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Your body goes through many changes throughout pregnancy and as it prepares for the biggest change of all – caring for your new baby. The last thing you want to be worrying about is acne. Unfortunately, the shift in hormone levels that occurs throughout pregnancy can lead to outbreaks of acne across your face and body. These hormonal changes can lead your body to produce more natural oils, also known as sebum, which can clog the pores and lead to breakouts. Acne is extremely common during pregnancy – in fact, more than half of pregnant women will experience acne during pregnancy and if you have suffered from acne before if your life, it is even more likely that you will experience acne during your pregnancy.

Acne breakouts are annoying and uncomfortable and can make you feel self-conscious about your skin. While there are many common treatments for acne, it is particularly difficult to navigate a treatment plan on your own while you are pregnant due to the risk of birth defects associated with certain treatments and common ingredients. However, there are a great deal of treatments that are effective at treating acne and safe to use while you are pregnant. It is extremely important to find an experienced dermatologist who can prescribe the treatment plan that keep your baby safe while effectively curing your breakout.

microneedling acne

Luckily, expert, board-certified dermatologist, Dr. Michele Green, has years of experience working with patients seeking acne treatment at her Upper East Side NYC practice. Dr. Green has over 25 years of experience in treating acne, acne scars, chemical peels, laser treatments, Thermage®, Botox®, and Juvederm® injections. Whether your acne is new or chronic, Dr. Green will customize and recommend the best treatment protocol for you. Dr. Green has been consistently voted as one of the best dermatologists in New York by Castle Connolly, New York Magazine, Super Doctors, and the New York Times. Using a combination of over-the-counter topical products, the best skin care, and acne treatments, Dr. Green is here to help.

Does pregnancy cause acne?

Developing acne while pregnant is very common. Over fifty percent of pregnant women develop acne typically beginning around the sixth week of pregnancy. Throughout the first trimester, your body produces more of the hormone called progesterone, which results in an increase in the body’s production of sebum. Sebum is the oil that is produced by the sebaceous glands and secreted into hair follicles to lubricate the skin and hair. While the body’s production of sebum is natural, too much oil on the skin can clog the pores, resulting in an outbreak of acne vulgaris. As such, becoming pregnant does not inherently cause acne but the hormonal changes can lead to skin changes and be a risk factor for developing pimples. Another risk factor for developing acne during pregnancy is having a history of acne in general or a history of developing acne breakouts at the start of your menstrual cycle.

What is acne vulgaris?

Acne vulgaris is the scientific name for common, or traditional, acne. It is a skin condition characterized by small blemishes that can appear in many places across the body but most commonly the face, upper back, chest, and arms. The blemishes appear as a result of the hair follicles getting clogged by dead skin cells, oil, and bacteria. There are several different types of acne that are formed in different ways and can be either be described as inflammatory or non-inflammatory lesions.

What causes acne?

Acne is caused when the hair follicles are clogged by excess oil (called sebum) and debris, such as dead skin cells. Oily skin results from an increase in oil production from the sebaceous glands, which exist everywhere on your body, except on your lower lip, the soles of your feet, and palms of the hands. When the pores are clogged by oil and dead skin cells, this is called non-inflammatory acne and manifests as whiteheads or blackheads. When the clogged hair follicles become infected with bacteria, such as the Propionibacterium, the swelling and redness of the blemishes worsens and the acne becomes inflamed. Inflammatory acne, or the acne infected with bacteria, can manifest as papules or pustules on the surface of the skin. Inflammatory acne can be particularly painful as a result of the bacterial infection of the pores.

Does pregnancy acne go away?

Acne that occurs during pregnancy results largely from a change in the body’s hormones, which can trigger an increase in oil production on the skin. For many, breakouts begin around week 6 and can persist throughout the first trimester. Breakouts may subside throughout the second trimester but can return during the third trimester, due to changes in the hormones. Early on during pregnancy, high levels of the hormones progesterone, are produced. Increased progesterone levels stimulate the oil production, clog your pores, and lead to increased acne.

In addition, an increase in another type of hormone, androgens, causes the sebaceous glands to increase and produce more sebum, which leads to an increase in inflammation, bacteria, and acne breakouts. While some women find that acne goes away postpartum, when hormone levels go back to normal, some find that their acne persists after the birth of their child. In these cases, Dr. Green will help you find a treatment plan to stop these acne breakouts and a skincare routine to help maintain clear skin.

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8 months before and after acne treatment

What do you do for pregnancy acne?

