Acne in pregnancy

During pregnancy, the severity of acne can improve or get worse. It is common for acne to get a bit worse in early pregnancy and for it to improve as pregnancy progresses. This may relate to the increased levels of oestrogen present in pregnancy.

A few women have severe flares of acne throughout pregnancy.

Acne in pregnancy 

Treatment of acne in pregnancy

On the whole, it is preferable to avoid drugs in pregnancy in case they have an effect on the fetus.

Which treatments are safe during pregnancy?

The absence of safety data can make it difficult to advise on treatment of acne in pregnancy. Most experts agree that topical treatments that can be used safely in pregnancy include:

• Benzoyl peroxide
• Azelaic acid
• Fruit acids such as glycolic acid
• Low-concentration salicylic acid preparations

Topical antibiotics and oral erythromycin may be prescribed if the acne is severe. Other antibiotics that may be prescribed are penicillins and cephalosporins.

Light and laser therapies for acne are also safe.

Which treatments are unsafe during pregnancy?

The following drugs must be avoided in pregnancy or if pregnancy is being contemplated.

Do not use topical preparations containing:

• Topical retinoids (tretinoin, isotretinoin and adapalene)
• High concentration salicylic acid

Do not take the following oral medicines:

• Tetracyclines in later pregnancy, eg doxycycline, minocycline, lymecycline — these may discolour the teeth of the baby
• Other oral antibiotics such as trimethoprim + sulphamethoxazole or fluoroquinolones
• Isotretinoin — a teratogen if taken during early or mid-pregnancy, causing fetal loss (miscarriage) or severe birth deformities