Pregnancy acne: Causes and treatment

Does pregnancy cause acne?

It can. Whether you've never had acne before or already struggle with existing adult acne, pregnancy can cause pimples to show up or increase in numbers. (On the other hand, some women with acne-prone skin report a decrease in breakouts during pregnancy, so you never know.)

Acne early in pregnancy may happen as higher levels of hormones called androgens surge. While we don't know for sure what causes pregnancy breakouts, androgens are at least partly responsible because they can prompt the sebaceous glands in your skin to get bigger and boost production of an oily substance called sebum.

This extra sebum, combined with shed skin cells, blocks your pores, creating an environment in which bacteria can rapidly multiply. All this can eventually lead to the inflammation and skin eruptions of acne. Unfortunately, your body doesn't get used to the increased hormones, which means the acne may progress through pregnancy, or even get worse.

Some women have mild cases of acne, while others have moderate or even severe cases. And it doesn't always start in early pregnancy. Pregnancy acne can flare up at any time. It may come and go, or it may progress and last the entire pregnancy.

Keep in mind that your pregnancy isn't all bad for your skin! While you may have to put up with some new blemishes, as you circulate more blood and retain more water you may find that you have that famous pregnancy glow, and your complexion is more radiant than ever before.

Can I take any medication for pregnancy acne? 

Maybe, but talk with your doctor, midwife, or dermatologist first about safe pregnancy acne treatment. That goes for both prescription medications and over-the-counter medications, oral drugs, and topical ones (creams and gels that you apply to your skin).

Because researchers don't test medications on pregnant women, many products are not well studied for use in pregnancy. We know that some medications are definitely not safe, though.

Do not take orally or apply topically any of these medications during pregnancy:

(Note that there are many more brand names for these medications, so be sure to check the generic names of all products.)

• Isotretinoin (Accutane) and other retinoids, such as tretinoin, tazarotene, trifarotene, and adapalene
• Spironolactone (Aldactone)
• The antibiotics tetracycline, minocycline, or doxycyline
• Hormonal therapy (oral contraceptives)
• Dapsone (Aczone) or clascoterone (Winlevi) – the safety of these newer medications hasn't been established yet for pregnancy.

Some of these medicines can cause serious birth defects.

Topical acne medications – partly because they're absorbed in small amounts – tend to be safer than oral acne medications during pregnancy. Topical retinoids are not recommended during pregnancy, but these topical acne medications are considered safe to use during pregnancy:

• Benzoyl peroxide
• Antibiotics such as clindamycin and erythromycin
• Azelaic acid
• Salicylic acid (a beta hydroxy acid), in small amounts
• Glycolic acid
• Metronidazole

The oral antibiotics erythromycin and cefadroxil are also considered safe for pregnancy acne treatment. (Experts are not sure about the pregnancy safety of other antibiotics used for acne, such as azithromycin and clarithromycin.)

Laser and light therapies are also considered relatively safe during pregnancy, but be sure to talk with a dermatologist. If a numbing solution or medication is used during the process, those may not be safe.

Learn more about safe skincare products during pregnancy.

What are some safe ways to prevent and treat pregnancy acne? 

The safest way to prevent and treat pregnancy acne is good skin care. You may still have some pregnancy breakouts, but here are some tips that may help:

• Wash gently with a mild soap or cleanser twice a day. Rinse with lukewarm water.
• Don't scrub your face with a washcloth, since that can irritate the skin and make the problem worse. Use your hands to gently wash your face.
• Pat your skin dry rather than rubbing it.
• If you use moisturizer, make sure it's oil-free.
• Don't squeeze, rub, or pop your pimples – it'll aggravate the problem and could lead to scarring.
• If you wear makeup, use products that are water-based rather than oil-based and that are labeled "noncomedogenic" or "non-acnegenic," meaning they won't clog your pores and cause breakouts. Be sure to wash your makeup off thoroughly before going to bed, too.
• Shampoo regularly, especially if you have oily hair, to reduce oil accumulation around your hairline.
• Keep your hands off your face throughout the day.
• Stay hydrated by drinking plenty of water.
• Freshen your pillowcases and towels by washing them often.

Ask your healthcare provider about any all-natural acne treatments you'd like to try. Natural recipes containing citrus or vinegar are too harsh, especially on your facial skin, which is very sensitive. Some natural essential oils and extracts are sometimes used to treat acne, but their safety and effectiveness hasn't been well studied overall – and not at all in pregnant women.

Read more:

Is it safe to get a facial when I'm pregnant?

Best stretch mark creams

Skin darkening during pregnancy (melasma or chloasma)

Hair and nail changes during pregnancy