Guest Post: Pregnancy Skincare Dos and Don’ts with Dr. Joyce

Over the past couple of years, I have gotten a ton of questions about skincare during pregnancy. Questions that I’ve never been comfortable with answering, since I chose to follow the Way of Parental Disappointment and not become a doctor. But today I bring you…pregnancy skincare tips from a doctor!

Our guest poster, Dr. Joyce, is a dermatology resident in NYC. She went to college and medical school at Stanford and is currently finishing her last year of dermatology training at NYU, and she’s graciously sharing her expertise with us on skincare during pregnancy.

Dr Joyce from Tea with MD

Image courtesy of Tea with MD


This post is written for a general audience and is not a substitute for personal medical advice. Please bring any concerns you have to your physician.


Guest Post: Pregnancy Skincare Dos and Don’ts

Hi everyone! My name is Dr. Joyce Park and I am a dermatology resident in New York City and health and beauty blogger at Tea with MD. I love writing about science based skincare, helping you figure out what has been proven to really work for your skin and what is just fluff. Today I have the pleasure of teaming up with Fiddy Snails to talk to you about pregnancy skincare do’s and don’ts, quite a popular topic for both of our readers!

When women are pregnant, our bodies obviously go through huge changes in every system, and our skin, the largest organ we have, is no exception (if you are interested, read more from this Yale Dermatology text here!). These changes range from darkening of the skin, also known as hyperpigmentation, to engorgement of your blood vessels, and even changes in your hair and nails. The following are a list of skincare do’s and don’ts during pregnancy, tailored towards addressing skincare concerns that develop when women are pregnant.

Pregnancy skincare tips

Image courtesy of Tea with MD

Pregnancy Skincare Dos

Sunscreen, sunscreen, sunscreen

Three out of four pregnant women develop melasma, which appears as brown spots on the cheeks but also forehead and chin. (Note from Fiddy: I got this. BAD.) This condition is particularly bad during pregnancy because of hormone fluctuations, and can be very difficult to treat. The best thing you can do is PREVENT the darkening in the first place by always wearing sunscreen SPF 30 or above, using physical sunscreens containing zinc oxide or titanium dioxide, and wearing hats with large brims and clothing that protects the skin from UV radiation. Different dermatologists will have differing opinions regarding which topical medications you can start during pregnancy to prevent and treat melasma.

Check your ingredients

Products that you commonly use in skincare may no longer be safe for your developing baby. The biggest example of this is in acne. Several acne therapies may cause adverse effects, including developmental abnormalities in the fetus. Generally, topical antibiotics such as clindamycin or erythromycin are safe, as well as glycolic acid, salicylic acid, benzoyl peroxide (newly reclassified this year!), and light based therapies.

Monitor your skin

If you notice new dark spots, itchy rashes, blisters, painful bumps, or strange growths, please go see your dermatologist! There are lots of dermatologic conditions that can occur in pregnancy, and we can help make you feel more comfortable and help keep your baby safe.

Eat healthily and exercise

This is for all the mom-to-be’s out there who are worried about STRETCH MARKS! I wrote an in depth blog post looking at the scientific evidence about different therapies for striae (stretch marks). The short answer is there’s no magic cream I can give you to take stretch marks away. However, stretch mark development is linked to the amount and rate of skin stretching in areas like the breasts and the abdomen. So if you can grow and stretch your belly at a healthy rate, and moisturize often so the skin is more pliable and able to stretch, you may be able to help reduce the development of striae.

DO wear compression stockings

Blood volume increases by about 50% during pregnancy, so it makes sense that you will have more leg swelling from gravity and varicose vein development during this time. If you’re on your feet a lot, make sure to buy compression stockings to help circulate the extra fluid back up to the heart. Depending on your size and symptoms, your doctor may recommend 20-30 mm Hg or 30-40 mm Hg of compression.

Pregnancy skincare don’ts

DON’T use the following ingredients
As I mentioned above, there are a whole host of medications we use for skincare that are no longer safe when you are pregnant. I talked about acne above; here are a list of commonly used skincare medications that you should avoid. This is by NO means an exhaustive list, so you must ask your dermatologist what medications to continue and what to stop. In a nutshell, we want to assess the risk benefit profile for each medication; does the benefit of the medication outweigh the risk of side effects to you and your developing baby?

Generic Name Brand Name Treats Pregnancy Category
Doxycycline Oracea, Vibramycin, Doza, Atridox Acne D
Minocycline Dyancin, Minocin, Solodyne, Myrac Acne D
Spironolactone Aldactone Acne, hair loss D
Tetracycline Sumycin, Actisite, Panmycin Acne D
5-Fluorouracil Effudex, Fluoroplex, Carac Skin Cancer X
Isotretinoin Accutane, Amnesteem Acne X
Tazorotone Tazorac, Avage Acne X

DON’T get cosmetic treatments that can hurt the baby

I know we are all crazy about preventing and treating wrinkles but we don’t have a lot of evidence in the literature about whether or not botox, fillers, or laser procedures are safe during pregnancy (summarized in this paper here). Since the studies have not been done, we can’t definitively say one way or the other whether these treatments are safe. It’s better to be on the safe side and wait until after you deliver to consider cosmetic skin treatments.

