Skincare in pregnancy: what to avoid

The general approach to skincare in pregnancy is to simplify: a gentle cleanser, a moisturiser and sun protection are usually enough. A few ingredients such as retinoids and hydroquinone are commonly advised against. This article is general information rather than medical advice; discuss the products you use with your doctor or pharmacist.

In pregnancy hormones change the skin, and the change does not go the same way for everyone: some women get more pigmentation and sensitivity, some break out, and for some the skin does not change at all. So there is no single routine that suits everyone. Below we gathered the most-debated ingredients, those generally considered safe, and what that distinction actually rests on.

Why does skin change in pregnancy?

Oestrogen and progesterone levels rise markedly in this period, and that has three typical effects on the skin. The first is increased pigment production; symmetrical dark patches can appear on the cheeks and forehead, known as melasma, and they become more pronounced with sun exposure. The second is acne triggered by increased oil production. The third is that the skin generally becomes more sensitive; a product used without trouble before can sting or cause redness in this period.

Most of these changes recede within months after birth. Melasma can sometimes be more stubborn, which is why sun protection during this period is the most practical step for reducing the work you face later.

Why is 'be cautious' the usual advice?

There is an important point here: caution around ingredients used in pregnancy usually comes not from data showing definite harm, but from a lack of sufficient data. Experimental studies in pregnant women are not ethically possible, so the information comes largely from animal studies, cases of accidental exposure and how much of a substance is absorbed.

So 'not advised' usually means 'the risk is not worth taking because it is not necessary' rather than 'it has been proven harmful'. Since most skincare steps can be postponed, the cautious approach is a reasonable choice.

Generally advised against

The table below sums up the most-debated ingredients and the reasoning behind them. The wording describes the general approach; for an individual situation a doctor's view is what counts.

Retinoids are the clearest item on this list. High-dose oral vitamin A derivatives are known to carry risk in pregnancy; although the absorption of topical retinoids is far lower, they are commonly advised against in this period because alternatives exist. We explained what they do and what can replace them in our retinol guide.

With salicylic acid the distinction matters: a low-strength rinse-off cleanser at around two percent is usually not considered a problem, while high-strength peels and large-area use are not advised. The details are in our salicylic acid guide.

Generally considered safe

The good news is that the core of skincare barely changes in pregnancy. The following are generally considered suitable for moisturising, barrier support and pigmentation:

• Niacinamide: a versatile, gentle active for oil balance, the look of redness and pigmentation.
• Hyaluronic acid and glycerin: they work as humectants, stay on the skin and carry a low risk of irritation.
• Ceramides: they support the skin barrier and are particularly useful on skin that has become sensitive.
• Azelaic acid: one of the options often preferred in pregnancy for both acne and pigmentation.
• Vitamin C: generally considered suitable as an antioxidant and brightening ingredient.
• Mineral sun filters (zinc oxide, titanium dioxide): often preferred because they stay on top of the skin.

You can find more on these on our niacinamide and hyaluronic acid pages. Even so, every product is different, and an ingredient being generally considered safe does not mean every component of that product will suit you.

Sun protection and melasma

Sun protection is the highest-return step of skincare in pregnancy. Melasma becomes more pronounced with sun exposure, and once established it can take months to fade. Daily, regular and sufficient sunscreen keeps a problem you would otherwise have to deal with later from growing.

Mineral filters (zinc oxide, titanium dioxide) are often preferred in this period because they stay on top of the skin and are poorly absorbed. Products with chemical filters are also widely used; the choice depends largely on how your skin tolerates them and how comfortable the product is to wear. Physical protection such as a hat and shade should also count.

Acne in pregnancy: what can be done?

Acne triggered by hormonal change is common in this period, and it can be confusing because some of the usual solutions (retinoids, high-strength acids) are not advised. The approach generally considered suitable works through options such as a gentle cleanser, azelaic acid and niacinamide.

