Safe skin care during pregnancy

You may have put a lot of thought into what you're eating during your pregnancy (cravings are real), but what you put on your body could be just as important as what you're putting in it.

While most commonly used skin care products are completely safe, there are a handful of ingredients experts say it's best to avoid during pregnancy.

Skin care ingredients to avoid during pregnancy

Retinol

Retinoids (also known as tretinoins) are a type of vitamin A that speeds up cell division (quickening your skin's renewal) and prevents skin collagen from breaking down. These powerful substances are found in some antiaging moisturizers and treatments for acne, pigment disorders, and plaque psoriasis.

But retinoids are one of the skin care ingredients that experts recommend that pregnant women stay away from. Some studies have shown that taking high doses of vitamin A during pregnancy can be harmful to an unborn child. And oral retinoids, such as isotretinoin (a prescription acne treatment previously sold under the brand name Accutane), are known to cause birth defects.

"With the exception of the known correlation between vitamin A derivatives like retinoids, most topical skin care is low risk," says Layan Alrahmani, M.D., a board-certified ob-gyn, maternal-fetal medicine specialist, and member of the BabyCenter Medical Advisory Board."If you're ever unsure about specific medications or ingredients, it's best to consult your obstetric provider."

If you've been using a skin cream that contains a retinoid, don't panic. Retinoids that you put on your skin have not been shown to cause problems in pregnant women. Doctors are just being extra cautious in recommending that you avoid them.

Avoid products with these ingredients:

• Avage, Fabior, Tazorac (tazarotene)
• Avita (tretinoin)
• Differin (adapelene)
• Panretin (alitretinoin)
• Retin-A, Renova (tretinoin)
• Retinoic acid
• Retinol
• Retinyl linoleate
• Retinyl palmitate
• Targretin gel (bexarotene)

Bottom line: Don't take oral retinoids, such as isotretinoin, during pregnancy. To be on the safe side, it's best to avoid topical retinoids (the ingredients listed above), too.

Acids

Hydroxy acids such as beta hydroxy acid (BHA) and alpha hydroxy acid (AHA) are found in products to treat certain skin disorders, including acne, skin inflammation, and redness. They're also found in a number of cleansers, toners, and exfoliants touted to reduce the signs of aging.

Salicylic acid is the most common BHA you'll find listed as an ingredient and the only BHA that has been studied in pregnancy. High doses of the acid in its oral form – it's an ingredient in aspirin – have been shown in studies to cause birth defects and various pregnancy complications. Other BHAs have not been studied in pregnancy.

Very little of a BHA would be absorbed into the skin when it's applied topically. But because oral salicylic acid is not safe during pregnancy, doctors also recommend avoiding excessive or frequent use of skin products containing BHAs.

Small amounts applied to the skin – such as a toner with salicylic acid used once or twice a day – are considered safe.

You can use a facial wash that contains no more than 2% salicylic acid (look for the percentage on the product label). This small amount is considered safe. If you want to be doubly sure, ask your healthcare provider exactly how much would be safe for you to use.

The concern is stronger about face and body peels containing salicylic acid. Always check with your doctor before having a peel treatment. Better yet, if you must have a peel, have it done professionally at your dermatologist's office. A dermatologist will know how to do it safely during pregnancy.

If you do use a BHA product, use it with sun protection, since BHA can cause sensitivity to sunlight.

The two most common alpha hydroxy acids (AHAs) in cosmetic products are glycolic acid and lactic acid. AHAs have not been studied in pregnancy, but because only small amounts are absorbed into the skin, they are considered low risk when used in skin treatments. Still, to be safe, it's a good idea to use them only in small amounts.

Products containing these ingredients are safe to use in small amounts:

• Alpha hydroxy acid (AHA)
• Azelaic acid
• Benzoyl peroxide
• Beta hydroxy acids (BHA)
• Beta hydroxybutanoic acid
• Betaine salicylate
• Citric acid
• Dicarbonous acid
• Glycolic acid
• Hydroacetic acid
• Hydroxyacetic acid
• Hydroxycaproic acid
• Lactic acid
• Salicylic acid
• Trethocanic acid
• Tropic acid
• 2-hydroxyethanoic acid

Bottom line: Don't take BHAs orally, and it's best to limit their use topically.

Phthalates

It's borderline impossible to avoid phthalates entirely. A type of chemical used in everything from plastic food containers to garden hoses, phthalates truly are all over the place – including skin care.

They're commonly used in products with scents, which is why experts recommend using skin care and makeup products clearly labeled "fragrance free." This is different from "unscented," which can mean that chemicals are used to cover up a scent. (Tricky, right?)

Studies have shownOpens a new window that children born to mothers who were exposed to certain phthalates during pregnancy are more likely to experience motor skill deficiencies and speech delays.

Several phthalates have been linked to endocrine disruption, as well as developmental and reproductive toxicity. One type in particular, DBP, is linked to proliferation of breast cancer cells. DBP and DEHP, which has been shown to cause liver tumors in animals, are both banned in cosmetics in the European Union, but not in the United States. DBP is sometimes used in nail polish, so check those labels.

