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Dr.Macrene on Acne Skincare During Pregnancy

Posted by Alex Wong on

Q: Dr. Macrene, I am pregnant and breaking out, but do not know what I can safely use during pregnancy. Can you please help me?

A: Skin care ingredients that are safe during pregnancy have become a big part of what I do in dermatology practice and in formulating 37 Actives. When it comes to prescriptions for your breakouts, you can look up the pregnancy category of any drugs you already use (see table). Stick to pregnancy category B or better to be the safest. If you have a serious acne problem, many OB-Gyn doctors will approve the use of category C drugs as well. Examples of good category B topical prescriptions include erythromycin, clindamycin, azeleic acid and some sulfur preparations, like Sodium Sulfacetamide 9% and Sulfur 4.5%.

 

Pregnancy Category Table:

Category A  Adequate, well-controlled studies in pregnant women have not shown an increased risk of fetal abnormalities.
Category B

Animal studies have revealed no evidence of harm to the fetus; however, there are no adequate and well-controlled studies in pregnant women.

or

Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus.

Category C

Animal studies have shown an adverse effect and there are no adequate and well-controlled studies in pregnant women.

or

No animal studies have been conducted and there are no adequate and well-controlled studies in pregnant women.

Category D Adequate well-controlled or observational studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy may outweigh the potential risk.
Category X Adequate well-controlled or observational studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. The use of the product is contraindicated in women who are or may become pregnant.
NA A US Food and Drug Administration pregnancy rating is not available.

 

Below are a list of acne preparations with their pregnancy category:

Azelaic acid

B

Benzoyl peroxide

C

Salicylic acid

C

Erythromycin

B

Clindamycin

B

Tazarotene

X

Tretinoin

C

Adapalene

C

Dapsone

C

 

When it comes to over the counter medications or even cosmetics that make anti-acne claims, you need to be a savvy consumer! Note that benzoyl peroxide and salicylic acid are not as safe as prescription erythromycin or azeleic acid. As for non-acnegenic moisturizers during pregnancy, look for products that are plant-derived, and free of oil, petrolatum, parabens, phthalates and other unwanted ingredients, and those packaged in glass, not plastic, like 37 Actives.

By Macrene Alexiades MD PhD

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