What should I do if I used retinol before realizing I was pregnant?

What should I do now?

1. 1Stop the product. Avoid retinol and retinyl palmitate during pregnancy, as well as prescription retinoid creams and gels such as tretinoin and adapalene.
2. 2Contact your pregnancy care provider. Explain whether you applied a skincare product, used a prescription cream, or took a medicine by mouth. If you took an oral retinoid such as isotretinoin, stop taking it and contact the prescriber promptly.
3. 3Describe the exposure. Tell your clinician the product name, when you used it, how much you applied, and which areas you treated. Mention any application to broken or irritated skin, because that can increase absorption of topical tretinoin.

Keep the packaging handy for the conversation; 'the serum in the nice bottle' is a description, not a product name.2

Does accidental use mean the baby was harmed?

No. Accidental exposure does not mean harm occurred. For properly applied topical tretinoin, the chance of birth defects is probably low, and use is not expected to increase the chance of miscarriage. Birth defects and miscarriage can also happen in pregnancies without any retinoid exposure. Some birth defects have been reported after topical retinoid use, however, and a connection cannot yet be ruled out. That uncertainty is why these products should be avoided during pregnancy.23

Cosmetic retinol, prescription topical tretinoin, and oral isotretinoin are not interchangeable exposures. The low risk information above concerns topical retinoid medicines, especially tretinoin; your clinician should assess the actual product you used. Oral isotretinoin enters the bloodstream at much higher levels and is known to cause birth defects involving the face, heart and brain.3

Does the amount I used matter?

Yes. Skin acts as a barrier, so only a small amount of topical tretinoin is likely to enter the body when used as directed. More can be absorbed when the skin is broken or irritated, when more product than needed is applied, or when a large area is treated. Those details help your clinician assess the exposure rather than treating every cream application as equivalent.3

Will I need extra scans?

Extra monitoring for major birth defects is not routinely required after topical retinoid use. In the UK, a detailed scan at around 20 weeks is already part of routine pregnancy care. Discuss your exposure with your pregnancy care provider so they can confirm the plan for you. The advice for a skin cream should not be applied to an oral retinoid exposure.2

Can I restart later in pregnancy?

Avoid retinoids throughout pregnancy, not just during the first trimester. A baby's organs form during the first three months, but the body and brain continue growing later. Passing the first trimester is not a reason to restart tretinoin. Retinol and retinyl palmitate should also be avoided while breastfeeding; discuss prescription tretinoin separately with your healthcare provider before restarting.134

What should I use instead?

If you were treating acne, speak to a dermatologist before choosing a replacement, including a product sold without a prescription. Non retinoid treatments are available, and stopping acne medicine during pregnancy is usually safe. You do not have to replace the retinoid immediately. For basic acne care, wash twice daily with a gentle cleanser, remove makeup at night, and avoid scrubbing or squeezing spots.256

A gentle cleanser handles the washing; the bathroom does not need to become a replacement serum showroom.6