Pregnancy is a bumpy ride, and with everything else changing at once, your skin is usually the last thing you get round to thinking about.
In one study of 2,000 pregnant women, nearly 88% had at least one noticeable skin change. Somewhere between 15% and 50% get melasma, [1] the brownish patches across the cheeks and forehead that people call the mask of pregnancy. Around half deal with acne, and for most of them it starts in the first trimester, before they’ve told anyone they’re expecting. So if your skin feels like it’s giving up on you, you’re not alone. And here’s what you need to hear to live through it!
First, The Short List of Things to Stop
There are really only three you need to think about.
1. Retinoids
Retinol, tretinoin, adapalene, anything with “retinal” or “retinoid” on the label. Dermatology experts generally advise stopping these during pregnancy. If you were using retinol before you knew you were pregnant, though, take a breath. A Nordic study of nearly 3.9 million infants found no increased risk of major birth defects among those exposed to topical retinoids in the first trimester. [2] Researchers still say don’t keep using them, because absence of evidence isn’t proof of safety. But past use is not something to lie awake over.
2. Hydroquinone
This is the one to be most careful about, because far more of it is absorbed through the skin than most topicals. It is also worth knowing that in the US, hydroquinone is not approved for over-the-counter sale, so be cautious with hydroquinone products sold online.
3. Strong Salicylic Acid
Here, the rule is narrower than the internet suggests. The American Academy of Dermatology advises limiting salicylic acid at concentrations above 2%. [3] Check the percentage before you throw the bottle out.
What You Can Keep Using
The AAD actively recommends vitamin C and glycolic acid products during pregnancy and calls azelaic acid safe, which is useful because azelaic acid works on both acne and melasma, the two things most likely to be bothering you. Mayo Clinic lists benzoyl peroxide as an option for treating pregnancy acne, and only small amounts are absorbed through the skin. Dermatologists generally recommend using it in limited amounts during pregnancy.
Hyaluronic acid, niacinamide, ceramides, and peptides sit in a slightly different category. Pregnancy-specific safety data vary by ingredient, but these ingredients are commonly used in gentle, hydrating skincare routines. They are hydrating and barrier-supporting rather than active, and they are the backbone of most pregnancy-safe routines for that reason.
The One Thing Worth Doing Properly: Sunscreen
If you do nothing else, at least do this!
Pregnancy often brings melasma, and it is the one that really gets to you. And why not? It sits right on your face and can hang around long after the baby arrives. Worse, sun exposure can make it darker, and heat and visible light can contribute too.
So here is what to look for: a mineral sunscreen with zinc oxide or titanium dioxide. And if you can find a tinted one, grab it. The iron oxides that give it that bit of colour can also help protect against visible light, which regular sunscreens may not adequately address. Then just wear it. Every day, grey days included, and yes, even the days you barely make it out of the house.
A Routine for Moms-To-Be With No Time
Here’s a routine that will take no more than 2 minutes, pinky promise!
Start with a gentle cleanser at night, followed by a hydrating serum or moisturiser while your skin is still damp. Beyond that, don’t forget the mineral SPF in the morning. And azelaic acid a few nights a week if acne or dark patches are bothering you.
That is genuinely it. When it comes to Pregnancy skincare, keeping your routine simple and focusing on gentle, supportive products can often be the easiest approach.
About Stretch Marks, Honestly
Between 50% and 90% of women get stretch marks in pregnancy. In 2022, Cochrane reviewed six trials covering 800 women and concluded there was no high-quality evidence that any topical product prevents them. [4] Cocoa butter, olive oil, almond oil, or vitamin E: none of them outperformed doing nothing.
Moisturizing still helps with the itch and the tightness, and that is a good enough reason to do it. But if you have been rubbing oil in twice a day out of anxiety rather than comfort, you can let that go. Genetics, skin stretching, hormones, and other factors all play a role, and there is no proven cream that can reliably prevent them.
Closing Thoughts
The good news is that almost all of this settles down once your little one arrives. Melasma usually fades within about three months of giving birth, and pregnancy acne tends to leave with the hormones that caused it. So just breathe, and let the best time of your life come with a few bad skin days.
And when you’re unsure about a product, ask your midwife or doctor rather than a forum. Your care providers would far rather answer a small question about a face cream than have you worry about it for a week.
