Pregnancy is a hormonal roller coaster, and your skin has no choice but to go along for the ride. Here's how to treat pregnancy acne with safe medications and tactics.

By Beth Janes
Updated February 26, 2020
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Illustration by Sarina Finkelstein; Adobe Stock (1)

For some lucky women, pregnancy provides a beauty treatment for skin that trumps anything you can buy in a jar. But many others skip that “pregnancy glow” and battle skin problems instead. Here’s what you need to know about pregnancy acne causes and treatment options.

What Causes Pregnancy Acne?

The quick-and-dirty science on how a pimple forms: The skin’s oil glands secrete sebum (oil) into pores, and if it’s sticky and thick enough, the sebum traps dead skin cells and dirt, clogging pores. Those plugs create an all-you-can-eat buffet and perfect hiding spot for Propionibacterium acnes bacteria, which then flourish and trigger zits you see and feel.

A surge of progesterone in the first trimester tends to ramp up oil production in all pregnant women. In some, the oil is lighter and hydrating, giving you that famous pregnancy glow. But if your body's unique mix of pregnancy hormones is especially strong, you may find yourself with acne like you haven't seen since high school.

Other factors besides hormones can also contribute to pregnancy acne. For example, pregnant women seem more overextended these days, and stress is clear-skin kryptonite, explains Rachel Nazarian, M.D., a dermatologist in New York City. 

Plus, many women previously cured acne with combination estrogen-progestin birth control pills, which heal your skin by stabilizing hormones and lowering levels of circulating androgens, says Amy Wechsler, M.D., a dermatologist in New York City. But if you stop taking the pills when pregnant or trying to conceive, acne may rebound.

The Best Treatments for Pregnancy Acne

If your skin usually breaks out during your menstrual period, you're likely to find the same thing happening during the early months of your pregnancy. But this isn't always the case: some women find that their regular acne problems disappear during pregnancy, while others who were never troubled by pimples find that pregnancy brings them on. 

If you're one of the unlucky women with newfound blemishes, try the following treatment methods for pregnancy acne. 

Don’t go crazy with products.

Many women who have acne go full kamikaze with products, bombing their skin with harsh formulas and starving it of moisturizer in an effort to clear pores and dry up oil, says Dr. Nazarian. Be forewarned: That strategy typically leaves you with more inflammation and a weakened skin barrier that is vulnerable to irritation. 

Establish a smart daily routine with pregnancy-safe over-the-counter topicals.

To clear pregnancy acne, start with a few gentle over-the-counter products, says Steven Feldman, M.D., Ph.D., professor of dermatology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Clear your shelves of any topical cleansers, makeup, or moisturizers that contain chemical exfoliants made with salicylic acid. Several over-the-counter topicals without salicylic acid, like benzoyl peroxide and glycolic and azelaic acid, are considered safe in limited amounts (to be sure, talk to your obstetrician first). 

Don’t use acne medications

Most acne medications— including retinoids, oral isotretinoin, spironolactone, oral tetracyclines (a group of antibiotics), and combination birth control pills—are off the table if you’re pregnant or breastfeeding. Certain drugs used to treat acne may cause serious birth defects.

Try exfoliating.

Most pregnancy acne is caused by pores clogged with oil, so keep them clear with mechanical exfoliants. These products may contain synthetic beads or ground-up nutshells, which help scrub away dead skin. 

Whatever you do, don't pop.

Adolescents typically get pimples everywhere, and they’re prone to whiteheads—those raised orbs that call out to be squeezed. Women, on the other hand, often break out around the jawline, chin, and mouth, and pimples look red and feel inflamed rather than poppable, Dr. Nazarian says. Plus, skin heals more slowly as you age, so an errant, scab-inducing “squeeze” can take weeks to vanish. 

Visit a dermatologist.

If your acne doesn’t improve within a few weeks of following a consistent routine, or if your acne is severe or really bothers you, go to a board-certified dermatologist rather than trying new products, says Dr. Nazarian. Adult acne is notoriously hard to treat—what works for one expectant mom may not work for you—and a personalized regimen can be effective.

And remember: There’s no shame in pimples!

We’re not saying you need to walk around feeling good about your acne, but pimples are no reason to hide from the expectant mom squad. In fact, more and more celebs and influencers are posting Instagram photos featuring brightly colored pimple patches or their unfiltered zits. 

“The ‘pimple-positive movement’ helps women realize how common acne really is and that they shouldn’t feel bad about it,” says Dr. Nazarian. Isn’t it nice to be out of high school?

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