DON’T get funky with hair dyes

The scientific literature shows mixed results; however, this excellent review paper I found (written by my voluntary attending Dr. Peter Saitta!) highlights that there have been some alarming reports of hair-dye use during pregnancy and development of childhood tumors. Others state that you should avoid hair dye use during the first trimester when the baby’s organs are developing. If you are willing to take the potential risk, things you can do to minimize exposure include applying petrolatum-based ointments to the scalp in a thick layer so the dye doesn’t touch the scalp as directly, and also to decrease the tie of dye application.

I hope this was helpful, and I hope this information is useful for all the expecting mama’s out there! Don’t forget to follow my blog and to connect via my Instagram!

And of course thank you to Fiddy Snails for partnering on this guest post!

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13 responses to “Guest Post: Pregnancy Skincare Dos and Don’ts with Dr. Joyce

  1. This is so informative, thanks a lot.
    I have one question about differin gel. Is it safe to use during pregnancy?. If not how long should I stop before I get pregnant? Same question for topical tretinoin.
    Thank you in advance .

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    • Hi Kris, the FDA recategorized their pregnancy and lactation safety ratings this year, and the new recommendation for Differin is “may use during pregnancy; risk of fetal harm not expected based on limited human data and insignificant systemic absorption; no known risk of fetal harm based on animal data.” That being said, some of the older dermatologists recommend stopping Differin when you are trying to conceive or pregnant. I would recommend seeing a dermatologist to see whether or not you have special considerations that place you more in one group vs. the other.

      For tretinoin, the FDA recommendation says, “Consider avoiding use during pregnancy, esp. in 1st trimester; risk of teratogenicity and holoprosencephaly low based on limited human data and minimal systemic absorption.” I would steer clear of this one if you are trying to conceive or as soon as you find out you’re pregnant (if it’s a surprise)! The risk of systemic absorption is low but I wouldn’t take any chances.

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    • Hi Dora, great question. I cannot find any published information or data on the safety of natural henna in pregnancy, but in general, natural brown henna is considered safe.

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  2. “if you can grow and stretch your belly at a healthy rate”

    I find this statement really weird and misleading. I mean, a lot of this growth is dictated by factors outside of your control, like how fast your baby grows or water retention. And if your belly grows at a rate that does result in stretchmarks, that doesn’t mean you didn’t grow at a healthy rate. What’s “healthy” is dependent on the individual and completely unrelated to whether you end up with stretch marks.

    I just hate the idea of someone seeing something so common and largely unavoidable as stretchmarks after pregnancy as a sign that the mother did something unhealthy.

    Like

    • Hi Jenny,

      Stretch marks are a normal part of pregnancy and they do not signify that a mom was unhealthy during pregnancy. However, for anyone who is gaining more weight than recommended during pregnancy, I think that could put them at higher risk for stretch marks, along with other health risks. As physicians we do have a limit when it comes to healthy vs. unhealthy weight gain during pregnancy. According to the American College of Obstetricians and Gynecology, weight gain recommendations for pregnant women are as follows:

      For those with BMI < 18.5 (underweight): 28-40 lbs
      BMI 18.5 – 24.9 (average weight): 25-35 lbs
      BMI 25-29.9 (overweight): 25-29.9 lbs
      BMI >30 (obese): 11-20 lbs

      My recommendation is to follow these guidelines and not gain more weight than your ob/gyn recommends, which helps for general health during pregnancy as well. The weight you and your ob/gyn decide on as healthy depends on your medical history and personal risk factors.

      Source: https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Weight-Gain-During-Pregnancy

      Like

  3. Love the post! Extremely informative!!
    Is the recommendation for physicals screens because they work better or are chemicals unsafe to use while pregnant? I also did it see any mention of tretinoin. I’ve always thought it was unsafe but didn’t see it on your list.

    Like

    • HI Maren, thanks! I recommend physical sunscreens because they work better and pregnant ladies need really robust sun protection! I spoke about tretinoin in one of the comments above, but the FDA does not recommend tretinoin use during pregnancy.

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  4. I do have one further question for Dr. Park: can you talk more about whether it’s really necessary to use inorganic sun filters during pregnancy rather than organic ones? I thought the whole endocrine-disruption thing was overstated and for some of use, it’s unpleasant to use inorganic filters in effective quantities.

    Like

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