About Acne Medications and Pregnancy

Pregnancy is a time when the body undergoes hormonal changes, particularly during the first trimester as the body equips itself to sustain another life. The rise in hormones can cause an increase in oil production, which may result in acne breakouts. Pregnancy is also a time when you should be extra vigilant about what you put into your body because it will directly affect the fetus. There are acne treatments that are safe to use during pregnancy, and then there are those that must be avoided.

Over-the-Counter Treatment

Benzoyl peroxide and salicylic acid are the most used active ingredients in over-the-counter acne products. Benzoyl peroxide has been tested and approved for use by pregnant women. On the other hand, salicylic acid taken by pill has been found to produce birth defects and cause difficulties in pregnancy. For this reason, there is a warning against using products containing salicylic acid even if applied topically. It is best to consult your doctor before taking any kind of pharmaceuticals during pregnancy.

Treatments to Avoid

Isotretinoin is a strong, oral medication that is sometimes prescribed for persistent, severe acne that has not responded to other forms of treatment. This treatment involves administering high doses of chemically produced vitamin A. Isotretinoin is the generic name for Accutane. The Organization of Teratology Information Specialists reports that between 25 percent and 35 percent of babies born to women who took isotretinoin during the first trimester exhibited various defects, including those to the cranium and face, heart problems, and issues with the central nervous system. A higher risk of miscarriage and infant death also was observed in women who used isotretinoin during their pregnancy.

Tretinoin (generic name of Retin-A) is a topical cream that is prescribed to treat acne. Although the Organization of Teratology Information Specialists concedes that less than 10% of tretinoin goes into the mother's bloodstream and an even smaller amount gets to the baby, it advises against use by pregnant women or those considering getting pregnant.

Tetracycline is an oral antibiotic that is sometimes prescribed for acne. The Organization of Teratology Information Specialists claims tetracycline use correlates with reduced bone growth and a discoloration of teeth in a fetus. For this reason, tetracycline is not recommended during pregnancy.

Natural Solutions

The safest acne treatments during pregnancy are natural. One of the easiest things to do is to keep skin clean and avoid picking at pimples. Warm, cooked oatmeal applied to the face for 15 to 20 minutes a few times a week can clear up skin fairly quickly. Uncooked oatmeal can be used as a natural exfoliant to unclog pores, while lemon juice can be applied to dry up blemishes. There are other natural products that have been approved to be applied to the skin during pregnancy, such as tea tree oil, lavender essential oil and echinacea.

FDA Prescription Medication Use in Pregnancy Ratings

The Federal Drug Administration put together specifications in 1975, called Prescription Medication Use in Pregnancy Ratings, to guide pharmaceutical companies in classifying medicines with respect to their effects on procreation and gestation (see Resources). The ratings go from "A" through "D," then jump to "X." Basically, a rating of "A" means there were controlled studies that prove the drug does not pose a risk to the fetus if taken during pregnancy. A "B" rating shows there is no proof that the drug is dangerous if taken during pregnancy, but there is a remote possibility of risk to the fetus. "C" means though there is no proof of harm, the risk cannot be ruled out; however, potential benefits may exceed potential harm. "D" states that although there is proof of risk, the potential benefits outweigh the potential risk, such as in life-threatening situations. A rating of "X" means there is proof that the drug is harmful to a fetus, and the potential benefit is not worth the risk.

Tretinoin (Retin-A) has a "C" rating, and tetracycline has a "D." Isotretinoin (Accutane) has an "X."

Medications While Breastfeeding

After pregnancy, you will still need to watch what you put into your body if you are breastfeeding. While there are many kinds of medications approved for use by breastfeeding mothers, it is important to bear in mind that whatever you ingest will end up in your milk. For this reason, you should discuss any medications you are considering taking while breastfeeding with your health care provider. For information on drugs that are safe to take while breastfeeding and what drugs to avoid, see Resources.

Resources

• Organization of Teratology Information Specialists Fact Sheets
• FDA Drug Category Ratings
• Drug Safety During Breastfeeding