Skincare in Pregnancy

Congratulations Mama! You are worried about what is safe and what to avoid in this period and we got you! All eyes are on your skincare products for a good reason. Certain ingredients can be absorbed into your body, and therefore, your baby’s body too. Some face washes, body lotions and makeup contain ingredients that are proven to pose a threat to a developing fetus, and others have to be avoided postpartum since they can pass into breastmilk.

You will find it comforting that most over-the-counter (OTC) body care products are completely safe, but there are a few ingredients that could be harmful to your little one. So here’s the good news, you can find a balance between maintaining your mama-to-be glow and protecting your baby.

You want to stay far away from anything that could harm your baby, because there’s a lot of uncertainty surrounding the safety of skincare for moms-to-be. There hasn't been much medical research done in this area, because no scientist or doctor is willing to run a study on pregnant women. The risk is just too high. Many doctors and dermatologists recommend erring on the side of caution. The best way to do that is by switching to healthier, nontoxic products.

First, let’s discuss some skin changes during pregnancy:

Pregnancy related skin changes happen to many people. Hormones are to blame and it’s just another one of those things that come with being a mama-to-be. While some lucky ladies experience 9 months of pure skin perfection, others experience at least one skin issue or worsened skin issue at some point. The most common are, dry skin, darkening skin (a condition called melasma or chloasma), and acne. 

People with pre-existing skin conditions such as eczema, psoriasis, or rosacea may also experience a change in their symptoms (for better or worse).

And because pregnancy takes over the whole body, some skin changes can affect other places too, stretch marks, spider veins, hair growth, and even hair loss.

Top skincare ingredients to avoid 

Before we jump into our list, we must point out that evidence-based data on the safety of specific products in pregnancy is limited. In almost all cases, clinical trials on pregnant women that could prove that certain ingredients are harmful are an ethical no-no. But some animal, anecdotal, or case-specific studies have shown some serious fetal effects related to a few common skin care ingredients. That’s the basis for our recommendations.

1. Retinoids

Vitamin A is a crucial nutrient that’s required for optimal skin, immune, reproductive, and eye health. Once consumed or absorbed through skin, your body converts it to retinol.

Some anti-aging skin care products use a type of retinol called retinoids, which have become a holy grail because they can help reverse acne and reduce fine lines. Over-the-counter products have lower levels of retinoids, while prescription medications — such as Retin-A (tretinoin) and Accutane (isotretinoin) — contain much higher doses. The amount of retinoids absorbed by topical products is likely low, but birth defects have been linked in higher doses. As such, all retinoids are advised against during pregnancy and during breastfeeding.

Prescription retinoids like Accutane have been widely documented for posing a 20 to 35 percent risk of severe congenital defects, with up to 60 percent of children showing neurocognitive problems with exposure in utero.

Another reason to avoid retinoids is because as they speed up cell turnover, they also make the skin much more prone to sun damage and developing pigmentation.

2. High Dose Salicylic Acid

Salicylic acid is a common ingredient to treat acne due to its anti-inflammatory capabilities. But a 2013 study concluded that products that deliver a high dose of salicylic acid — such as peels and oral medications — should be avoided during pregnancy. That said, lower-dose topical OTC products that contain salicylic acid up to 2% have been reported safe.

3. Hydroquinone

Hydroquinone is a prescription product to lighten skin or reduce skin pigmentation that occurs from melasma and chloasma, which can be brought on by pregnancy.

Although, there’s no proven link between severe congenital defects or side effects and hydroquinone, the body can absorb a significant amount of hydroquinone compared to other ingredients (25 to 35 percent according to this article), it’s best to limit exposure (if any at all) during pregnancy. 

4. Phthalates

Phthalates are endocrine-disrupting (environmental pollutants) chemicals found in many beauty and personal products. They exhibit weak steroid-like activity and therefore can affect reproductive development. Cosmetics are the top source of phthalate exposure. Human exposure occurs mainly by ingesting contaminated food and by applying makeup. Women especially have five times greater exposure when compared to men.

5. Formaldehyde

Formaldehyde also known as Formalin is rarely used as a preservative and disinfectant in beauty products because it’s a known carcinogen, and, can increase the risk of infertility and miscarriage. However, in some hand washes, liquid detergents, dish soaps etc. sold in some countries, it is widely used. Buy from reputable brands and read your ingredients list.

