, niacinamide, titanium dioxide, and zinc oxide.

Q: What skincare ingredients should I avoid while pregnant?

A: You should avoid the following skincare ingredients during pregnancy:

  • Hydroquinone
  • Topical retinoids (e.g., tretinoin, adapalene, tazarotene)
  • Parabens
  • Phthalates
  • Oxybenzone
  • Salicylic acid

These ingredients can pose risks to fetal development and should be replaced with safer alternatives.

Q: How can I prevent stretch marks during pregnancy?

A: To help prevent stretch marks during pregnancy:

  • Hydrate your skin: Use moisturizing creams and oils specifically formulated for pregnancy.
  • Maintain a healthy diet: Ensure you get plenty of vitamins and nutrients to support skin elasticity.
  • Stay hydrated: Drink plenty of water to keep your skin hydrated from within.
  • Manage weight gain: Try to gain weight gradually to reduce stress on your skin.

Q: Is it safe to use sunscreen during pregnancy?

A: Yes, it is safe to use sunscreen during pregnancy. Opt for mineral-based sunscreens containing zinc oxide or titanium dioxide, which are effective and safe for protecting your skin from UV radiation without harmful chemicals like oxybenzone.

Q: Why am I experiencing more acne during pregnancy?

A: Increased acne during pregnancy is common due to hormonal changes, particularly the increase in androgens, which stimulate oil production. This can lead to clogged pores and breakouts. Using gentle, pregnancy-safe products like those containing niacinamide or azelaic acid can help manage acne.

Q: Why is my skin more sensitive during pregnancy?

A: During pregnancy, increased blood flow, hormonal changes, and shifts in the immune system can make your skin more sensitive and prone to irritation. Products you previously used without issue may now cause reactions. It’s essential to use gentle, fragrance-free products and avoid harsh chemicals.

Q: How can I manage melasma or “pregnancy mask”?

A: To manage melasma during pregnancy:

  • Use sunscreen daily: Protect your skin from UV radiation to prevent further pigmentation.
  • Use safe brightening agents: Ingredients like vitamin C, niacinamide, and glycolic acid can help reduce pigmentation.
  • Avoid triggers: Limit exposure to heat and sunlight, which can exacerbate melasma.
  • Consult a dermatologist: For persistent melasma, seek professional advice for safe treatment options.

Q: What are the best practices for skincare during pregnancy?

A: Best practices for skincare during pregnancy include:

  • Choose safe ingredients: Use products with pregnancy-safe ingredients like hyaluronic acid, vitamin C, and niacinamide.
  • Avoid harmful substances: Steer clear of ingredients like hydroquinone, retinoids, and parabens.
  • Use sunscreen: Apply a mineral-based sunscreen daily to protect your skin from UV damage.
  • Stay hydrated: Keep your skin hydrated with moisturizers and drink plenty of water.
  • Be gentle: Use gentle, fragrance-free products to avoid irritation.
  • Consult professionals: Regularly consult with your healthcare provider or dermatologist for personalized skincare advice.

Disclaimer

This article is well-researched and intended for educational purposes only. Always consult with a qualified healthcare provider or dermatologist before starting any new skincare regimen, especially during pregnancy. Individual responses to skincare products may vary. The information provided does not replace professional medical advice. Use at your own risk, and read product labels carefully.

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