When it comes to what to expect when you’re expecting, most women are prepared to experience morning sickness, having to pee every five minutes, and some nicely tender and swollen breasts. Sorry, but they’re practically part of the pregnancy contract (although, despite the severe exaggeration in Hollywood films, not all pregnant women experience these symptoms, so don’t freak).
But one pesky pregnancy symptom we’re not given the heads up about: pregnancy acne. If you’re growing a baby bump and battling breakouts, you’re probably wondering where the hell that pregnancy glow is, and why you’re not basking in it. The answer lies in your pregnancy hormones, which will do some crazy and unexpected things as you grow a tiny human for nine months. “A surge in androgens–a group of hormones responsible for ‘male’ features–can trigger acne flares in pregnant women,” explains Beverly Hills-based dermatologist Tsippora Shainhouse, MD.
This acne is not a special form of acne, though—it’s just more plentiful. And if you’re already prone to breakouts or have adult acne, you may have a tougher time managing it when pregnant, especially if you’ve been taking an oral acne medication, like Accutane or spironolactone, and now need to stop your meds (these medications can cause significant harm to your unborn baby, so your doc will likely advise you to stop oral acne meds as soon as you start trying for a baby). In fact, most of the popular ingredients used in acne treatments, like benzoyl peroxide and salicylic acid, are not FDA-approved for regular use during pregnancy, making your hormonal acne one tough (though not impossible!) condition to treat.
And because you might not have time to visit your derm in between all your prenatal appointments and obligatory trips to the mall for the cutest baby clothes possible, we brought the experts to you for advice on how to safely get rid of acne while pregnant. Click through to find the best acne-zapping products, below, and get ready for relief from your zits.
Giovanni Cosmetics D:tox System Purifying Facial Cleanser
“Over-the-counter acne washes and creams containing salicylic acid and benzoyl peroxide are actually a pregnancy Class C in the US, meaning they’re not recommended in pregnancy,” says Shainhouse. If your skin tends to be on the greasier side, she recommends looking for charcoal washes or foaming washes instead, which can gently mattify oily skin while clearing pore-clogging skin cells. "Avoid harsh scrubs and overly-drying cleansers, which can irritate already inflamed, acne-prone skin," she notes.
Giovanni Cosmetics D:tox System Purifying Facial Cleanser, $9.95; at Giovanni Cosmetics
Peter Thomas Roth Acne Spot and Area Treatment
"Intermittent use of on-the-spot benzoyl peroxide gel or salicylic acid 1- or 2-percent gel should be safe in pregnancy," says Shainhouse. "One study suggested that most benzoyl peroxide gets destroyed within the skin, leaving only 3-percent absorbed." Thus, a dab on a pimple every once in a while should be totally safe—just don’t go overboard.
Peter Thomas Roth Acne Spot and Area Treatment, $19; at Sephora
Elizabeth Arden Skin Illuminating Retexturizing Pads
“I used these as a ‘treatment toner’ two to three times a week when I was pregnant,” says Dendy Engelman, MD, dermatologist and cosmetic surgeon at Manhattan Dermatology and Cosmetic Surgery. “Unlike beta hydroxy acids, like salicylic acid, which can be damaging during pregnancy, glycolic acid is an alpha hydroxy acid that’s safe to use.” Not only can glycolic acid clear blocked pores, but it's also great at fading the hyperpigmentation (a.k.a. chloasma) that can occur from the hormonal surges in pregnancy.
Elizabeth Arden Skin Illuminating Retexturizing Pads, $56; at Elizabeth Arden
SkinCeuticals Phloretin CF Gel
With a mix of 10-percent pure vitamin C and acne scar-fading ferulic acid and phloretin, this antioxidant-rich gel is "great at fighting signs of aging caused by free radicals," says Engelman. Plus, the vitamin C can keep blackheads at bay while combating acne marks.
SkinCeuticals Phloretin CF Gel, $165; at SkinCeuticals
Cetaphil Foaming Face Wash
“For irritated, red, sensitive, acne-prone skin, choose a gentle face wash, like Cetaphil,” says Shainhouse. “This light and gentle face wash soaks up some of your skin's excess oils while leaving it looking matte throughout the day.” Plus, it’s fragrance-free, which is a bonus for easily nauseated mommas.
Cetaphil Foaming Face Wash for Redness Prone Skin, $10.49; at CVS
Differin Gel Acne Treatment
This lightweight gel is the first prescription-strength synthetic retinoid that's now available over-the-counter. “The active ingredient is the retinoid adapalene, which is safe to use moderately during pregnancy for severe acne,” says Santa Monica-based OB/GYN Sherry Ross, MD. Consider it the closest you can get to Rx power, without needing to worry about possible negative effects to your baby. Still, Ross adds that the gel should be applied like a spot treatment and used sparingly, rather than in daily, full-face layers. If you feel the need to use it more frequently, chat with your doctor to ensure it’s safe.
Differin Gel Acne Treatment, $29.99; at Walgreens
The Ordinary Azelaic Acid Suspension 10%
Prescription medication is the last line of defense for pregnancy acne, though totally an option if your skin is really bothering you. “Azelaic acid, erythromycin, and clindamycin are antibiotics and anti-inflammatories, making them the drugs of choice for pregnancy acne,” says Ross. But if the idea of taking pills worries you, try layering on a topical azelaic acid instead, like The Ordinary Azelaic Acid 10% Suspension. Just make sure to keep your OB/GYN in the loop while weigh the benefits and risks of various treatment options, and always consult with your doctor before starting any acne products. And remember: Your acne is temporary, so try to take deep breaths...for nine months.
The Ordinary Azelaic Acid Suspension 10%, $7.90 at The Ordinary