Also, there are formaldehyde-releasing chemicals commonly found in cosmetics with a similar potentially dangerous affect. These are usually found in preservatives and some emollients. They include the following, as noted by the Environmental Working Group: bronopol, DMDM hydantoin, diazolidinyl urea, hydroxymethylglycinate, imidazolidinyl urea, quaternium-15, 5-bromo-5-nitro-1,3-dioxane.

6. Chemical sunscreens

Oxybenzone and its derivatives are the most frequently used ultraviolet (UV) filter in sunscreens. It’s proven effective for skin protection, but the potentially adverse health and environmental effects of oxybenzone are bringing it into a more unfavorable light.

Oxybenzone is a known endocrine-disrupting chemical, the concern for use in pregnancy is that it could disrupt hormones and cause permanent damage to mother and baby.

A 2018 animal study concluded that oxybenzone exposure during pregnancy at levels humans would commonly use made permanent changes to mammary glands and lactation. Other animal studies have linked the chemical to permanent fetal damage, possibly associated with developing neurological conditions in adulthood, such as Alzheimer’s disease.

7. Essential Oils

Although natural, there are several essential oils that should be used with caution during pregnancy. They are very potent and may affect the body as a whole. Many essential oils increase the skin’s sensitivity to UV, which isn’t great considering the risk of pigmentation is higher during pregnancy. Talk to your doctor or midwife about which oils are best bets for topical products.

In general, orange, lavender, vanilla, frankincense, ylang-ylang are considered safe, but others like clary sage, juniper, thyme, basil, rosemary, juniper berry, jasmine and cypress are some of the essential oils to avoid given their potential to over-stimulate and encourage menstruation. 

Some essential oils could also increase your risk of uterine contractions, for instance; a few of these are cinnamon, clove, wormwood, rue, oak moss, rosemary, and clary sage. And yes, these are associated with an increased risk of contractions even if you just use them topically. That’s because essential oils can penetrate the skin, get absorbed, and some may even cross the placenta. 

Remember, never ingest essential oils during pregnancy. Second, when using topically, use a carrier oil like jojoba or sweet almond oil to mix the essential oils in. Lastly, check with your OB before using any essential oils during pregnancy.

8. Caffeine – Celluliite creams

Caffeine usually present in cellulite creams, is a stimulant that should only be consumed in limited amounts during pregnancy. Some eye creams also contain caffeine.

Safe skincare ingredient alternatives for Common Pregnancy Issues

Here are a few alternatives to safely conquer pregnancy’s most common (and frustrating) skin problems.

Acne and hyperpigmentation

If you’re prone to breakouts or get pregnancy acne, there are some safer alternatives to using retinoid-based products while expecting. One of the most effective is glycolic acid and azelaic acid.

Glycolic acid in large quantities isn’t recommended during pregnancy, but in small amounts commonly found in OTC beauty products is safe. Glycolic acid and azelaic acid can also help with reducing fine lines, brightening skin, and reducing enhanced skin pigmentation.

Glycolic and azelaic acid are safe to use for treating acne during pregnancy, in addition to topical salicylic acid.

Anti-aging/wrinkles

Topical antioxidants such as vitamin C can safely enhance your skin’s vitality by protecting your skin from damage and maintaining collagen.

Other pregnancy-safe antioxidants to try in your skin care products include, Vitamin E, Niacinamide and Green tea.

Dry skin

Pregnancy requires a lot from your body, so if your baby needs more water at any point, it will pull it from your body. That, in addition to hormone changes can lead to dry skin. This can be temporary, but lots of women notice permanent changes.

In addition to drinking plenty of water, moisturizing products that have shea butter, glycerin, sodium lactate, allantoin, cocoa butter, peptides, and hyaluronic acid (HA) can improve hydration.

Stretch Marks

Stretch marks that occur during or after pregnancy are caused by the skin becoming stretched and expanded for a period of time. The abnormal stretching causes a breakdown or rupture in the skin's support structure of collagen and elastin (particularly elastin, which gives skin its bounce-back quality).

Stretch marks seem to be genetically related as some women get them and others don’t, yet no one is sure why.