Many patients who experience acne during pregnancy wonder how to cure pregnancy acne. It can be a tricky question to navigate on your own for several reasons. Most importantly, you need to be aware of which treatment options have the potential to cause birth defects for your baby. It has been challenging to determine which treatment methods are safe to use for pregnant and breast-feeding women because ethically, researchers cannot test medication on pregnant women due to the risk of damaging the fetus. What researchers do know about acne treatments for pregnant women they learned either through animal studies or anecdotal evidence from women who tried the treatment while pregnant. If you are experiencing pregnancy acne and would like to treat the condition, it is imperative to consult a healthcare professional, such as Dr. Michele Green, to receive a safe treatment plan. Rather than looking for over-the-counter options for acne treatment, it is best to consult with Dr. Green, who knows which products to avoid during pregnancy.

How to treat acne during pregnancy

While there are some products that are absolutely necessary to avoid during pregnancy, there are still many treatment options that will be safe for your developing baby and effective at eliminating breakouts. Expert dermatologists, such as Dr. Michele Green, are well equipped to lead you through acne treatment while pregnant.

What acne treatments are safe to use during pregnancy?

if you are looking for how to treat acne while pregnant, the first step is consulting with an expert, board-certified dermatologist, such as Dr. Michele Green. Dr. Green is experienced in prescribing acne treatments that work well to clear acne that, at the same time, protect your baby. Additionally, while some products are safe in small amounts, they may become hazardous to your baby when used in larger doses or for an extended amount of time. This is another reason why it is so important to consult with Dr. Green before using any acne treatment products. The acne medications that are safest to use during pregnancy are as follows:

Topical treatments

Azelaic Acid – Azelaic acid is an ingredient found in topical acne treatments, which works as an anti-inflammatory and anti-microbial. In research trials, it was found that azelaic acid did not cause any birth defects in animals. The azelaic acid in products such as Finacea works by promoting the growth of new skin cells and targeting the bacteria that infect the hair follicles. It can reduce the symptoms of current breakouts and help to prevent future acne outbreaks.

Benzoyl peroxide – One of the most common ingredients in topical acne treatments, benzoyl peroxide is said by experts to be safe to prescribe in small amounts. If you are using products containing benzoyl peroxide, it is very important to follow Dr. Green’s recommended dosage so you do not exceed the amount that is safe to use. Benzoyl peroxide works by eliminating the bacteria that is found in papsules and pustules and by drying out the skin to reduce the amount of sebum present. You would find benzoyl peroxide in products such as Perea-Gel, Brevoxy, and Benzoic, however, be sure to consult with Dr. Green before using any of these products on your own.

Topical Antibiotics – The two most commonly prescribed topical antibiotics that are safe to use during pregnancy are clindamycin and erythromycin. These spot treatments are best to treat inflammatory acne for a short period of time during pregnancy as there have been no studies documenting the effects of long term use. These topical antibiotics work by targeting the bacteria that cause infection in the clogged pores.

Salicylic Acid – Salicylic acid is another ingredient commonly found in over-the-counter topical acne medications. Researchers believe that salicylic acid is safe to use during pregnancy for a short duration in a localized treatment area. Salicylic acid is an oil-soluble ingredient, which works by exfoliating the skin to unblock the pores. The ingredient works well to target non-inflammatory acne such as whiteheads and blackheads, as well as inflammatory acne such as pustules because it also works as an anti-inflammatory.

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Fraxel Laser treatment – 2 months, 2 sessions

Oral acne treatments

If you are suffering from severe acne and topical acne products are not sufficient to reduce the breakout, there are certain oral antibiotics that are safe to take during pregnancy. Oral antibiotics such as Penicillin, Cephalexin, Erythromycin, and Cindamycin, are generally considered to be safe while pregnant. However, it is imperative to consult with your obstetrician to see which antibiotics he/she will approve to take while you are pregnant. Tetracyclines, Streptomycin, and Kanamycin are not recommend to take while you are pregnant, as these antibiotic can cause birth defects.

It is best to use oral antibiotic treatments for a short duration while pregnant. Penicillin is one of the safest antibiotics to take, as long as there is no history of allergy. Common side effects with any oral antibiotic are skin rashes, diarrhea, and fever. If any of these unwanted side effects occur, it is important to discontinue the oral antibiotic and contact your treating physician. It is also important to complete the antibiotic medication for the entire prescribed length of time, even if the acne disappears so that the bacteria do not build up a resistance to the medication.

