It seems like it’s in the water with co-workers and friends (as evidenced by the three pregnant ladies to the left from Sylvestre Franc). I’ve had a lot of questions about what is and isn’t safe to do when you’re pregnant in regards to skin care products, laser, and injectables. It is understandable that women want to look their best during this time and hormonal changes during pregnancy can sometimes result in acne, unwanted hair growth, melasma and other skin problems. So what is safe to use and what isn’t?
Not surprisingly (to me anyways), there really is not a lot of information on product safety during pregnancy. The FDA rates products on their risks during pregnancy as follows:
| Rating | Definition |
|
A |
Controlled Studies Show No Risk. Studies in pregnant women show the medication causes no increased risk to the fetus during pregnancy. |
|
B |
No Evidence of Risk In Humans. Studies in pregnant women have not shown increased risk of fetal abnormalities despite adverse findings in animals or in the absence of adequate human studies, animal studies show no increased fetal risk. |
|
C |
Risk Cannot Be Ruled Out. Studies are unavailable and animal studies have shown a risk to the fetus or are also lacking. There is a chance of fetal harm if taken during pregnancy but the potential benefits may outweigh the potential harm. |
|
D |
Positive Evidence Of Risk. Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy may outweigh the potential risk such as in life-threatening situations. |
|
X |
Contraindicated In Pregnancy. Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. The use of the product is contraindicated in women who are or may become pregnant. |
Skin Care Products
Most skin care products fall into the Class C category; however, some products are recommended by doctors not to be used during pregnancy (although there is not enough evidence for or against them).
Not Recommended:
-
Retinoids
- In A Practical Guide to Dermatological Drug Use in Pregnancy (Zip, MD, FRCPC) category B topical such as erythromycin, clindamycin, and benzoyl peroxide were recommended over topical tretinoin. This study states reports of congenital malformations in infants whose mothers used tretinoin during the first trimester.
- This ingredient is found in anti-aging products such as moisturizers, and acne products.
- Chemically a form of vitamin A, which in high doses can cause birth defects.
-
Oral retinoids, such as isotretinoin (Accutane, an acne treatment), are known to cause birth defects.
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- In A Practical Guide to Dermatological Drug Use in Pregnancy (Zip, MD, FRCPC) category B topical such as erythromycin, clindamycin, and benzoyl peroxide were recommended over topical tretinoin. This study states reports of congenital malformations in infants whose mothers used tretinoin during the first trimester.
-
Beta Hydroxy acids (Salicylic Acid)
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Ingredients used for their exfoliating and acne-treating properties. They penetrate deep inside the pores and clean out excess oil and dead skin cells that can clog pores and cause acne, blackheads and dull-looking skin.- High doses of the acid in its oral form have been shown in studies to cause complications and birth defects.
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Small amounts applied topically are considered safe (over the counter face wash for example), but peels containing Salicylic Acid are not considered safe when pregnant.
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-
Hydroquinone
- Clinically used for pigmentation for conditions such as melasma, and it is used cosmetically as a skin-whitening agent. Although a large percentage of this topical agent is systemically absorbed, the use during pregnancy does not appear to be associated with increased risk of congenital defects. This finding, however, is based off one study, with a small sample size (so it is recommended to avoid hydroquinone during pregnancy).
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Ingredients used for their exfoliating and acne-treating properties. They penetrate deep inside the pores and clean out excess oil and dead skin cells that can clog pores and cause acne, blackheads and dull-looking skin.
Safe
-
Vitamin C, Glycolic acid, and Lactic Acid: derived from fruit and milk sugars, considered nontoxic.
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Hyaluronic Acid. This is a product your body naturally produces (which means its safe). Because of its molecular size, hyaluronic acid cannot penetrate the skin’s surface, and it is not systemically absorbed.
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- Benzoyl peroxide. Only 5% of topical benzoyl peroxide is absorbed through the skin. It is completely metabolized to benzoic acid within the skin and excreted.
Self-Tanners
Dihydroxyacetone is a color additive that is found in self-tanning products to produce an artificial tan. Color develops following topical application. These products contain dihydroxyacetone in concentrations ranging from 1% to 15%, and when applied topically, systemic levels are minimal (0.5%), and are considered safe to use.
Hair Removal and Bleaching Agents
- Sodium, calcium, and potassium hydroxide, which are also found in depilatory creams, disassociate into sodium, calcium, potassium, and hydroxide ions, which are all present in the human body. Topical application of these products would not disrupt serum levels and would not be considered a problem for use during pregnancy.
- Hydrogen peroxide. Hair-bleaching creams contain low concentrations of hydrogen peroxide, making it unlikely to be systemically absorbed. In addition, should it be absorbed, hydrogen peroxide is rapidly metabolized. Therefore, use of these products during pregnancy is not expected to be a concern when done in moderation.
- Laser has some controversy as to whether or not it’s safe; again, there isn’t a lot of information. Lasers do not penetrate very deep and there is not chemical exchange into the body. One interesting thought from me, (not speaking from personal experience) the body becomes more sensitive during pregnancy, and some laser treatments hurt to begin with. I’m not sure I’d want to get laser under those circumstances!
Botox and Fillers
The safety of Botox injections during pregnancy is unknown (Class C), and while I wouldn’t recommend intentionally getting Botox injections during pregnancy, many women receive injections prior to being pregnant or when they do not know they are pregnant, and have not had any problems. Botox Cosmetic has never traveled systemically, and works only on the muscles into which it has been injected. Therefore, one could presume it is safe to undergo this procedure. But I still don’t recommend it. Unless you’re planning on having a “Toddler and Tiara” baby. Then it’s ok.
xoxo,
not pregnant LK