Stretch marks are one of the toughest skincare concerns to treat because there are no cosmetic ingredients or products that can really improve them.

A strategy to preventing them is to frequently moisturize and massage the skin areas prone to stretch marks, such as your belly, thighs and breasts, in order to help the skin stretch naturally as your bump (and baby) grow. Use a product formulated for this purpose. 

Sun protection

Sun protection is one of the most important things you can do for long-term wrinkle and skin cancer prevention. The verdict on the safety of chemical broad-spectrum sunscreens is still out, so try mineral-based sunscreens that protect the skin by forcing the UV rays to bounce off of the skin entirely. Mineral-based sunscreen ingredients include zinc oxide and titanium dioxide. There are several mineral sunscreens without the white cast. Using a wide-brimmed hat can also be beneficial.

Melasma

Coupled with increased sensitivity to sunlight, you can experience a surge in pigment-stimulating hormones while pregnant and these can contribute to melasma – large patches of discolouration which appear on the face. It is usually genetic and often fades post-pregnancy.

However, it's worth remembering that many pregnancy-related hormones still stay in the body during breastfeeding, and can take six to nine months post-partum to settle after you stop feeding. Melasma triggered by pregnancy can also become a longer-term condition. 

The best thing you can do to prevent melasma from further developing is to wear a mineral sunscreen every day. It is advisable to wait to actually treat hyperpigmentation until you're done breastfeeding, as a lot of the topical treatments for this can enter the bloodstream. Also, stay away from soy-based skincare products, they can make melasma worse.  

Hormonal Acne

When you're in the first and second trimesters of your pregnancy, you may experience hormonal acne. That's when your androgen levels are higher than normal. While you definitely want to stay away from traditional acne remedies containing retinol during pregnancy, you might also want to avoid prescription strength products containing salicylic acid (a BHA).

You can use a product containing azelaic acid, which is a PHA and totally safe to use in pregnancy. Azelaic acid can significantly reduce the appearance of blemishes as well as help fade post-acne marks and other discolourations to reveal a more even skin tone.

Conclusion

It’s not easy to give up your beloved skin care regimen, but we know you’ll do anything to protect your little one. 

This includes avoiding products that could be harmful to you or your baby during pregnancy — with evidence suggesting that prescription retinoid-containing products are the most likely candidate to lead to severe congenital defects.

"Gentle" is the word you need to remember. The ideal pregnancy skincare routine is unique for everyone. Even if you’ve been pregnant before, your skin can react completely differently the next time around! That being said, it's a perfect time to treat your skin with extra TLC.

References

1. https://www.healthline.com/health/pregnancy-glow#takeaway

2. https://www.aafp.org/afp/2007/0115/p211.html

3. https://www.healthline.com/health/melasma

4. https://www.healthline.com/health/pregnancy/acne-remedies

5. https://www.healthline.com/health/how-to-prevent-stretch-marks

6. https://www.healthline.com/health/hair-loss-in-pregnancy

7. https://www.healthline.com/health/vitamin-a-for-skin

8. https://www.healthline.com/health/tretinoin

9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602257/

10. https://www.healthline.com/health/pregnancy/salicylic-acid#Salicylic-acid-and-pregnancy

11. https://www.cfp.ca/content/57/6/665.full

12. https://www.ewg.org/research/exposing-cosmetics-cover/formaldehyde-releasers

13. https://pubchem.ncbi.nlm.nih.gov/compound/Oxybenzone

14. https://academic.oup.com/jes/article/2/8/903/4999716

15. https://link.springer.com/article/10.1007/s12035-018-1401-5

16. https://www.sciencedirect.com/science/article/abs/pii/S0190962212001314

17. https://www.sciencedirect.com/science/article/abs/pii/S0890623818305835

18. https://www.harpersbazaar.com/uk/beauty/skincare/a24109674/melasma-causes-treatments/ 

19. https://www.harpersbazaar.com/uk/beauty/skincare/a31278199/best-retinol-cream/

20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114665/  Bozzo P, Chua-Gocheco A, Einarson A. Safety of skin care products during pregnancy. Can Fam Physician. 2011 Jun;57(6):665-7. PMID: 21673209; PMCID: PMC3114665.