Cause of acne during pregnancy

Acne or acne vulgaris is very common in mums-to-be and often starts in the first three months of pregnancy.

During pregnancy, especially during the first trimester, estrogen and progesterone levels increase therefore increasing the skin's production of sebum.

This extra sebum together with dead skin cells creates an ideal condition for bacterial growth which can promote inflammation. The first stage of acne usually starts as oily skin; the next stage is the appearance of comedones (white heads and black heads). If the pore becomes inflamed due to the influx of white blood cells, pustules and papules appear. If the inflammatory response spreads to adjacent tissue, this represents cystic acne.

Managing acne during pregnancy

Mums-to-be need to be careful when it comes to treating acne as some medications can be harmful to your baby. Many prescription and OTC acne medications contain retinoids, a type of vitamin A. Pregnant and breastfeeding mums should avoid using these altogether. It is very important for any pregnant woman to ask her doctor before embarking on a medicated regimen.

ask dr. ee today

What Acne Treatments To Avoid During Pregnancy?

Retinoids: These are known to cause birth defects and some retinoids may also increase the risk of miscarriage, especially the acne drug Isotretinoin. Isotretinoin is known under the brand name, Accutane and a number of generic names. It is an oral product used mostly for treating severe acne. It is especially dangerous before and during pregnancy as the drug is known to affect a fetus and cause serious birth defects.

Hydroquinone: This topical depigmenting agent is regularly used for skin lightening products and has a higher absorption rate than other topical treatments, so it is more likely that higher amounts could enter your bloodstream and affect the growth of your baby.

Oral antibiotics: Some antibiotics such as tetracycline, doxycycline, lymecycline and minocycline can cause discolouration to your unborn or nursing baby’s teeth.

Salicylic acid: This is an ingredient found in almost all over-the-counter acne products with Proactive®, Clearsil® and other known brands. Salicylic acid is part of the aspirin family and can help to reduces redness and inflammation. Whilst it’s super effective at cleansing pores, in high doses it’s been shown to cause birth defects and can cause pregnancy complications. So until your baby is born and you stop breastfeeding, it is best avoided.

Hormone Therapy & Medication: This includes the “female” hormone estrogen and the anti-androgens flutamide and the potassium sparing diuretic spironolactone. Spironolactone cannot be taken if you are thinking about becoming pregnant, if you are pregnant, or if you are breastfeeding. Birth defects have been associated with its use.

How To Safely Treat Acne When You Are Pregnant?

For most women, outbreaks flair up and then go away again or are limited to a few spots here and there. While getting spots may be irritating, at least they are not harmful so unless you are suffering from a severe case of acne, it is best to avoid treating them with medication. If your acne is mild and you did not suffer from acne before becoming pregnant, you can actually try to control your pregnancy breakout by maintaining a gentle, oil-free and non-comedogenic skincare regime.

However, if your symptoms are really troublesome, below are several treatments that you can use safely in pregnancy, but always consult your doctor before administering any forms of treatment.

Topical Antibiotics: Topical antibiotics such as Erythromycin, Clindamycin and Azelaic acid are considered safe medications by Food and Drug Administration (FDA) for use during pregnancy and pose no known risks to the health of the fetus.

Light Therapy: Red and blue light therapies are safe and can be used in instances where topical prescription or over-the-counter medications are not working to clear acne. The red and blue lights act as topical antibiotics, targeting the bacteria in your skin that causes inflammation, and can be really beneficial for the inflamed hormonal acne that comes from pregnancy.