10/16/11

Topical Acne Treatments During Pregnancy: Are There Any Risks?

What are topical acne treatments?
Medications applied directly to the skin that are used in the treatment of acne. Common ingredients of topical acne treatments include salicylic acid, benzoyl peroxide, Retin-A® (tretinoin), clindamycin, azelaic acid, and glycolic acid.
Are topical acne treatments generally safe to use during pregnancy?
Over-the-counter skin products have not been associated with an increased risk when used during pregnancy. Studies have demonstrated that in most cases only 2% to 10% of the active ingredients are absorbed through the skin into your system. With so little passing into the body, the amount that reaches the developing baby, if any, is likely too low to cause birth defects.
Prescriptions topical treatments typically have higher amounts of the active ingredients than the over-the-counter products. Therefore, the amount of medications absorbed into the body may be higher.
Can I use topical salicylic acid?
There may be a concern when a pregnant woman takes a certain dose of acetylsalicylic acid (aspirin), a related medication which is taken by mouth. When applied on the skin, the amount of salicylic acid that enters the body is very small. As a result, it is unlikely that topical salicylic acid would pose any risk to a developing fetus.
Can I use topical benzoyl peroxide?
Although no substantial controlled studies have been conducted on pregnant women using benzoyl peroxide, it is considered to be relatively safe to use, as only about 2% of benzoyl peroxide is absorbed into the system, which is not enough to cause any fetal harm.
However, benzoyl peroxide is also classified as a category C drug, which is an index of drugs and medications that have not been tested on humans or animals. Experts have not yet determined whether benzoyl peroxide can pass into breast milk. If you are considering using acne products with this active ingredient, consult your obstetrician before beginning any course of treatment.
Can I use glycolic acid or azelaic acid?
Glycolic acid and azelaic acid have not been studied in pregnancy. These medications are absorbed into the skin in small amounts, making it unlikely that topical forms would pose any risk to a developing fetus.
Can I use topical antibiotics such as clindamycin?
Topical clindamycin has been assigned to pregnancy category B by the FDA. Animal studies have failed to demonstrate a risk to the fetus and there are no adequate or well-controlled studies in pregnant women. Considered to be safe by most dermatologists, topical clindamycin is only recommended for use during pregnancy when there are no over-the-counter alternatives.
Can I use tretinoin (Retin-A® )?
Studies attempting to find out the effects of tretinoin on pregnancy have not found that babies whose mothers used tretinoin during pregnancy are any more likely to have birth defects than babies whose mothers did not use tretinoin. However, there have been a few reports of babies born with birth defects after their mothers used tretinoin during pregnancy. Typically, a few reports do not cause health professionals to be concerned, but the birth defects reported in those cases are like the defects seen in babies whose mothers took isotretinoin (Accutane®, an oral retinoid) during pregnancy. Therefore, it is generally recommended to avoid use of tretinoin in pregnancy due to the possible risks.

If you are pregnant and considering the use of acne products during the pregnancy, make sure to consult your dermatologist and obstetrician before beginning any course of treatment. 

A great resource for learning more about pregnancy and safety:

http://www.otispregnancy.org/