During pregnancy there can be elevated anxiety about making better choices about chemical exposures. When it comes to skincare, we certainly don’t want to do anything that would harm our baby or truthfully ourselves for the sake of vanity. Fortunately, there are many great options, but it can be hard to know what is in the products you use, if they are safe, and what you truly need to avoid. I want to make it easier for people to find effective, safer skin care products for our entire life and I made Doctor Rogers Skin to provide this option. Our award-winning line is unparalleled in efficacy and safety, including during pregnancy. Every product made supports your skin without risk to your body or the planet by using only well-studied, hypoallergenic, plant-based, nontoxic, biodegradable ingredients.
How Does The Skin Change During Pregnancy?
There are many remarkable physiological changes to your body during pregnancy, and the skin is no exception. Increases in hormones like estrogen and progesterone drive many of these changes.
-Hyperpigmentation: Increased levels of hormones like estrogen can stimulate the production of melanin, causing areas of the skin to darken, often on the face, nipples and abdomen. On the face it is called melasma -or "mask of pregnancy.”
-Stretch Marks: As the skin stretches to accommodate the growing uterus, it may develop stretch marks, especially on the abdomen, breasts, hips, and thighs. These marks appear as pink, red, or purple streaks. They typically develop in the 3rd trimester and are more common in mothers who are under 30, gain more than 35 pounds during pregnancy or have a mother who also developed stretch marks.
-Acne and Oily Skin: Hormonal fluctuations may increase oil production in the skin, leading to acne breakouts or exacerbating pre-existing acne.
-Increased Skin Sensitivity of the Face: Some women experience heightened skin sensitivity during pregnancy. Our blood vessels dilate, flushing our skin and increasing what we absorb through our skin making reactions more common.
-Spider Veins and Varicose Veins: The increased pressure on the circulatory system during pregnancy can lead to the development of spider veins (small, red blood vessels) or varicose veins (enlarged, twisted veins), especially in the legs.
-Skin Tags and Seborrheic Keratosis: Increase hormone levels and weight gain can lead to more benign growths, often in areas of friction like armpits, under breasts and inner thighs.
-Glowing Skin of Pregnancy: While not experienced by all women, some pregnant women may notice an improvement in their skin's appearance, often described as a "pregnancy glow." This is thought to be due to increased blood circulation and hormonal changes. Do not feel bad if you don’t experience this. I did not. In fact, pregnancy seemed to be an exercise in rapid aging.
What Skincare Should I Avoid When Pregnant?
I read the ingredient list of anything I’m putting on my body. However, pregnancy is often the first time people truly consider what they are putting on their skin. It can be a bit daunting at first, but we are here to help you through.
There are actually very few studies evaluating the safety during pregnancy of the active ingredients in many skin care products. This makes it difficult for physicians to say with certainty that a specific ingredient is completely safe to use regularly throughout pregnancy. Because pregnancy is a very important and very temporary state, doctors often recommend avoidance. This is the safest, most conservative course, but can sometimes lead to a long nine months for mom!
-Prescriptions: For any prescription medication you need to speak with your OB/GYN or prescribing doctor to make a plan for what to do during pregnancy and breastfeeding. Commonly prescribed oral dermatology medications that should be stopped as soon as you know you are pregnant include Isotretinoin, Finasteride, 5-Fluorouracil, Tazarotone topical, Spironolatacone, Tetracycline, Doxycycline and Minocycline. Topical prescriptions to stop include 5-Fluorouracil, hydroquinone, Tazarotone and tretinoin.
Over the Counter Ingredients to Avoid
-Retinoids: Oral isotretinoin, topical prescriptions of tretinoin (Retin-A) should be avoided during pregnancy because of the association between high dose vitamin A and birth defects. Over the counter versions including retinol have not been well-studied in pregnancy and although the risk to the baby is very low, because they are still vitamin A it is best to avoid them. To learn more about how to start using a retinol, check out my blog A Primer on Retinoids: What to Know Before You Start.
-Hydroquinone: This skin-lightening ingredient is also available over the counter and should be stopped due to potential concerns about fetal development.
OTC Ingredients to Minimize
-Salicylic acid: While small amounts of salicylic acid, 2% or less, in skincare is generally considered safe, high concentrations (such as those found in chemical peels or oral Aspirin) should be avoided during pregnancy.
-Benzoyl peroxide: While benzoyl peroxide is commonly used to treat acne, its safety during pregnancy is not well-established. It's generally considered safe when used in concentrations under 5%, but it is's best to consult with a healthcare provider before using it during pregnancy.
-Essential oils: Some essential oils, particularly when used in high concentrations or ingested orally, may pose risks during pregnancy both to the fetus, but also as skin irritants. Examples include rosemary, basil, jasmine, and sage. It's advisable to avoid essential oils.
