Pregnancy-Safe Skincare: Ingredients to Use and Those to Avoid

During pregnancy, women commonly experience many physiological changes, including changes in hormone levels, such as increases in androgen levels. This may result in acne development or worsening of acne, as well as an increase in hair growth. The safety of common skincare agents used for acne as well as bleaching creams and hair removal products for pregnant women are often undermined, even though most skincare products are safe and not expected to cause malformations or adverse effects on the developing foetus. In this article, learn how women can still look and feel their best with a pregnancy-safe skincare routine, without putting their developing foetus at risk. 

How does the skin change during pregnancy?

During pregnancy, a change in hormonal levels and blood flow can cause changes in the skin. Firstly, there may be an increase in pigmentation – dark patches developing on facial skin, a condition known as chloasma. To prevent worsening, avoid sun exposure as the rays can cause more dark spots to form. Many women tend to become more acne-prone during pregnancy as well. Lastly, stretch marks are also common during the second and third trimesters. 

Are topical antibacterials safe?

Topical antibacterials such as clindamycin and erythromycin are used either by itself or as adjunct topical treatments for acne. A study showed that clindamycin resulted in no increased risk of malformations among 647 women with use in the first, second or third trimester of pregnancy. Furthermore, consuming erythromycin during pregnancy has not been associated with causing abnormal birth defects in several thousand women. 

Skincare ingredients to avoid 

Topical Retinoids 

The amount of drug absorbed from the skin after applying retinoids is very low, however, there have been 4 published case reports of birth defects in the literature associated with topical tretinoin use. How harmful the use of retinoids is during pregnancy is unclear as 2 prospective studies that examined use during the first trimester of pregnancy with 96 and 106 women did not find an increased risk of major malformations. However, until data on larger groups of subjects are collected, it is recommended that women should switch to other safer alternatives other than retinoid-based products. One of the most safe and effective is glycolic acid,  in addition to topical benzoyl peroxide and topical salicylic acid.

Skin whitening agent – Hydroquinone

Clinically, hydroquinone is used as a topical depigmenting agent for skin conditions such as melasma, and cosmetically, it is used as a skin-whitening agent. Research has shown that an estimated 35% to 45% is systemically absorbed following topical use in humans. Based on current available evidence, topical use of hydroquinone during pregnancy is not associated with increased risk of major malformations or other adverse effects for the foetus. However, due to fairly substantial absorption compared with other skincare products, it is recommended to be used sparingly or switch to other safer alternatives. Studies show that alpha hydroxy acids, such as citric and lactic acids, are effective in treating hyperpigmentation, and they are generally safe to use in pregnancy. 

Learn more about why the skin whitening agent, hydroquinone, should be avoided in our podcast, Dermatologist Talks: Science of Beauty Ep 36, by accredited dermatologist Dr. Teo Wan Lin.

A note about organic skincare products 

According to Dr. Teo Wan Lin, in her book Skincare Bible: Dermatologist’s Tips for Cosmeceutical Skincare: “most people think organic skincare is either eco-friendly, natural or vegan. Here’s the catch, they can and cannot be. Organically farmed produce can be friendlier on the environment in general, as less pesticide use means less harmful release of chemicals to the environment which accumulates as waste and potentially harms wildlife. However, these can also come at a greater cost, and by no means does that translate into any real benefits when incorporated into skincare which is not consumed but applied.

In fact, organic skincare often boasts essential oils which can cause both allergic (in susceptible individuals) and irritant contact dermatitis (due to the concentration of most essential oils, it is not medically advisable to apply any type of essential oil directly to skin as it can result in a chemical burning type of reaction).

Brands touting “organic skincare”, especially when home-made, lack the stringent quality controls present in a laboratory setting, which is required for the formulation of dermatologist-grade cosmeceutical skincare. One real danger of certain types of “organic skincare”’ is that they are not regulated for safety, in terms of bacterial contamination. Preservatives such as parabens have gotten some bad press in recent years but the overall consensus in the dermatological community and by the FDA is that they are still regarded as safe and necessary to reduce bacterial growth in applied creams. The lack of “preservatives” is again a questionable label because this means that something else should be added to the product to increase the shelf-life of such a product which is meant for public sale.”

Pregnancy-safe skincare ingredients 

Sunscreen

Many use sunscreens to protect their skin from the sun’s harmful UV rays. Research conducted shows that sunscreens have very limited systemic absorption. Additionally, sunscreens have been used in pregnant women to treat or prevent melasma, and there have been no adverse events reported. One can consider mineral-based sunscreens, which include zinc oxide and titanium dioxide, that protect the skin by forcing the UV rays to bounce off of the skin entirely. 

The SunProtector™ is formulated with physical blockers like titanium dioxide and zinc oxide that effectively blocks blue light emitted by indoor devices. It is a pregnancy-safe skincare product that contains Portulaca Oleracea (Purslane) and Oligopeptides in our SunProtector™ are potent antioxidants which actively fight free radicals generated by blue light as well as airborne pollutants – for comprehensive protection.

Glycolic acid 

The first pregnancy-safe skincare ingredient is Glycolic acid is an alpha hydroxy acid that can be found in many skincare products. There have not been any studies analysing the use of glycolic acid in pregnant women, however, application of topical glycolic acid during pregnancy is safe as only a small amount is expected to be absorbed systemically, hence it will unlikely cause harm to the foetus. 

Phytoceramide-rich moisturizers

The nextpregnancy-safe skincare ingredient is the inclusion of shea butter, which acts as a phytoceramide. It is a plant-derived, ceramide-like molecule that helps to maintain a healthy protective skin barrier in the skin. There are new sources of ceramides such as phytoceramides (ceramide-like molecules derived from plant seed oils).

The Radiancé Fluide™ Hydrating Emulsion contains LARECEA™ Extract for regeneration and skin brightening ingredients for a dewy glow. A pregnancy-safe skincare product that is specially formulated for a light-weight feel to impart a radiant glow without make-up.

Botanical ingredients 

Functional dermatology refers to the use of pharmaceutically active, botanical ingredients. A lot of drugs are actually derived from plants – it applies these principles to formulas. This includes natural ingredients specifically tailored to individual patient concerns like pigmentation, oily/acne prone skin and eczema. As scientific knowledge of dermatology advances, so will the discovery of the immense potential of botanical and plant extracts in both skin and hair cosmeceuticals. Furthermore, botanical cosmeceutical extracts do not involve the synthetic ingredients that often have an environmental impact in the manufacturing process.

These ingredients would also be safe for pregnant women, who wish to continue their anti-ageing skincare throughout pregnancy. This narrowed down the choice of ingredients to plant-derived actives which had also demonstrated efficacy in the laboratory testing phase.

Salicylic acid 

Many cosmetic and skincare products contain the ingredient salicylic acid and the amount of systemic absorption varies. Many published studies show that there is no increase in the baseline risk of adverse events, such as major malformations, preterm birth, or low birth weight in women who have taken low-dose acetylsalicylic acid during pregnancy. Additionally, since only a small proportion of salicylic acid will be absorbed through the skin, it is highly unlikely to cause harm to a developing baby, hence can be considered as another pregnancy-safe skincare ingredient.

References:

Bozzo P, Chua-Gocheco A, Einarson A. Safety of skin care products during pregnancy. Can Fam Physician. 2011;57(6):665-667.