Products containing these ingredients should be avoided:

• Dibutyl phthalate (DBP)
• Diethyl phthalate (DEP)
• Di-2-ethylhexyl phthalate (DEHP)
• Butyl benzyl phthalate (BBP)

Bottom line: Make sure the products you're using are labeled "fragrance free" to avoid harmful phthalates during pregnancy.

My aesthetician stopped me on all active ingredients, so it's mainly gentle cleanser, gentler toner, moisturizer, and sunscreen. Always ask your doctor, though.

- BabyCenter Community member Chelseatx

Skin care ingredients that are safe during pregnancy

Makeup

You may not give a second thought to the kind of makeup you use, but even cosmetics are something to consider when pregnant.

Many makeup products are marked "noncomedogenic" or "nonacnegenic" – meaning they're oil-free and don't clog pores. These are safe and will not affect the health of your baby.

If you want to be super careful during pregnancy, try some of the minerals-only makeup lines. These products use ingredients that primarily sit on top of the skin and don't cause irritation for most people.

Bottom line: Most makeup is safe to use during pregnancy. If you want to be extra cautious, use mineral-only makeup.

Sunscreens

Just because you're pregnant doesn't mean you can't hit the beach. But don't forget the sunscreen. Even sunscreens with ingredients that penetrate the skin are considered safe during pregnancy. However, as an extra precaution, you might opt for products that use titanium dioxide and zinc oxide – physical sunblocks that don't penetrate the skin.

(In addition to sunscreen, avoid the sun between 10 a.m. and 4 p.m.; wear a sun hat, sunglasses, and protective clothing; and reapply your sunscreen every two hours when you're outside. And yes, even if you have dark skin you should wear sunscreen and follow these guidelines).

It's best not to use a sunscreen containing the skin lightener hydroquinone. There's limited data on its safety during pregnancy, and most experts agree it's best to avoid it.

These topical ingredients are considered low risk during pregnancy:

• Avobenzone (Parsol 1789)
• Benzophenone
• Dioxybenzone
• Octocrylene
• Octyl methoxycinnamate (OMC)
• Oxybenzone
• Para-aminobenzoic acid (PABA)
• Titanium dioxide
• Zinc oxide

Bottom line: Sunscreen is safe to use when you're pregnant. Check out our favorite pregnancy-safe sunscreens here.

Steroids

Steroid creams – such as over-the-counter hydrocortisone creams – are often used for minor skin irritations, inflammation, itches and rashes caused by contact dermatitis, mild eczema, rashes, psoriasis, soaps, detergents, cosmetics, jewelry, and insect bites.

These topical steroids are considered safe to use during pregnancy. More potent steroid products are sometimes prescribed by dermatologists or primary care physicians, and most of these are safe as well.

But do talk with your healthcare provider about the safety of any prescribed products, including topical prescriptions, before using them during pregnancy.

These ingredients are considered safe:

• Alclometasone (Aclovate)
• Desonide (Desonate, DesOwen)
• Fluocinolone (Capex, Derma-smoothe)
• Hydrocortisone (Aquanil HC)
• Triamcinolone (Aristocort A, Kenalog)

Bottom line: Most topical steroids are safe, but always check with your healthcare provider just in case.

Hair removers and minimizers

Lotions that remove your hair chemically (depilatories) or that minimize hair between shaves sound like a dream come true when you can barely reach – not to mention see – your legs. The good news is that these products are considered safe, as long as you use them as directed.

If you've had an allergic skin reaction to hair minimizers or removal creams in the past, then you should avoid these products during pregnancy as well.

Also, some women's skin gets extra sensitive during pregnancy, so you may have a reaction to these ingredients even if you haven't before. Before slathering your whole leg, do a patch test on a small piece of skin behind your knee and wait 24 hours to see if you react.

These topical ingredients are considered low risk during pregnancy:

• Calcium thioglycolate (depilatory)
• Hydrolyzed soy protein (minimizer)
• Potassium thioglycolate (depilatory)
• Sanguisorba officinalis root extract (minimizer)
• Sodium hydroxide (minimizer)

Bottom line: Most hair removers and minimizers are safe to use during pregnancy.

The final word

If you have any concerns about a skin product, it's a good idea to discuss it with your healthcare provider. If you've used a product that contains a potentially harmful ingredient, don't panic. Simply stop using the product now and pick one with safer ingredients.

"My aesthetician stopped me on all active ingredients, so it's mainly gentle cleanser, gentler toner, moisturizer, and sunscreen," says BabyCenter Community member Chelseatx. "Facials, but no peels. Always ask your doctor, though."

In addition to checking the labels in your medicine cabinet, there are nonprofits that'll give you all the info you need before you buy anything new. The Campaign for Safe CosmeticsOpens a new window has an in-depth breakdown of every product and chemical of concern for pregnant women.