-Self-tanning Lotions and Spray Tans: While the active ingredient in most self-tanning products, dihydroxyacetone (DHA), is generally considered safe during pregnancy, it's best to avoid inhaling or ingesting it. Opt for safer alternatives like tinted moisturizers or bronzers if you want to achieve a tan during pregnancy.
-Aluminum Chloride Hexahydrate: The active ingredient in many antiperspirants, it affects the cells that produce sweat and is in FDA pregnancy category C. Better to switch to a natural deodorant.
-Parabens: Parabens are a group of preservatives commonly used in cosmetics and skincare products to prevent microbial growth. Some studies have suggested that parabens may have estrogenic activity, meaning they can mimic the hormone estrogen in the body.
-Phthalates: Phthalates are a group of chemicals used to soften and increase the flexibility of plastics. They are also used in some skincare products as fragrance carriers and plasticizers. Phthalates have been associated with disruption of the endocrine system, including interference with reproductive hormones.
-Triclosan: Triclosan is an antibacterial agent commonly found in skincare products like hand soaps, body washes, and toothpaste. It has been shown to have hormone-disrupting effects in animal studies, although its impact on human health is still being studied.
What Skincare Can I Use When Pregnant?
All Doctor Rogers products are made from hypoallergenic and 100% biodegradable ingredients, meaning they will not accumulate in you, in your breast milk or the world that we live in. They don’t contain ingredients from the lists above. I feel incredibly comfortable having my patients using my products throughout that period of their life, and I would use them if I were pregnant or breastfeeding.
-Vitamin C: Topical Vitamin C appears to be completely safe during pregnancy. Oral Vitamin C is generally considered safe for pregnant women when consumed in recommended amounts through food sources or supplements. The Recommended Dietary Allowance (RDA) for vitamin C during pregnancy is 85 milligrams per day for women aged 19 years and older.
-Niacinamide: Also known as vitamin B3 or nicotinamide, it is a water-soluble vitamin that is considered safe for use during pregnancy when used in skincare products because when it is applied to the skin it is unlikely to be absorbed into the bloodstream in significant amounts.
-Hyaluronic Acid: This is a naturally occurring substance found in the body, primarily in connective tissues, skin, and eyes. It is also a popular skincare ingredient known for its hydrating and plumping properties although has limited evidence to support its use topically. Hyaluronic acid is considered safe for topical use during pregnancy.
Some Pregnancy Considerations with Doctor Rogers Products
-Doctor Rogers Day Preventive Treatment is a powerful product that is very effective. When you are pregnant or breastfeeding your skin is oftentimes more sensitive. As such, I recommend you really listen to your skin and watch for signs of irritation. You may need to use less than you needed when you weren't pregnant. For example, it might mean using it every other day instead of on a daily basis. Don’t forget to add a rich moisturizer afterwards, too.
- Doctor Rogers Night Repair Treatment contains bakuchiol (not a retinoid). Bakuchiol has not been studied specifically in pregnancy, but it is regarded as safe. I just want to highlight that it is not a vitamin A derivative (ex: Retinol), which has been studied in pregnancy. Oral vitamin A in high doses is associated with birth defects. The Night Repair Treatment also has a very low percentage of salicylic acid, less than a half a percentage point. Salicylic acid is also the ingredient in aspirin, which is also not recommended during pregnancy.
I favor mineral based sunscreen that contains zinc during pregnancy, particularly if you are applying to large areas where you will have increased absorption of whatever you are using on your skin. There are a large number of animal studies showing endocrine disrupting effects of chemical UV-filters present in sunscreens, although other studies failed to find such effects and human studies are lacking. Here is an article I wrote on sunscreen ingredients and my favorite options. I also wrote this blog on choosing safer sunscreen options during pregnancy.
Chemical Sunscreen Concerns
-Benzophenone derivatives (e.g. Oxybenzone, Avobenzone, Benzophenone): These chemicals are often used in sunscreens to absorb UV radiation. Some research suggests that benzophenone derivatives may have hormone-disrupting effects, particularly on thyroid hormone activity.
-Octinoxate (Ethylhexyl methoxycinnamate): Another common ingredient in sunscreens, octinoxate has been found to have estrogenic activity in some studies, raising concerns about its potential impact on hormonal balance.
Cosmetic Procedures During Pregnancy
-You should not have cosmetic procedures like Botox, Dysport, or fillers of any kind.
-Laser treatments, chemical peels, microneedling should also be avoided. Even though there are no studies for these products or devices on pregnant women, there is an elevated risk of unwanted complications. And if you have a complication, you want to have the full set of tools to address the complication. Some of those tools can be detrimental in pregnancy. For example, IPL treatments (photorejuvenation or photofacials) will not have a negative consequence to the baby but having the treatment during pregnancy increases your risk of developing melasma. Plus, our blood vessels are more dilated, so the results will not be as good.
-Peels can include higher concentrations of retinoids and salicylic acid. A filler complication might require blood thinners, steroids, aspirin or hyperbaric oxygen, all that would put the pregnancy at increased risk.
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