Pregnancy Skincare Do’s and Don’ts

Pregnancy Skincare Dos and Don’ts

I wrote a blogpost in collaboration for Fiddy Snails a few years ago, and now that I’m pregnant, I wanted to revisit the topic of PREGNANCY SKINCARE! I get so many questions about this on social media, so I wanted to share what I’ve learned through research.

When women are pregnant, our bodies obviously go through huge changes in every system, and our skin, the largest organ we have, is no exception (if you are interested, read more from this Yale Dermatology text here!). These changes range from darkening of the skin, also known as hyperpigmentation, to engorgement of your blood vessels, and even changes in your hair and nails. The following are a list of skincare do’s and don’ts during pregnancy, tailored towards addressing skincare concerns that develop when women are pregnant.

Pregnancy Skincare Do’s

Sunscreen, sunscreen, sunscreen

Three out of four pregnant women develop melasma, which appears as brown spots on the cheeks but also forehead and chin. I see this condition all the time in my daily practice, from women who are pregnant or on oral contraceptives. This condition is particularly bad during pregnancy because of hormone fluctuations, and can be very difficult to treat. The best thing you can do is PREVENT the darkening in the first place by always wearing sunscreen SPF 30 or above, using physical sunscreens containing zinc oxide or titanium dioxide, and wearing hats with large brims and clothing that protects the skin from UV radiation. My coworker Dr. Mitalee Christman used Azelaic Acid daily preventatively (you can get a prescription for this from your dermatologist or over the counter at The Ordinary). I am also trying to use Vitamin C more often (either the Drunk Elephant C firma day serum or my SkinCeuticals Phloretin CF gel), though I forget because I keep it all the way in my fridge. Different dermatologists will have differing opinions regarding which topical medications you can start during pregnancy to prevent and treat melasma so check with your dermatologist for safe and effective options for you!

Check your ingredients

Products that you commonly use in skincare may no longer be safe for your developing baby. The biggest example of this is in acne. Several acne therapies may cause adverse effects, including developmental abnormalities in the fetus. Generally, topical antibiotics such as clindamycin or erythromycin are safe, as well as low percentages of glycolic acid, salicylic acid, benzoyl peroxide (newly reclassified this year!), and light based therapies.

Monitor your skin

If you notice new dark spots, itchy rashes, blisters, painful bumps, or strange growths, please go see your dermatologist! There are lots of dermatologic conditions that can occur in pregnancy, and we can help make you feel more comfortable and help keep your baby safe.

Eat healthily and exercise

This is for all the mom-to-be’s out there who are worried about STRETCH MARKS! I wrote an in depth blog post looking at the scientific evidence about different therapies for striae (stretch marks). The short answer is there’s no magic cream I can give you to take stretch marks away. However, stretch mark development is linked to the amount and rate of skin stretching in areas like the breasts and the abdomen. So if you can grow and stretch your belly at a healthy rate, and moisturize often so the skin is more pliable and able to stretch, you may be able to help reduce the development of striae.

DO wear compression stockings

Blood volume increases by about 50% during pregnancy, so it makes sense that you will have more leg swelling from gravity and varicose vein development during this time. If you’re on your feet a lot, make sure to buy compression stockings to help circulate the extra fluid back up to the heart. Depending on your size and symptoms, your doctor may recommend 20-30 mm Hg or 30-40 mm Hg of compression. I’ve been wearing compression stockings on long flights or during long walks to prevent swollen legs, feet, and veins.

Pregnancy skincare don’ts

DON’T use the following ingredients
As I mentioned above, there are a whole host of medications we use for skincare that are no longer safe when you are pregnant. I talked about acne above; here are a list of commonly used skincare medications that you should avoid. This is by NO means an exhaustive list, so you must ask your dermatologist what medications to continue and what to stop. In a nutshell, we want to assess the risk benefit profile for each medication; does the benefit of the medication outweigh the risk of side effects to you and your developing baby?

Generic Name	Brand Name	Treats	Pregnancy Category
Doxycycline	Oracea, Vibramycin, Doza, Atridox	Acne	D
Minocycline	Dyancin, Minocin, Solodyne, Myrac	Acne	D
Spironolactone	Aldactone	Acne, hair loss	D
Tetracycline	Sumycin, Actisite, Panmycin	Acne	D
5-Fluorouracil	Effudex, Fluoroplex, Carac	Skin Cancer	X
Isotretinoin	Accutane, Amnesteem	Acne	X
Tazorotone	Tazorac, Avage	Acne	X

DON’T get cosmetic treatments that can hurt the baby

I know we are all crazy about preventing and treating wrinkles but we don’t have a lot of evidence in the literature about whether or not botox, fillers, or laser procedures are safe during pregnancy (summarized in this paper here). Since the studies have not been done, we can’t definitively say one way or the other whether these treatments are safe. It’s better to be on the safe side and wait until after you deliver to consider cosmetic skin treatments.

DON’T get funky with hair dyes

The scientific literature shows mixed results; however, this excellent review paper I found (written by my voluntary attending Dr. Peter Saitta!) highlights that there have been some alarming reports of hair-dye use during pregnancy and development of childhood tumors. Others state that you should avoid hair dye use during the first trimester when the baby’s organs are developing. If you are willing to take the potential risk, things you can do to minimize exposure include applying petrolatum-based ointments to the scalp in a thick layer so the dye doesn’t touch the scalp as directly, and also to decrease the tie of dye application.