Pregnancy / Obstetrics Women's Health / Gynecology

Is salicylic acid safe to use during pregnancy?

During pregnancy, many women develop acne, or their acne gets worse. People may be more concerned about the safety of skin care products, such as those containing salicylic acid.

Many acne treatments contain this acid. In this article, we discuss whether it is safe for people to use during pregnancy.

We also describe a range of skin care products that are safe and others to avoid during pregnancy. Finally, we explore why pregnancy can cause acne, and we list tips for treating it.

Is salicylic acid safe to use during pregnancy?

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Applying salicylic acid products during pregnancy is safe.

Yes, people can safely apply products containing salicylic acid once or twice a day during pregnancy. Cleansers and toners commonly include this ingredient.

However, doctors recommended using products containing salicylic acid no stronger than 2 percent.

Salicylic acid is a type of beta hydroxy acid (BHA). Other products that commonly contain it include:

  • topical acne medications
  • treatments for skin inflammation and redness
  • anti-aging products
  • cleansers, toners, and exfoliants

Doctors generally recommend avoiding excessive or frequent use of salicylic acid during pregnancy.

However, the skin absorbs very little salicylic acid from creams. Face and body peels that contain salicylic acid pose a greater risk. Women should always speak with a doctor before using one of these products during pregnancy.

Doctors also recommend applying sun protection when using products that contain BHAs. These acids can increase a person’s sensitivity to sunlight.


Treating acne during pregnancy

For people with acne during pregnancy, the American College of Obstetricians and Gynecologists suggest:

  • washing the face twice daily with a mild cleanser and lukewarm water
  • shampooing oily hair every day and keeping the hair off the face
  • avoiding picking or squeezing pimples, which can lead to scarring
  • using oil-free cosmetics

Products that are safe during pregnancy

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Washing the face with a mild cleanser twice a day can help reduce acne during pregnancy.

Cosmetic products commonly contain alpha hydroxy acids (AHAs) as well as BHAs. The skin only absorbs small amounts of these acids when applied in creams or ointments, making the risk during pregnancy low.

Skin care products often contain one or more of the following AHAs or BHAs:

  • glycolic acid
  • lactic acid
  • azelaic acid
  • benzoyl peroxide
  • beta hydroxybutyric acid
  • betaine salicylate
  • citric acid
  • dicarbonous acid
  • glycolic acid
  • hydroacetic acid
  • hydroxyacetic acid
  • hydroxycaproic acid
  • lactic acid
  • trethocanic acid
  • tropic acid
  • 2-hydroxyethanoic acid

Soy-based lotions and facial products tend to be safe during pregnancy. However, individuals with melasma, or dark skin patches, may find that these creams make the patches darker.

The general advice for people with dark patches is to choose products that include active soy, or those free from lecithin, phosphatidylcholine, and textured vegetable protein.

Doctors consider topical steroids, such as over-the-counter (OTC) hydrocortisone creams, to be safe during pregnancy. However, speak with a healthcare professional before using any prescription-strength steroid creams during pregnancy.

The following common ingredients in steroid creams are safe to use during pregnancy:

  • alclometasone
  • desonide
  • fluocinolone
  • hydrocortisone
  • triamcinolone


Products to avoid

salicylic acid products are fine in pregnancy but retinoids should be avoided
During pregnancy, people should avoid creams containing retinoids.

Most OTC skin care products are safe, but during pregnancy, people should avoid the following ingredients and treatments commonly used to combat acne:

  • retinoids
  • oral tetracyclines
  • hormonal therapies
  • isotretinoin

Retinoids are derivatives of vitamin A that can help to improve skin renewal. They are ingredients in some acne creams, anti-aging moisturizers, and treatments for psoriasis.

There is no evidence that using retinoids on the skin is dangerous. However, some studies have shown that oral retinoids and high dosages of vitamin A can cause birth defects. As a precaution, some doctors advise against using skin care products that contain retinoids during pregnancy.

There are many types of retinoids. In general, it is best to avoid the following types during pregnancy:

  • tazarotene
  • tretinoin
  • adapalene
  • alitretinoin
  • retinoic acid
  • retinol
  • retinyl linoleate
  • retinyl palmitate
  • bexarotene

Leave-on acne lotions, gels, and creams and DIY skin peels can contain high levels of salicylic acid or retinoids. People should avoid these treatments during pregnancy.

Some prescription acne medications are not safe to use during pregnancy. For example, certain hormonal therapies have been linked to birth defects.

Also, doctors sometimes prescribe oral tetracyclines to treat acne. These antibiotics can adversely affect the baby’s bone growth if taken at any time during pregnancy. They can also discolor the baby’s teeth if taken after the fourth month.

Isotretinoin is a type of vitamin A. People take it in pill form, and it can cause severe congenital abnormalities that in some cases affect the brain or heart.

Causes of acne during pregnancy

Pregnancy can change the skin, nails, and hair in several ways. Many find that their acne gets worse during pregnancy, while others develop it for the first time.

Fluctuating hormones may be responsible for acne and some of the following skin-related effects of pregnancy:

  • dark spots on the skin, such as the breasts or inner thighs
  • brown patches on the face
  • a dark line running from the navel to the pubic hair area
  • stretch marks
  • varicose veins
  • spider veins


Outlook

Many people experience acne during pregnancy, whether or not they had it in the past, and hormonal changes are likely responsible.

It is common for acne to be severe early in the term but to improve as the pregnancy progresses.

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