Treatment of acne during pregnancy and while breast-feeding is difficult as it is preferable to avoid medication during pregnancy in case such medication may have an effect on the developing fetus or the growing baby.
There are however certain topical therapies which may be used during pregnancy and also while breast-feeding. The following topical therapies are deemed safe:
▫️Azelaic acid has anti-bacterial, anti-inflammatory and anti-keratinizing properties (preventing build up of dead skin cells which could block pores) This topical therapy therefore targets many of the mechanisms of action resulting in development of acne.
▫️Benzoyl peroxide (BPO) works by reducing the number of bacteria on the skin’s surface, which cause the inflammatory lesions of acne but also does not result in bacterial resistance. It also dries out the skin therefore when using it one will notice that spots dry up more quickly
▫️Glylcolic acid (a small alpha hydroxy acid/AHA) works by enabling the dead skin cells to shed more easily therefore preventing blockage of the pores
▫️Low concentration salicylic acid preparations such as in a toner are allowed during pregnancy, however high oral doses can result in birth defects, so it is advised that topical SA preparations are also used sparingly.
▫️Topical antibiotics such as prescription Erythromycin may also be used twice daily which will reduce bacteria on the skin surface. This may also be taken orally for those with more severe acne, however it can cause gastrointestinal upset for some, therefore is not always well tolerated for women suffering with morning sickness during pregnancy. Other penecillins may also be used temporarily if a woman has more severe acne flares during pregnancy.
It is also not recommended to use topical or oral retinoids while pregnant, however some would deem it safe to use topical retinoids while breastfeeding as negligible amounts would be found in the blood, however it is advisable to avoid using it on an area the baby would come in contact with.