Acne During Pregnancy

People often talk about the “pregnancy glow”—that elusive radiance that's supposed to come with growing a tiny human. But let's be honest here: not every woman experiences this dewy complexion. In fact, for many women, pregnancy can bring on a whole host of skin issues, including acne.

Acne is a chronic inflammatory condition with links to genetics, environment, and—yep, you guessed it—hormones. The hormone connection is why it's most often seen in the teen years, but it's also common any other time your hormones fluctuate, like during pregnancy.

The tricky thing about treating acne during pregnancy is that many medications, like accutane or spironolactone, used to treat it are not safe to use at this time. That means we must look at other ways to support your skin and reduce inflammation. In this article, I'll share why acne can happen during pregnancy and what you can do about it.

Do You Get Acne When Pregnant?

Many women experience acne while pregnant, so you aren't alone. Some may notice early in the first trimester when hormones are surging, while others may experience it towards the end of pregnancy. Studies suggest that women who had acne as teens are more likely to experience acne again while pregnant. Women with PCOS are also more likely to have severe acne during pregnancy.

Let's take a closer look at why this happens.

What Causes Acne During Pregnancy?

The primary cause of acne during pregnancy is hormones, specifically androgens and progesterone. Sebum, the oily substance that lubricates the skin, is produced in greater amounts when these hormones are present. Excess sebum can clog pores and make acne worse.

There are 4 factors that lead to acne:

Increased sebum production
Abnormal follicular hyperkeratinization (rapid shedding of skin cells)
Inflammation
Propionibacterium acnes colonies on the skin

Reproductive Hormones and Acne

Androgens are sex hormones that stimulate the sebaceous glands to produce more sebum, resulting in clogged pores and acne. For example, testosterone can increase up to 70% during pregnancy. As beta-human chronic gonadotropin (a hormone made by the placenta) increases, it also stimulates androgen production.

The surge of hormones in the first trimester of pregnancy contribute to increased sebum production and progesterone can cause changes in the pores making it easier for them to clog. While for some women skin may improve into the second trimester, others will find that the increased androgens of the third trimester contribute to acne returning.

Inflammation also plays a role in acne. Some research suggests that some of the immunological changes that occur during pregnancy could also affect the skin.

How to Treat Pregnancy Acne

Treating pregnancy acne is a bit different than other times in life. You'll want to be especially mindful about safety for you and your baby. There are some pregnancy-safe topical options that you can discuss with your doctor, but I will focus on tips to naturally support your skin health.

Please also remember that while everything I suggest is considered safe for pregnancy, you should always check with your obstetrician or midwife before supplementing or using any of these products because your body and health background are unique to you!

Gentle Cleansers

Starting with the basics, it's essential to use gentle cleansers that won't strip the skin of its natural oils. Fragrance-free, gentle cleansers that are free from endocrine disruptors like parabens are a good choice (for you and your baby). Endocrine disruptors are chemicals that act like hormones in the body and in some instances, are known to cause reproductive harm.

Scrubbing at already inflamed skin also won't do you any favors, so stay away from harsh exfoliating scrubs. You can use a soft washcloth to help gently exfoliate without damaging your skin barrier.

Some people find double cleansing with an oil based cleanser and then following up with a gentle cleanser to also be helpful. Coconut oil is sometimes used because it is antibacterial and antifungal. While this may work for some, understand that more scrubbing and cleansing can also aggravate your skin. Be mindful of how your skin responds to any strategies you employ.

Honey Masks

Honey is both anti-inflammatory and anti-microbial. Applying manuka honey to the face or affected area for 20 minutes and then rinsing off with warm water may help to soothe irritated skin.

These are generally used on clean skin two to three times per week.

Probiotics and Gut Health

Inflammation and dysbiosis (an imbalance of healthy gut bacteria) are linked to acne and skin health—so optimizing gut health is an important strategy. Certain strains of probiotics may support this relationship and may help alleviate acne during pregnancy.

