Which skincare ingredients should I avoid during pregnancy?

Which ingredients are the main concern?

Retinoids include prescription treatments such as tretinoin, adapalene, tazarotene, and isotretinoin, as well as skin care with retinol. Avoid topical retinoids as a precaution, including when planning a pregnancy. Skin absorption is very low, but evidence on topical tretinoin is mixed: four case reports described birth defects, while two first trimester studies of 96 and 106 women found no increase in major malformations.134

Hydroquinone is used to lighten skin. An estimated 35 to 45 percent can be absorbed through the skin, and pregnancy evidence comes from one small study. Minimize exposure during pregnancy.14

Other medicines on pregnancy skin care avoid lists include finasteride, spironolactone, 5 fluorouracil, tetracycline, doxycycline, and minocycline. Some are prescribed treatments rather than ordinary cosmetic ingredients, so check acne and hair loss products as well as moisturizers.1

Which ingredients should I limit or check first?

Salicylic acid at concentrations greater than 2 percent and benzoyl peroxide belong in the discuss first, use sparingly group, not the clear avoid group. Parabens, phthalates, phenol, triclosan, and essential oils are also on the limited use list. Some of these ingredients have not been researched enough to know how safe they are during pregnancy.1

Topical salicylic acid has not been studied in pregnancy, and the amount absorbed varies with the product, its strength, and how much you apply; absorption can be higher on damaged skin. A previous review considered limited topical absorption unlikely to pose a risk and said systemic effects from topical benzoyl peroxide would not be expected. Since advice differs by strength and use, discuss both ingredients with your obstetrician or dermatologist before using them.24

What can I use instead?

Azelaic acid is thought to be safe during pregnancy, and topical glycolic acid is not expected to be a concern. Vitamin C in the morning and glycolic acid in the evening can help with pregnancy related skin color changes.124

Keep the routine simple: cleanse up to twice daily and after sweating, moisturize regularly, and use a broad spectrum, water resistant sunscreen with SPF 30 or higher on skin not covered by clothing. A physical sunscreen containing zinc oxide, titanium dioxide, or both can help avoid skin irritation. Three steps leave fewer jars auditioning for a speaking part.1

What if I already use a prescription product?

Tell your obstetrician and dermatologist about all medicines and prescription skin care you use, including when you are trying to become pregnant. For medicines outside the acne treatments listed above, talk with your provider before stopping or starting them; needed treatment can matter to your health.15

Also check supplement labels: during pregnancy, do not take cod liver oil or supplements containing vitamin A, sometimes called retinol.6