Pregnancy acne: How can you deal with it?

    Published 17 January 2023
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    Medically Reviewed by Dr. Holly Singletary, Dermatologist, Westlake Dermatology and Cosmetic Surgery, Texas, US
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    Pregnancy acne can be an unexpected part of pregnancy. To help you manage and safely treat acne, we break down its causes, as well as where it might show up, and the treatment options available.

    Pregnancy brings with it a whole host of changes to areas of the body that you may not expect. We’ve all heard of the pregnancy glow, but the miracle of creating new life can also involve some less favorable changes to your skin. 

    If you’re reading this article, you might be wondering: does pregnancy cause acne? For some women, the answer is a resounding yes, with pregnancy causing acne, pimples, and oily skin, just like you may have experienced growing up. This can be a frustrating but common symptom of pregnancy, thought to affect up to 42% of pregnant women. You could be more likely to experience it if you had acne before your pregnancy, and if you already have acne, it’s possible that pregnancy could make it worse.

    Not all acne treatments can be used when you’re expecting, so if you’re experiencing acne during pregnancy, it can be useful to know why and how to deal with it safely. With this in mind, we spoke to Dr. Nazaneen Homaifar, obstetrician and gynecologist, Washington, DC, US, to answer all our questions on acne during pregnancy.

    What causes pregnancy acne?

    Those pesky pregnancy hormones don’t just help you grow a baby; they can also affect your mind and body, including your skin. Your levels of progesterone and estrogen increase over the course of pregnancy, as do your levels of some androgens (male sex hormones).

    “Hormonal changes [during pregnancy] can increase the production of sebum (oil) and may contribute to pregnancy acne,” explains Dr. Homaifar. Essentially, acne is caused when the excess oil combines with dead skin cells and blocks hair follicles on your skin, creating blemishes. She adds that during pregnancy, there are also changes in the body’s immune response, which could contribute to acne.

    One study found that pregnancy acne occurs mainly in women with a history of acne, with 90% of pregnant women with acne having experienced it before their pregnancy. “​​Patients with a history of acne are more prone to developing acne during pregnancy, but it can affect anyone and be unpredictable in nature,” says Dr. Homaifar. 

    When does pregnancy acne start?

    As with most things related to pregnancy, there is no “normal” time for pregnancy acne to start, as it can vary from person to person. Some women experience early pregnancy acne, while others develop it later. “It can start at any point in the pregnancy,” explains Dr. Homaifar.

    Similarly, the intensity of acne can also vary throughout pregnancy. “Some studies have found that acne improves during the first trimester but may worsen during the third trimester,” adds Dr. Homaifar. This could be due to the hormonal changes that occur during this time, specifically an increased amount of androgens. But of course, this pattern isn’t the same for everyone.

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    What does pregnancy acne look like?

    Pregnancy acne generally looks like regular acne. You might have comedones, which are small bumps that can be skin-colored or black (open comedones, known as blackheads) or white (closed comedones, known as whiteheads). You might also experience inflammatory papules and pustules (small red or pink bumps). These will show up in acne-prone areas such as the face, chest, shoulders, and/or back. These affected area(s) may also feel sensitive. 

    Unlike regular breakouts, however, during pregnancy, you may experience more inflammation (redness and swollen lesions) and more acne on the body. Try not to be too hard on yourself if you do experience this, and remember that it’s all part of the process of growing your baby. 

    Typical pregnancy acne areas

    Acne is generally common in areas with lots of sebaceous (oil) glands — which release oil into the hair follicles to lubricate the skin and hair — such as the face and torso. But there are several pregnancy acne locations. Other common pregnancy acne areas include the back, chest, and neck. Let’s explore these in a little more detail:

    Trunk (back, chest, abdomen, pelvis)

    Research suggests that the most common pregnancy acne location is your trunk (your back, chest, abdomen, and pelvis), with up to 87% of pregnant women developing acne here. You might be more likely to develop this type of acne later in your pregnancy, with one study finding that truncal acne was significantly higher in the third trimester than in the other stages of pregnancy.

    Chin

    Pregnancy chin acne appears to be the most common type of facial acne that develops when a person is expecting. Research found that 69% of pregnant women with facial acne developed chin acne, followed by 15% developing it on the cheeks and 14% developing it on the forehead.

    Neck

    Like the chin, some women may experience pregnancy neck acne. Age could also be a factor here; one piece of research on pregnant women with acne found that women over 25 had less of it on their necks and torsos than women under 25.

    When does pregnancy acne go away?

    Given that pregnancy acne is so individual, it’s unfortunately not possible to predict exactly when your pregnancy acne might go away. 

    Outside of pregnancy, you might find that acne also appears or becomes worse in the days leading up to your period or during menopause, which is thanks to the ever-changing levels of hormones at these times.

    Safe treatment of pregnancy acne

    So, how can you get rid of pregnancy acne? There are a few things you can try to help clear your skin during pregnancy.

    Choosing a face wash

    First, focus on basic prevention, such as choosing the right pregnancy acne skin care and face wash for your skin, says Dr. Homaifar. “Wash problem areas with a gentle cleanser, shampoo regularly to avoid oily hair along the forehead, avoid irritants, and watch what touches your skin,” she advises.

    “Pull your hair back, and avoid resting your hands on your face. It may also be helpful to look for skin care and makeup products that are oil-free and labeled non-comedogenic, formulated not to cause acne.” Wise words.