Probiotics are helpful bacteria and fungi that you introduce into your gut for their potentially beneficial qualities. Studies suggest that certain strains of bacteria may help reduce inflammation and improve your skin's overall health. Our gut health is also key for hormone balance and detoxification, so it's all closely connected.

Prebiotic foods are another essential factor in maintaining a healthy gut. These foods stimulate the growth and activity of good bacteria. Foods such as garlic, onions, apples, and oats are excellent sources of prebiotics. Adding more prebiotic-rich foods to your diet can help support your gut health, balance your gut flora, and improve your skin health.

Women's Probiotic by Dr. Brighten includes targeted strains of probiotics and prebiotics to support women's skin and gut health.

Liver Support

The liver is responsible for breaking down toxins to be safely eliminated from your body. Liver health is essential for clearing out excess hormones, metabolic waste, and environmental toxins that can contribute to the development of acne.

Our gut and kidneys are the primary ways we eliminate waste from the body, but your skin can also be a means of waste removal via sweat.

While many people turn to herbal supplements for a liver cleanse, it's important to note that many of these supplements are not safe during pregnancy. Instead, you can optimize hormone balance and detoxification through diet by increasing your intake of sulfur-rich veggies like broccoli, cabbage, and kale. Additionally, reducing your exposure to toxins in food, household cleaning products, and personal care items can help reduce the burden on your liver. You can find more about avoiding endocrine disruptors here.

Anti-Inflammatory Diet

An anti-inflammatory diet is packed with foods that help reduce inflammation in your body, which can help reduce the occurrence of breakouts. Foods typically included in an anti-inflammatory meal pattern are also good for mom and baby's health and include:

Fruits and vegetables
Whole grains like quinoa and oats
Lean proteins like fish, poultry, and eggs
Legumes and nuts
Healthy fats like avocado and olive oil

There have been numerous studies to show an association between acne and diet. In one study, it was found that adults who consumed dairy, high sugar, and high fat foods experienced acne. But because acne is multifactorial, it isn’t always just making dietary shifts alone and may require additional interventions on top of diet. That doesn’t mean diet isn’t effective, it means it is an important foundation that may need to be built on in order to resolve acne.

Not sure where to begin? Not to worry. My free Hormone Balancing Starter Kit includes a 7-day hormone-balancing, anti-inflammatory meal plan and recipe guide to help you get started.

Omega-3 Fatty Acids

Studies show that omega-3 fatty acids, found in oily fish like salmon, mackerel, and sardines, can benefit skin health by reducing inflammation. Be sure to choose low-mercury sources of omega-3s, especially while pregnant. Aiming for 8 to 12 ounces per week is recommended during pregnancy.

If fish is hard to swallow while pregnant, omega-3 fatty acid supplements are available and safe for pregnant women in the recommended dosage. We include our Omega Plus as part of our Pregnancy Support Kit.

While much of the focus in pregnancy is on DHA found in fish oil, EPA is important in skin health. DHA is given more gravity because of how it supports the fetal nervous system development. But EPA offers anti-inflammatory support that can help support skin affected by acne.

Prenatal Supplements

We know that taking prenatal vitamins during pregnancy is vital for the health of both mother and baby, but they can also be helpful for your skin. Prenatal vitamins are packed with essential nutrients that support the healthy growth and development of the fetus, but they also provide critical nutrients for maintaining healthy skin.

For example, Vitamin D may help calm inflammation, while vitamin A is involved in cell division and can even positively influence sebum production. However, it's important to note that too much vitamin A can be harmful during pregnancy, so taking the recommended amount is essential (more on this below).

In addition to vitamins D and A, prenatal vitamins contain other essential nutrients for skin health, like B vitamins, zinc, and vitamin C. And many of these nutrients, like the ones listed, also support healthy hormones. Regularly taking your prenatal vitamins provides your body with the nutrients necessary to support healthy skin throughout your pregnancy.

