During pregnancy many hormonal changes take place that can cause a pregnant Mum much anguish. Acne, pigmentation and unwanted hair all present a challenge to pregnant mothers during what should a wonderfully positive and nurturing time.
One of the most common questions I get asked as a Dermatologist by pregnant patients is: What products are safe to use in pregnancy and lactation? The greatest fear of an expectant mother is that she will harm her baby.
Below are a few of the more common skin concerns that occur in pregnancy and what you can use topically or as a treatment to try and minimise them:
Often with the hormonal changes in pregnancy, women will get an outbreak of acne which may be very frustrating. I generally recommend cleansing the skin with a gentle cleanser and to avoid toners and scrubs. Topical products that can be used safely as a spot treatment, according to the American Academy of Dermatology and rated Category B & C by the FDA are: topical Erythromycin, Azelaic Acid, 2% Salicyclic Acid and 5% Benzoyl Peroxide.
However, what may be confusing for the consumer is that in the package inserts of these products it often states that the safety of these products has not been established. It is important to note that topical Tretinoin and Retinol should be avoided in pregnancy and lactation.
If one has a darker skin type, more severe acne or if one tends to pick at blemishes on the skin then you are more prone to Post-Inflammatory Hyperpigmentation (PIH) in pregnancy. It is therefore very important that an appropriate high factor, broad spectrum sunscreen should be used on a daily basis to avoid pigmentation.
An excellent treatment for acne in pregnant and lactating women is the Acleara/Theraclear Acne Clearing System. This is a new breakthrough acne treatment which combines gentle vacuum therapy with Intense Pulsed Light (IPL). It helps to clear blocked pores and the IPL has an anti-inflammatory action on the acne. It is a very safe and effective treatment but it should be performed by a properly trained laser or skincare therapist.
Again, with hormonal changes in pregnancy, women will often experience increased hair growth on the face and body. I would be cautious about waxing or using depilatory creams on the face during pregnancy as these can cause Post-Inflammatory Hyperpigmentation.
Safer options during pregnancy would include shaving or threading.
Threading, is an ancient technique of removing facial hair that is thought to have first originated in India, spreading across the Middle East. In recent years, it has become increasingly popular in Western countries and is a quick and effective way of removing hair in smaller areas of the face and body. Threading is usually one by trained skin therapists.
There are no studies that evaluate the safety of laser hair removal during pregnancy. Many healthcare providers recommend avoiding laser hair removal during pregnancy because of the lack of information about the effect on the foetus. Therefore, it is safer to avoid laser hair removal until after the baby is born and it is best to rather use threading on the face and shaving on the body to remove hair while pregnant.
Pigmentation is one of the greatest challenges for pregnant mothers. Hormonal changes can cause melasma which is often beyond their control and this is when they are desperate for help and seek products. It is very difficult for them to use conventional treatments so I usually suggest one product that is generally safe in pregnancy and that helps to prevent pigmentation: Sunscreen
These days we have excellent high factor, broad spectrum sunscreens at our disposal to prevent pigmentation. The sunscreen should be applied on a daily basis and re-applied after swimming, towel drying or heavy sweating and if you are outdoors for prolonged periods of time.
Combined chemical as well as physical sunscreens are perfectly safe to use in pregnancy but to avoid the risk of possible allergic reactions to the chemical sunscreens it may be worthwhile using a physical-only sunscreen during pregnancy. Obviously, it is best to try and avoid sun exposure during the hottest part of the day when UV radiation is at its highest and to rather go outdoors earlier or later in the day. It is also advisable to wear a broad-brimmed UV protective hat.
Another safe product to use during pregnancy to help lighten pigmentation, is topical Niacinamide which is Vitamin B3. Topical hydroquinone should not be used in pregnancy to treat pigmentation.
Many women turn to self-tanning products when they are pregnant, to avoid the risk of pigmentation. Dihydroxyacetone (DHA) found in self-tanning lotions or creams and that is applied to the skin is safe to use in pregnancy and lactation. However, pregnant women should avoid going into a tan spraying booth where the DHA is sprayed onto the skin as there is a small risk of inhaling the DHA and this could possibly be harmful to the unborn foetus.
I think it is best to be overcautious and play it safe during pregnancy and to always discuss any queries you may have about products with your attending physician.
- American Academy of Dermatology
- Can Fam Physician 2011; June 57(6) 665-668 : Safety of skin care products during pregnancy
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