Rather than starting a new, strong active on your own, simplifying the existing routine and consulting a doctor is the safer route; with widespread or stubborn acne in particular, the treatment decision belongs to a doctor.

Fragrance, sensitivity and nausea

The sense of smell can sharpen in pregnancy, and a product scent that used to be pleasant can cause nausea. Because the skin also becomes more sensitive, fragrance components more often become a cause of irritation in this period. Switching to fragrance-free products reduces both problems at once and makes it easier to trace the source of any reaction.

The wording to look for on the label is 'fragrance-free'; 'unscented' can sometimes mean another masking fragrance was added to cover the smell of the raw materials.

Which names should you look for on a label?

Debated ingredients do not always appear on a label under their everyday names. Here is a list to make searching easier:

• Retinoids: Retinol, Retinal, Retinaldehyde, Retinyl Palmitate, Retinyl Acetate, Tretinoin, Adapalene.
• Hydroquinone: Hydroquinone.
• Salicylic acid: Salicylic Acid, sometimes referred to by the abbreviation 'BHA'.
• Fragrance components: Parfum or Fragrance, plus separately listed names such as Limonene, Linalool, Citronellol and Geraniol.
• Generally considered suitable: Niacinamide, Glycerin, Sodium Hyaluronate, Ceramide NP, Azelaic Acid, Zinc Oxide, Titanium Dioxide.

Rather than looking these names up one by one, you can photograph the label and see at a glance what the list contains.

Body care: stretch marks and itching

The stretch marks that appear on the abdomen, breasts and hips are largely to do with the skin stretching quickly and with individual predisposition. Moisturising is known to soothe the skin and ease the feeling of tightness; product claims of preventing stretch marks entirely, on the other hand, deserve caution.

In these areas plain, fragrance-free, thicker moisturisers usually do the job well. If itching is widespread, severe or unusual, it may have nothing to do with the product you are using, and in that case it is a matter for your doctor.

Hair dye, nail polish and long-lasting treatments

There is no definitive list of prohibitions here, and advice varies from source to source. The common approach is to wait through the first three months, to have treatments done in a well-ventilated space and to prefer techniques that reduce contact with the scalp.

With nail polish and long-lasting treatments the real topic of discussion is solvent vapour inhaled in an enclosed space, and ventilation reduces that exposure noticeably. For anyone who works with these products for long hours as part of their job in particular, the definitive decision belongs to a doctor.

When should you change the routine?

There is no need to reset your routine in a panic on learning you are pregnant. The job is to set aside the products containing debated ingredients and carry on with the rest. Having used retinol for a while beforehand is not regarded as a source of trouble in itself; the common advice is simply to stop from the moment you find out.

You cannot know in advance how your skin will behave in this period. So adjusting the routine according to how your skin responds works better than building a big plan up front: simplify if there is stinging and redness, move to a richer moisturiser if there is dryness, and tighten sun protection if pigmentation becomes more pronounced.

A practical rule: simplify

The best routine in pregnancy is usually the shortest one: a gentle cleanser, a good moisturiser and sunscreen. Rather than starting a new active in this period, sticking to your existing simple routine is both safer and more practical for tracing the source of any reaction.

If you do need to try something new, try one product at a time and leave a few days between them; starting two new products at once makes it impossible to tell which caused a reaction. If you want to see quickly whether a product contains a debated ingredient, you can scan its label.

While breastfeeding

A similar caution continues while breastfeeding, though the circumstances differ. The additional consideration here is the areas a baby may come into direct contact with: the possibility that products applied around the chest could reach the baby's mouth is taken into account. In this period too, the final decision rests with your doctor.

Who is this important for?

This article is not only for pregnant women. Recognising the names on a label is useful for everyone in the same household, because products get shared and the same cream is often used by more than one person. For the groups below the subject applies more directly.

