Tips for Acne-Prone Skin: Before, during, and after Pregnancy

From the article: Get the Glow
By Jonette Elizabeth Keri, MD, PhD, FAAD
Associate Professor of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine
Chief of Dermatology, Miami Veterans Administration Hospital

Prepregnancy

  • Women should try to get acne under control before trying to get pregnant. If a woman has acne before pregnancy and is taking an oral medication, her acne could get worse once she stops her current acne medication while pregnant.
  • Women should try to maintain a healthy body weight prepregnancy. If a woman is overweight before getting pregnant, studies show that there is an increased chance that a male child will reach puberty at an earlier age— thus having acne at an earlier age.

During Pregnancy

  • Wash the skin with lukewarm water and mild cleansers or foams. Avoid cleansers that contain beads that scrub the skin; they are too inflammatory for skin that is already inflamed by acne.
  • Use a broad-spectrum sunscreen (protects the skin from both UVA and UVB rays) with a sun protection factor (SPF) of 30 or higher every day to protect the skin from pigmentary changes that can occur during pregnancy. Physical sun blockers, which contain zinc or titanium, are best.

Post-Pregnancy

  • If a woman chooses to breastfeed her baby, she must view medications categorized by the FDA in the same way she would during pregnancy.
  • Generally, if a medication is safe to use during pregnancy, it is safe to use during lactation.
  • Pediatricians are the best resource for questions during lactation and can provide lactation ratings for medications.

If pregnant women develop acne and are concerned about taking medications, Dr. Keri encourages women to discuss their treatment options with a board-certified dermatologist. Oftentimes a woman’s dermatologist and obstetrician can work together to manage her acne and ensure that all medications used fall into the safest drug categories as outlined by the FDA.

FDA Medication Categories

These are the five categories established by the FDA to indicate the potential of a drug to cause birth defects if used during pregnancy.

  • Category A medications were determined safe for pregnant women in studies.
  • Category B medications were tested in pregnant animals and showed no risk to the fetus—presumed to be safe for pregnant women.
  • Category C medications have shown an adverse effect on the fetus when tested in some animals, but no testing has been replicated in humans—use with caution during pregnancy only when benefits outweigh risks.
  • Category D medications pose a risk to the fetus based on reported adverse reactions or human studies—use with caution during pregnancy and only when benefits outweigh risks.
  • Category X medications have demonstrated fetal abnormalities in human or animal studies, and the risks involved if taken during pregnancy outweigh any potential benefits.

In addition, a sixth category—drugs that have not been classified by the FDA—are rated as Category N medications.