    Antibiotics and other medications

    Your doctor might prescribe certain antibiotics to help treat your pregnancy acne. It’s important to note that health care experts have specific instructions for taking these safely, so take care to note anything they say about the medications.

    The American College of Obstetricians and Gynecologists (ACOG) recommends that some over-the-counter products containing certain ingredients can be used safely during pregnancy. These include: 

    • Topical benzoyl peroxide
    • Azelaic acid
    • Topical salicylic acid
    • Glycolic acid

    As ever, always consult your doctor before starting any new medications.

    Therapies 

    Certain laser and light therapies, which can banish bacteria within pores (and the inflammation that comes with it), are also recommended as safe for treating acne during pregnancy. 

    If you’re considering either treatment while pregnant, the American Academy of Dermatology Association recommends making an appointment to see a dermatologist first. This is because some require a numbing solution or medicine, which may not always be suitable for your baby.

    There are many acne treatments you should avoid during pregnancy as they can carry the risk of causing birth defects and other complications. These include oral isotretinoin and topical tazarotene and spironolactone, says Dr. Homaifar. ACOG also recommends avoiding some prescription acne medications while pregnant for your baby’s safety. These include, among others:

    • Hormonal therapy (medications that block specific hormones to treat acne)
    • Antibiotic oral tetracyclines and topical retinoids (a form of vitamin A in the same drug family as isotretinoin, which isn’t absorbed by the body in significant amounts but should still be avoided)

    However, always speak to your health care provider before considering any treatment at all, as they’ll be able to highlight which ones to avoid.

    When should you consult a doctor?

    “If you’re having significant pain from your acne or are worried about the appearance, reach out to your doctor for guidance,” advises Dr. Homaifar. Equally, if you’re concerned about which products to use to treat your acne, talk to your doctor to decide which option is best for you.

    The takeaway: Pregnancy acne

    Acne may not cause you as much physical discomfort as other pregnancy symptoms, but it can be a frustrating one to deal with. It’s completely understandable if it impacts your self-esteem, but try not to let it get you down, and remember that there are treatment options available. Whether you’ve developed acne for the first time during pregnancy, or you’ve had it before and pregnancy has brought it back, take some comfort in remembering that pregnancy acne affects many people, and you’re certainly not alone.

    So, treat yourself with compassion and focus on basic prevention first. Then consult your doctor or dermatologist about which pregnancy-safe acne treatment is right for you.

    References

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    “Acne: Causes.” NHS, www.nhs.uk/conditions/acne/causes/. Accessed 23 Dec. 2022.

    Bechstein, S. K., and F. Ochsendorf. “[Acne and Rosacea in Pregnancy].” Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und Verwandte Gebiete, vol. 68, no. 2, Feb. 2017, pp. 111–19.

    Chien, Anna L., et al. “Treatment of Acne in Pregnancy.” Journal of the American Board of Family Medicine, vol. 29, no. 2, Mar. 2016, pp. 254–62.

    “Comedones.” MedlinePlus, medlineplus.gov/ency/article/003236.htm. Accessed 11 Jan. 2023.

    Dréno, Brigitte, et al. “Acne in Pregnant Women: A French Survey.” Acta Dermato-Venereologica, vol. 94, no. 1, Jan. 2014, pp. 82–83.

    Gold, Michael H., et al. “Management of Comedonal Acne Vulgaris with Fixed-Combination Topical Therapy.” Journal of Cosmetic Dermatology, vol. 17, no. 2, Apr. 2018, pp. 227–31.

    “Is Any Acne Treatment Safe to Use during Pregnancy?” American Academy of Dermatology Association, www.aad.org/public/diseases/acne/derm-treat/pregnancy. Accessed 8 Nov. 2022.

    Leung, Alexander K.C., et al. “Dermatology: How to Manage Acne Vulgaris.” Drugs in Context, vol. 10, Oct. 2021, doi.org/10.7573/dic.2021-8-6.

    Khunger, Niti, and Krati Mehrotra. “Menopausal Acne: Challenges and Solutions.” International Journal of Women’s Health, vol. 11, Oct. 2019, pp. 555–67.

    Kutlu, Ömer, et al. “Acne in Pregnancy: A Prospective Multicenter, Cross-Sectional Study of 295 Patients in Turkey.” International Journal of Dermatology, vol. 59, no. 9, Sept. 2020, pp. 1098–105.

    Makieva, Sofia, et al. “Androgens in Pregnancy: Roles in Parturition.” Human Reproduction Update, vol. 20, no. 4, July 2014, pp. 542–59.

    Mor, Gil, and Ingrid Cardenas. “The Immune System in Pregnancy: A Unique Complexity.” American Journal of Reproductive Immunology, vol. 63, no. 6, June 2010, pp. 425–33.

    “Pregnancy Acne: What’s the Best Treatment?” Mayo Clinic, 26 Apr. 2022, www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/pregnancy-acne/faq-20058045.

    Robinson, Dionne P., and Sabra L. Klein. “Pregnancy and Pregnancy-Associated Hormones Alter Immune Responses and Disease Pathogenesis.” Hormones and Behavior, vol. 62, no. 3, Aug. 2012, pp. 263–71.

    “Skin Conditions during Pregnancy.” The American College of Obstetricians and Gynecologists, www.acog.org/womens-health/faqs/skin-conditions-during-pregnancy. Accessed 8 Nov. 2022.

    History of updates

    Current version (17 January 2023)

    Medically Reviewed by Dr. Holly Singletary, Dermatologist, Westlake Dermatology and Cosmetic Surgery, Texas, US

    Published (17 January 2023)

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