Procedure-based acne treatments

Glycolic Acid Peels – Glycolic acid is a chemical peel that works to exfoliate the skin and unclog the pores. The peel works by removing the excess oil and dead skin cells that plug the hair follicles and lead to acne breakouts. It is an effective treatment for whiteheads, blackheads, papsules, and pustules. This treatment has not been extensively studied in pregnant women and have been proven to be safe and effective.

HydraFacials – HydraFacial are one of the most popular treatments for acne breakouts in Dr. Green’s office. It is a medical grade facial, which has a three-pronged approach. Cleansing, exfoliating, and then infusing the skin with medical grade serums to improve your complexion and treat acne breakouts. The unique vortex technology removes blackheads without any irritation. It incorporates ingredients, such as salicylic acid, which has been proven to be safe and effective in treating acne during pregnancy.

Acne surgery – Certain acne breakouts and cysts need a more traditional approach to removal. For these deeper types of acne breakouts, traditional acne surgery is needed. While using a comedone, these acne pimples and cysts and removed. This process is generally followed up with injections of intralesional cortisone. The injections will decrease the inflammation and help these cysts heal up more quickly, without forming acne scars.

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What acne treatments are not safe to use during pregnancy?

There are certain common treatments for acne that are absolutely not safe to use during pregnancy or while you are breast-feeding. The ingredients in the treatment can be absorbed into your bloodstream and into the baby’s bloodstream and cause serious birth defects. It is vitally important to consult with your obstetrician and an expert dermatologist, such as Dr. Michele Green, before starting your acne treatment so you know which of these medications you must avoid.

Topical Retinoids – Topical tretinoin, such as Retin-A, is very common for treating acne vulgaris, however, they can be very dangerous to use while pregnant. Derived from vitamin A, retinol treatments work by exfoliating the skin and drying out the excess sebum to help clear the hair follicles. Retinoids have been shown to cause birth defects and should be avoided during pregnancy and while breast feeding. Other common brand names for tretinoin that are unsafe for use during pregnancy include Refissa, Renovva, and Avita.

Isotretinoin – Isotretinoin, also referred to as Accutane or known by brand names Absorica, Claravis, Zenatane, and Amnesteem, is an acne treatment commonly prescribed to treat severe acne and/or cystic acne. Similarly to tretinoin, isotretinoin is derived from vitamin A and is a treatment employed if antibiotics and topical creams have not been sufficient to treat the breakout. When healthcare providers prescribe isotretinoin, patients have to take pregnancy tests before, during, and following treatment because it is so dangerous for a fetus.

Oral Tetracycline – Two other oral medications that should not be consumed as acne treatment during pregnancy are doxycycline and minocycline. Typically, these treatments are prescribed for moderate to severe acne due to their anti-inflammatory properties. Both products have been shown to be linked to birth defects such as inhibited bone growth.

Spironolactone –  Spironolactone is a medication that suppresses the hormone androgen, which is responsible for a rise in oil production on the skin. Spironolactone has been shown to lead to birth defects and is, for that reason, not recommended for use in pregnant women. The brand name for spironolactone is Aldactone.

Other pregnancy acne FAQs:

How to treat pregnancy acne at home

There are many home remedies for how to clear up pregnancy acne that are a great place to start if you are experiencing an outbreak during pregnancy. First, it is very important to keep your face clean by washing with a mild cleanser or gentle soap. When washing your face, use a clean washcloth or towel each time. When it comes to skincare products, be sure to use a light moisturizer that is oil-free. Adding oil-based moisturizer to your face can upset the balance of oils and lead to clogging of pores. Dr. Green recommends that your lightweight moisturizer contain SPF to protect against the sun or that you use a separate sunscreen. It is important to wear sunscreen every day but especially if you are using acne treatments that may make your skin more sensitive to the sun.

How to avoid pregnancy acne?

Pregnancy acne is very common and with the changes in hormones in the body, it can be difficult to prevent. That said, establishing a skincare routine that keeps your skin moisturized and oil-free can help to prevent outbreaks throughout your pregnancy. Dr. Green recommends cleaning your face with a gentle soap twice a day, using the proper exfoliants, a light moisturizer with SPF 30 or higher. She also advises patients against touching their face, as bacteria and oils on your hands can contribute to clogging your the pores.

Where is pregnancy acne located?

