Dermatologist Debriefs

Pregnancy Skincare: What's Safe and What to Skip

• Stefanie Williams

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Confused about which skincare products are safe during pregnancy? Dermatologist Dr. Stefanie Williams cuts through the confusion with clear, science-backed guidance on what to avoid and what to embrace. From retinoids and salicylic acid to pregnancy-safe alternatives for acne, hyperpigmentation, and sun protection, discover exactly which ingredients deserve a spot in your routine—and which ones should stay on the shelf until after delivery. Essential listening for expectant mothers who refuse to compromise on either safety or results.

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Dermatologist debriefs. Join no-nonsense dermatologist Dr. Stephanie Williams as she debunks myths and shares her professional insights. Separating facts from fiction in just a few minutes.

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Hello, this is Dr. Stephanie. So today I'm going to talk about which skincare to avoid during pregnancy and which skincare is safe to use during this period. And the reason why this is important is because we have to choose our skincare carefully during pregnancy because some of the common ingredients may carry risks for an unborn baby. And I have to say this is more of a theoretical risk because over-the-counter skincare should always be safe to use, as it's not supposed to cause blood levels of active ingredients via resorption. But in any case, I would recommend to air on the side of caution and avoid certain ingredients simply to be on the safe side. So the first group of active ingredients in skincare to avoid, and I think the most important one really are vitamin A derivatives. And this is of course even more important for prescription retinoids like tretinoin, adaplin, and isotretinoin. But I would also avoid over-the-counter retinoids like retinol, again, just to be on the safe side. The reason why retinoids are contraindicated in pregnancy is due to their link with birth defects, and that's of course much a much higher risk in the case of oral retinoids like Rocheton, which is one of the brand names for isotretinoin. But I would avoid topical retinoids too if I was pregnant. This group of retinoids, so vitamin A derivatives, contain a lot of different family members. So it might be confusing if you look onto the ingredient list, the so-called inky list, and you may not even recognize some of them as retinols. So because they have different names. Retinol is the one you you probably all know and recognize on the ingredient list, but then there are also others like retinaldehyde, also referred to as retinol, and then various retinol esters such as retinol palmitate, retinol acetate, etc. So basically anything starting with retin is kind of a warning sign, and you should look into and probably avoid that kind of skincare product. And in addition to the ones I already mentioned, there is also a newer group of retinoid esters where the esterization is not done with a retinol but with retinoic acid. One of the best known examples is maybe gran actives, hydroxy, pinacolone retinoid, as well as retinol retinoid and tocopherol retinoid. So you can hear that they all have the retinoid at the end. So but again they do contain the retin, all of them. So anything that has the R E T I N in the name you should really be careful with. Another topical ingredient definitely to be avoided during pregnancy is uh hydroquinon, which is a powerful skin brightening ingredient. Um in the UK, this is available on prescription only. However, in other countries you can purchase this over-the-counter, so I thought I should definitely mention that here. And another ingredient that is frequently found in over-the-counter skincare products is salicylic acid, whether that's in cleansers, in peels, or in home care leave-on products, and I would recommend to avoid any salicylic acid in skincare. Safer alternatives to that BHA include um AHAs like glycolic acid and lactic acid, as long as they are in low concentrations and applied in smaller skin areas like the face, for example, rather than as a full-body product. And then there are the polyhydroxy acids like gluconolactone, which are also considered safe for small skin areas, and they're also less irritating compared to glycolic acid as they're resorbed slower because they are bigger molecules, and the bigger the molecule size, the more difficult it is to get into the skin, which slows down the resorption. So I mentioned already salicylic acid, which is in many acne products, and to avoid this, and the problem is of course that some women will experience acne breakouts during pregnancy. So it is quite tricky to find something that is safe to use during pregnancy because both salicylic acid as well as retinoids you shouldn't use, and those are both staples when it comes to topical acne treatment. But one ingredient that most dermatologists consider as safe to use during pregnancy in small skin areas is benzyl peroxide. In some countries this is a prescription product, while in other countries this is available over the counter, and this is not officially licensed for use in pregnancy in practice. Many doctors use it in their pregnant patients, and it is considered as safe in small amounts. But what I should mention here is that none of what I say here is, of course, medical advice. This is for education only, and you should always check with your own doctor whether or not they want you to use those products. Another acne ingredient that many dermatologists do use in pregnant patients is azalic acid, which in the UK is prescription only in higher concentrations of 15 to 20%, but is available over the counter in lower concentrations such as 1%. So for small skin areas, azolic acid is generally considered safe to use during pregnancy. And then also safe during pregnancy are vitamin C, niacinamide, ceramides, and hyaluronic acid. So all of these are very commonly found in topical skin care, vitamin E as well, so tocophrol is another one that is considered safe during pregnancy. With regards to sunscreens, we divide those into two groups: the chemical filters and the mineral filters. So the chemical filters absorb UV light and turn it into a less harmful type of electromagnetic irradiation, whereas the mineral filters, they're also called physical filters, reflect UV light more like a mirror. So, in my opinion, pregnant women should use physical filters ideally rather than chemical filters. Some people also think that chemical sunscreens such as oxybenzone or avobenzone are not ideal in pregnancy because they may be connected to hormonal disruption. This is a little bit controversial whether this is really the case or not, but to be on the safe side, why don't you stick to pure mineral filters like zinc oxide or titanium dioxide to be on the safe side? And on the note of sunscreens, um, healthy vitamin D blood levels are very very important whether you're pregnant or not. So I would definitely recommend to get a blood test to look at your vitamin D level, and if it is not in the ideal range, start a vitamin D3 supplement. You can even get home tests, so you do them with a little finger prick to get a drop of blood and send it away, and you'll get the vitamin D level report back by mail, or you just ask your GP, I'm sure they'll always be happy to test the vitamin D, especially in pregnancy, because it is so important that that is optimal. And then there are some help ingredients in skin care which are considered as potential endocrine disruptors, so hormonal disruptors, by some people. That includes parabens, which actually we're not allowed to use anymore in the UK and in the EU anyway, plus um phthalates and uh thin septic fragrances. Um I would say avoid these maybe in body products where you use really larger amounts, and there is a much bigger skin surface for resorption, although the actual risks remain uncertain. With regards to essential oils, there can be some that can be unpredictable and may cause some uterine stimulation. Um those may include sage, basil, aniseed, and tea tree oil. But again, this is controversial, and then there are other essential oils like lavender or chamomile, which are considered safe in moderation. So I would say be mindful of using essential oils, and if you want to be on the safe side, maybe avoid them or consult your doctor first. And in general, it's really important to understand that just because something is natural doesn't automatically mean it is safe. So, in summary, although topicals from skincare are absorbed through the skin in only minute quantities, if at all, it is safer to avoid certain groups of ingredients during pregnancy. And the primary groups are retinoids and salicylic acid. But always speak to your doctor first if you're using products to make sure that these are okay for you to use. I will speak to you again soon and let me know if you want any specific questions answered in one of my next posts.