Our Pregnancy Support Kit is formulated to safely support nutritional needs during pregnancy, including healthy skin. The kit includes Women's Probiotic to support optimal gut health, Omega-Plus to target inflammation while also providing baby with the DHA they need, and Prenatal Plus to provide essential nutrients for a healthy pregnancy, healthy baby, and glowing skin.

Pregnancy Safe Acne Strategies

Change your pillowcase once a week and wash bedding
Stay hydrated with filtered water
Change your towels once to twice weekly, at minimum
Avoid picking, popping, squeezing or anything that can aggravate the skin or introduce harmful organisms
Keep oily hair off your face and consider sleeping with a hair bonnet
Avoid touching your face and clean off items that come into contact with your face like your phone
Always wash hand before touching your face
Use products that are non-comedogenic or made for acne prone skin
Talk to your doctor before applying topical medications or taking acne supplements because not all are safe in pregnancy

When Should You See a Doctor for Pregnancy Acne

If you're concerned about your complexion during pregnancy, discussing it with your OB-GYN or midwife may be helpful. Your provider may recommend a topical cream or other treatment, and you can also discuss natural support options. While acne can be a completely normal part of pregnancy, you also don't need to struggle with feeling uncomfortable in your own skin.

If your pregnancy provider isn’t able to provide you support for your skin, ask for a referral to a dermatologist. In some instances, they may recommend benzoyl peroxide, topical antibiotics, or other treatments that are considered safe in pregnancy.

When Does Pregnancy Acne Go Away?

As I mentioned earlier, acne typically starts 6 weeks into pregnancy. While it can last up to the third trimester, many women find that their symptoms begin to improve in the second trimester as they adjust to the new hormone levels. There's no set timeline for when your acne should go away, as everyone's experience is different, but if you're concerned or the acne is getting worse, then it's helpful to talk with your provider.

Acne Treatments to Avoid

Safety during pregnancy is always a top priority which means being extra careful about what you put on your skin, the food you eat, and the supplements you take. Many herbs and supplements are considered unsafe for pregnancy simply because there hasn't been enough research (and it would be unethical to conduct that research on pregnant women).

When in doubt, talk with your provider to make sure any treatments—natural or otherwise—are safe for use during pregnancy. Here are two you definitely want to avoid:

Vitamin A Therapy

While vitamin A treatments can effectively reduce acne, they should be avoided during pregnancy. High doses of vitamin A, such as those found in some acne medications, are known to cause birth defects. Because of these risks, pregnant women are encouraged to avoid vitamin A treatments for acne and communicate with their healthcare provider before using any acne medication.

Please be aware that some vitamin A is absolutely necessary for fetal health and development. Needs are often easily met through a quality prenatal and nutrient dense diet.

Herbal Acne Treatment

I strongly believe in the power of herbal remedies for many health conditions, but when it comes to pregnancy and acne, it's important to err on the side of caution. While some herbs may be safe for use during pregnancy, many have not been extensively studied for their effects on fetal development. Herbs can be just as powerful as medications, so it's best to stay away until after you’re done breastfeeding.

The best approach is to stick to culinary herbs as part of your diet and save the others for outside of pregnancy. For example, oregano in your pasta sauce is fine, but oregano oil as a supplement could be problematic and should be avoided.

Acne During Pregnancy: Key Takeaways

Hormone changes are a primary cause of pregnancy-related acne breakouts, which can stem from increased sebum production and the resulting clogged pores.

Eating an anti-inflammatory diet or taking pregnancy-safe supplements (like your prenatal vitamin) can support skin health and may help reduce acne. Herbal supplements and vitamin A treatments should be avoided during pregnancy.

If you're experiencing acne during pregnancy, it's essential to talk with your healthcare provider before beginning any new treatment regimen. They can help determine what's safe and effective for you and your developing baby.

References

About The Author

Dr. Jolene Brighten

Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.