Pregnancy acne is most commonly located on the face, upper back, chest, and arms. These locations on the body have a high concentration of pilosebaceous units (meaning hair follicles and sebaceous glands) so the likelihood that those hair follicles could get clogged by a higher than normal concentration of sebum is more likely. As acne is caused by oil and dead skin cells clogging the pores, acne is more likely to occur in oily places on the body.

How to get rid of pregnancy acne

There are many ways to get rid of pregnancy acne. You can begin with home remedies, including washing your face twice a day with a light soap and clean cloth. If that is not effective in remedying your acne, Dr. Green recommends that you schedule a consultation at her NYC Upper East Side office. It is tricky to navigate the proper treatment during pregnancy but Dr. Green can prescribe and effective treatment that is safe for your baby. The topical cream, oral medication, or alternate acne treatments that Dr. Green prescribes will be based on the type of acne that you are experiencing and your particular health needs.

What is the best cleanser to use to prevent acne?

It is important to keep you face clean in order to prevent acne breakouts anytime. For that reason, Dr. Green recommends using a gentle cleanser to wash the area in which outbreaks frequently occur. Acne-specific cleansers will use ingredients such as salicylic acid, benzoyl peroxide, and glycolic acid. When you consult with Dr. Green, she will recommend the cleanser that will work best for you to use for the amount of time that is safe during your pregnancy. Dr. Green’s full line of cleansers can be viewed here. 

Can chin acne mean pregnancy?

Not necessarily. While acne can develop on the chin during pregnancy, the chin is a common place for acne vulgaris to develop generally. Acne on your chin can appear if you have been touching your chin with your hands, which can contain excess oil and bacteria, or if your chin comes into contact with other surfaces like a Covid-19 face mask. If you suspect that you may be pregnant, it is best to speak with Dr. Green before attempting to treat the acne breakouts.

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Before & After – Acne treatment with eMatrix

What are the different types of acne?

There are several different types of acne that can develop across the body. Understanding the difference between the types of acne is crucial for treating the acne effectively. Depending on the type of acne, you may require an anti-inflammatory or an antibiotic, which would not be effective in treating other varieties of lesions.

Comedone acne

Comedonal acne does not appear as traditional acne breakouts. Comedonal acne is not red or inflamed like traditional acne vulgaris. Comedones are non-inflammatory blemishes that can be further broken down into two subgroups: whiteheads and blackheads. Whiteheads occur when the hair follicles have been clogged by sebum and dead skin cells but the lesions are “closed,” meaning the plugged contents of the follicle are not in contact with the skin. Blackheads, on the other hand, are “open” lesions, meaning that the contents of clogged follicle are exposed to the skin. They appear black because the exposure to the skin leads to oxidization of the contents of the plugged pores. The most common locations for comedonal acne are on the forehead, chin, and jawline. However, comedones can also appear on the back, chest, neck, and shoulders, and can be treated in a similar manner. It is important not to squeeze your own comedones, as this can allow bacteria to enter, and lead to infections and scarring.

Inflammatory Acne

Inflammatory acne typically begins as comedones but then the pores get infected with bacteria, they form red, inflamed, and tender lesions. There are two types of inflammatory acne: papules and pustules. They differ only in that pustules contain pus, whereas papules do not. If you are experiencing pustules, it is important not to try to pop them on your own as the bacteria-infected pus can spread across your skin and lead to further infection and acne scars.

Cystic Acne

Cystic acne forms when clogged hair follicles are infected with bacteria under your skin. When the plugged pore is infected and trapped under the skin, it leads to the formation of acne cysts, which are red and swollen and usually very painful. Typically, the acne cysts under the skin are full of pus. Cystic acne lesions are most likely to cause acne scarring, and should have prompt medical attention. Choosing the right acne products is crucial in combating cystic acne and eliminating the infection under your skin. If you are pregnant and experiencing cystic acne, it is important to consult with Dr. Green so that she can provide you with the acne medication that will combat the bacterial infection while keeping your baby safe.

How to start pregnancy acne treatment today

If you are struggling with acne breakouts during pregnancy, expert, board-certified dermatologist, Dr. Michele Green, can help you to navigate the best treatment plan for you. With over 25 years of experience developing the best skincare and acne treatments, Dr. Green will help develop the right treatment protocol for you. Whether it be topical treatments, oral antibiotics, HydraFacials, chemical peels, or other acne treatments, Dr. Green will customize a unique plan for you to have beautiful, clear skin. Please contact us online or call 212-535-3088 to learn more about about safe and effective acne treatments for you while you are pregnant.

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