Not all pregnancies have an impact on acne but if you have hormonal acne, it is likely to flare during the first trimester (three months) of your pregnancy. Fortunately, your acne will probably then improve and may even disappear during the last trimester. Breast-feeding is also an excellent way of keeping acne away. Many females with persistent acne also notice that their acne is progressively less severe or disappears with subsequent pregnancies.
If you are pregnant or planning to conceive, you should avoid the following treatments:
Retinoids (tretinoin, adapaline, isotretinoin, tazarotene)
It is known that taking high levels of retinoids, such as isotretinoin, by mouth carries a high risk of birth defects. As such, this has led to a broader recommendation that no one who is pregnant or planning to become pregnant should use creams containing retinoids. If you find out that you are pregnant and have been using a retinoid cream, you should stop using the cream immediately.
If you have been taking retinoids while you were pregnant do not immediately assume the worst. Findings from a study of a large number of pregnancies where the mother was exposed to topical retinoids, along with data from studies looking into the absorption of retinoids after use of topical cream on the face, suggests that you have not exposed your child to any extra risks. However, as retinoids are known to cause birth defects, it is important that you discuss this issue with your doctor.
Tetracycline antibiotics which include doxycycline and minocycline should be avoided. Isotretinoin should be avoided.
If you discover you have become pregnant while taking spironolactone, you should stop the drug immediately. Reassuringly, there is no evidence of any risk of harm if it is taken inadvertently during the first few months of pregnancy. It does not cause birth defects but if taken during the last few months of pregnancy, it could interfere with the normal development of a male child, due to its effects on male hormones.
Acne treatments with proven safety in pregnancy include:
Topical treatments: benzoyl peroxide; erythromycin;clindamycin; Duac gel and azelaic acid
Oral medication: erythromycin