• Those planning a pregnancy: simplifying a routine in advance is easier than changing it in a hurry later.
• Those in the first weeks of pregnancy: this is when most of the questions come up.
• Those who are breastfeeding: areas the baby touches directly become an additional heading.
• Those who used strong actives before pregnancy: knowing which product to set aside makes things simpler.
• Anyone buying a gift for a pregnant friend: unscented, simple formulas are a far safer choice.

How binding is a 'suitable in pregnancy' claim on the label?

You will sometimes see phrases such as 'can be used during pregnancy' or 'pregnancy safe' on cosmetic packaging. There is no defined threshold or approval mechanism for these phrases in regulation; they reflect the manufacturer's own assessment. That does not make the phrase wrong, but it does mean it is not an audited document. The way to check is to read the ingredients list on the back rather than the sentence on the front. If no name from the retinoid family and no hydroquinone appears in the list, the claim is probably consistent; even so, the final word belongs to the doctor who knows your case. The same logic applies on the food side: the claim on the front and the list on the back do not always tell the same story.

A 30-second check at the shelf

• Turn the product over and find the ingredients list; the decision is made on the back, not the front.
• Scan for the names Retinol, Retinal, Retinyl Palmitate, Tretinoin and Hydroquinone.
• If Parfum or Fragrance is near the top of the list and your skin has become sensitive, look for an unscented version.
• For a sunscreen, look at the filter name: Zinc Oxide and Titanium Dioxide are mineral filters.
• If a name leaves you unsure, put the product back and buy it after asking your doctor or pharmacist.

Common mistakes

• Throwing out every product the moment a pregnancy is confirmed: keeping a simple routine is a more sensible course.
• Treating lists that circulate online as fixed rules without asking a doctor: sources can differ from one another.
• Assuming that anything labelled natural or herbal is automatically suitable: essential oils carry fragrance allergens too.
• Dropping sunscreen and looking for a brightening product when melasma appears: the order should be the other way round.
• Starting three new products in the same week: if a reaction appears, tracing its source becomes very hard.

Food labels get read more closely in the same period

In pregnancy the habit of reading labels grows not only on the bathroom shelf but in the kitchen too. Which foods to limit in this period is a list your doctor or midwife will give you, and it differs from person to person; our job is not to hand you that list but to make the label readable. Three things help in practice: knowing that allergens are printed in bold or otherwise distinguished within an ingredients list, recognising what mandatory warnings such as 'high caffeine content' mean, and comparing nutrition tables per 100 grams rather than per portion. Since portion sizes differ from brand to brand, a shared measure is the only fair way to compare two products. We set out how allergen labelling works in our allergen label piece.

When to speak to your doctor

Most questions about skin care can wait, but some situations cannot. Widespread and severe itching, a rash that spreads quickly, sudden swelling or a marked change in colour that was not there before may have nothing to do with your choice of product. Some of these pictures can be linked to conditions in pregnancy that need follow-up, and telling them apart is a doctor's job. Keeping a list of the products you use on your phone saves time at the appointment: showing a photo of the ingredients list on the back is more practical than giving the product name. You can use the scanning screen to record a label quickly.

After the birth: reopening the routine

Going back to the products you set aside usually happens gradually. Your skin may have changed over the course of the pregnancy, and picking up the same retinol at the same frequency where you left off can bring flaking and stinging in the first weeks. The common approach is to restart strong actives at a low frequency and build up according to how the skin responds; we gathered the steps for restarting a retinoid in how to start retinol. If you are breastfeeding, the timing of that transition is another heading to discuss with your doctor. Melasma usually fades after the birth, but it can darken again if sun protection is dropped; we covered how to choose a filter in our sunscreen guide.

The bottom line, and a reminder

Skincare in pregnancy is not as complicated as it is feared to be. Being cautious with a few ingredients and keeping a simple, gentle routine for everything else is enough in most cases. The highest-return step is sun protection; the riskiest is starting a strong, untried active on your own during this period.

To repeat: this article is general information, not medical advice. Pregnancy and breastfeeding differ for every woman; discuss the products you use or are considering with your doctor or pharmacist.