Pregnancy-safe skincare: what to leave out, and what is usually fine

Pregnancy changes skin. Some people get breakouts they have not had since school, some get darker patches on the cheeks and upper lip, and many find their usual products suddenly feel different. At the same time, it is the moment to look hard at what is in the routine.

This guide sets out what dermatology and obstetric bodies, such as the American Academy of Dermatology and the American College of Obstetricians and Gynecologists, generally advise. It is not medical advice, and we are a shop, not doctors. Take this page to your doctor or midwife if you want to check something, especially if you have a skin condition or use anything on prescription.

Leave these out

Retinoids, in every form. That means retinol, retinal (retinaldehyde), retinyl palmitate and the prescription ones: tretinoin, adapalene, tazarotene and, above all, isotretinoin tablets. The tablets are known to cause birth defects. How much of a cream reaches the bloodstream is small, but because the same family of ingredients is involved, the usual advice is to stop all of them for the whole pregnancy, and ideally from when you start trying to conceive.

On our own shelf, that means setting aside The Ordinary Retinol 0.2% in Squalane, Celimax The Vita-A Retinal Shot Tightening Booster and the Beauty of Joseon Revive Eye Serum, which contains retinal. Check the ingredient list of anything labelled "anti-aging", "renewing" or "vita-A".

Hydroquinone. A strong skin-lightening ingredient, much more of which is absorbed through the skin than most. It is usually advised against in pregnancy. It is also sold in unlabelled "fairness" creams, which are best avoided at any time.

Strong peels and high-strength leave-on acids. Salon chemical peels, and at-home ones like The Ordinary AHA 30% + BHA 2% Peeling Solution, are best left until after the baby. Pregnancy can make skin more reactive too.

Ask your doctor about these

The evidence is thin rather than worrying for these, so we would not call them either safe or unsafe:

• Alpha-arbutin and kojic acid, common in dark-spot serums.
• Tranexamic acid applied to the skin. Tablets are a different matter entirely.
• Leave-on salicylic or glycolic acid toners and pads used daily.
• Bakuchiol, often sold as a "pregnancy-safe retinol". It may be, but there is little research in pregnancy.

What is usually considered fine

Most of a good routine has nothing to change:

• A gentle cleanser. Cetaphil Gentle Skin Cleanser or CeraVe Hydrating Facial Cleanser.
• Hyaluronic acid, panthenol and ceramides for dryness, which often gets worse in pregnancy. The Ordinary Hyaluronic Acid 2% + B5 under CeraVe Moisturizing Cream or Illiyoon Ceramide Ato Concentrate Cream.
• Centella for redness and irritation, like SKIN1004 Madagascar Centella Ampoule.
• Niacinamide for oil, redness and uneven tone. The Ordinary Niacinamide 10% + Zinc 1% is niacinamide without the tranexamic acid some other serums add.
• Vitamin C, which helps with dullness and dark patches. Melano CC Vitamin C Anti-Spot Essence is a simple one.
• Azelaic acid, which is often suggested for both pregnancy acne and dark patches. Anua Azelaic Acid 10 Hyaluron Redness Soothing Serum or The Ordinary Azelaic Acid Suspension 10%.
• Low-strength salicylic acid in a wash-off cleanser, such as COSRX Salicylic Acid Daily Gentle Cleanser, is usually accepted, because it is rinsed off within a minute.

Sunscreen matters more now

Many pregnant women develop melasma, sometimes called the mask of pregnancy: brown patches on the cheeks, forehead and upper lip, driven by hormones and made much worse by sun. Daily sunscreen is the best thing you can do for it, and the patches often fade after the baby is born.

Chemical sunscreen filters have not been shown to harm a pregnancy, but if you would rather avoid them, mineral filters (zinc oxide, titanium dioxide) sit on the skin and are the cautious choice. SKIN1004 Madagascar Centella Air-Fit Suncream Plus uses zinc oxide. COSRX Aloe Soothing Sun Cream is a gentle option many sensitive faces like. Our sunscreen guide covers how much to use.

For dark patches, give it time and avoid anything that promises fast lightening. Our dark spots guide explains how they fade, but leave out its retinoid and stronger acid steps until after pregnancy.

Breastfeeding

Much of the same caution is usually advised while breastfeeding, especially for retinoids, and anything you put on your chest should be washed off before a feed. Ask your doctor what they are comfortable with.

Using the skin test

In our skin test, the question about retinol and exfoliating acids has an answer for exactly this: "Leave them out of my routine". Choose it and your routine will be built without leave-on retinoids or exfoliating acids. A wash-off cleanser with salicylic acid can still appear, and the test does not screen for everything on the "ask your doctor" list, so read the ingredient lists with this page in mind, or ask us before you order. When you are ready to bring retinol back after pregnancy and breastfeeding, our retinol and acids guide shows how to start again slowly.

Any skin change in pregnancy that itches badly, blisters or spreads should be seen by a doctor. We sell the products named here, so weigh our picks with that in mind.