1. I have not had bad acne in years, so why now? Acne can be very severe in pregnancy. The increased hormone levels (particularly androgens) in the first trimester increases the skin’s production of natural oils, and many women have severe outbreaks in the first trimester.
2. What products can I use for acne while I am pregnant? Using small amounts of salicylic acid, benzoyl peroxide, and finacea is safe in pregnancy. Large amounts can potentially be absorbed in the bloodstream, so please limit your use to small quantities. This is especially true of salicylic acid, which is related to aspirin. In LARGE doses aspirin and aspirin containing products can increase the risk of miscarriage and cause heart problems for the baby (That being said, do not be alarmed if your provider places you on baby aspirin as there are some medical indications for this medicine in pregnancy, and a small dose will not have this effect).
3. Is Proactiv safe? Yes. Proactiv is just benzoyl peroxide, salicylic acid and glycolic acid. Again, as long as you use it in small quantities, it is safe in pregnancy.
4. Can I get facials for my acne while I am pregnant? Yes, for the most part facials are safe in pregnancy, and after the fun of early pregnancy (nausea, zits, etc) you probably deserve one :) However, please make sure that your technician is aware that your are pregnant, so they can avoid the following: Retinol or Retin A containing products, Accutane and large amounts of salicylic acid. If your technician is going to use a peel, please avoid salicylic acid peels as large quantities are not safe in pregnancy. Peels that use glycolic acid, TCA or lactic acid should be safe in pregnancy. Extractions are safe in pregnancy, but be careful because your skin may be more sensitive while you are pregnant.
5. Are my prescription antibiotic creams that I use for acne safe in pregnancy? It depends on which antibiotic you are using. Clindamycin or erythromycin based creams are fine while pregnant. However, you should avoid tetracycline, doxycycline, and minocycline because they can damage your baby’s teeth.
6. Accutane and retinoids. Definitely, definitely don’t use Accutane if you may be pregnant or become pregnant. It has been associated with multiple birth defects and also pregnancy loss. If you use anti-wrinkle cream with retinoids and are pregnant, please stop because most of these creams all contain retinol-based products. While absorption through the skin is much less than if you ingest these products, they still contain high amounts of vitamin A and are best avoided in pregnancy.
I promise you, your skin will get better! Acne in pregnancy is usually worst during the first trimester and improves as the pregnancy goes on. When washing your face, make sure you use a gentle, oil-free, alcohol-free, and non-abrasive cleanser. Avoid over-cleansing as it can overstimulate your skin’s oil glands. More than anything, resist the urge to pick or “pop zits”. This can make your acne worse and cause unsightly blemishes or scarring to form. Just be patient, and you'll have your skin back to normal soon :)