Skincare in pregnancy – what is the evidence?


Pregnant women are wary of causing harm to their unborn babies during this vulnerable period in development. There is significant modification of lifestyle practices with huge emphasis on safer and healthier options. More than 50% of pregnant women also question their skincare regimen and seek guidance on the use of personal care products.

What are the common things that most women are most concerned about making them question use in pregnancy?
Women are concerned that certain ingredients in skincare products may be carcinogenic (causing cancer), teratogenic (harmful to the fetus) or unsuitable for their changing skin needs in pregnancy. In this article we explore the available evidence on a few commonly used ingredients to help you understand which products can be used safely when your pregnancy tests positive!

Vitamin A/ retinol
There is lots of evidence for the potential teratogenic effects of oral vitamin A and the drug commonly used for acne called isotretinoin. We do not actually know how much topically applied vitamin A is absorbed by the skin to eventually reach the circulation and the growing baby. There are however a few cases where birth defects were reported after using topical Vitamin A in pregnancy. The consensus opinion is that women should avoid products containing retinol during pregnancy, whether oral or topically applied.

Benzoyl peroxide
Benzoyl peroxide is a widely used over the counter treatment for acne. Minimal amounts are absorbed into the skin after topical application, but there have not been any reported ill effects in the babies whose mothers used topical treatment. Therefore this is one of the acne treatments considered safe for breakouts in pregnancy.

Topical antibiotics
Topical clindamycin and erythromycin are prescription antibiotics used mainly to treat acne. Studies have found both topical ingredients to be safe for use in pregnancy.

Salicylic acid
Topical salicylic acid is quite a common ingredient in acne treatments. The concentration in products as well as the amount of absorption into the blood stream varies. However it is still considered a small amount which is unlikely to cause any harm.

Glycolic acid
Glycolic acid is an alpha hydroxy acid found in many brands of resurfacing anti-ageing products. It is also used in face washes and creams to treat acne and hyperpigmentation.
There is minimal systemic absorption from topically applied glycolic acid so it does not pose a risk in pregnancy. However glycolic acid may be irritating to the skin especially in high concentrations, so first time users in pregnancy should be cautious.

Hydroquinone
Hydroquinone is a prescription skin lightening ingredient, banned as an over-the-counter product in South Africa. It may however be prescribed by doctors and dermatologists. There is a large amount of hydroquinone that is systemically absorbed after topical application. There is no conclusive evidence to suggest that hydroquinone will have an effect on your growing baby, but because of the large amount that is absorbed, it is not recommended for use in pregnancy.

Sunscreens
Sunscreens generally have very little systemic absorption and are safe to use in pregnancy.
The general consensus is that the benefits of sunscreens outweigh any unsubstantiated risk.

In summary, apart from notably hydroquinone and retinol there is no evidence to suggest that most other common topically applied skincare ingredients will cause harm to a developing baby.

Bear in mind that does not exclude the possibility of a localized cutaneous reaction (skin reaction) to the ingredients as we must take into account that pregnancy may cause a change in your skins’ condition and its ability to tolerate products.

In addition to this, skin reactions to skincare products may occur irrespective of whether you are pregnant or not.
Remember that a product recommendation or prescription given before you fell pregnant may no longer be safe or appropriate once your status changes, and its best to confirm with your doctor.

At Skinsmart we have a tailored pregnancy skin assessment to assist you with your product choice. We recognise that pregnant women would also like to look and feel their best without compromising the health of their babies.

Please email us on info@skinsmart.co.za to book an appointment  if you would like more specific advice.