How to help pregnancy acne

Having a baby can be one of life’s great joys. Pregnancy comes with many positives, but unfortunately for some, there can be a few drawbacks as well. This can include hormonal acne, where your skin begins breaking out like it would if you were a teenager.

The good news is that hormonal acne in pregnancy does not happen to everyone. If it does happen to you, there are some pregnancy-safe remedies to zap those zits. Keep reading to see what expert dermatologists recommend if you start to break out during pregnancy.

Hormonal acne typically occurs during a certain point in the menstrual cycle, often the week before your period. These breakouts usually appear on the jawline or chin.

Although a non-pregnant person can suffer from hormonal acne, it is very common when a person becomes pregnant. "In your first trimester, there is a hormonal surge of progesterone, which is a hormone that makes the uterus a hospitable environment for the baby," says Mona Gohara, MD, a board-certified dermatologist. "Progesterone can increase oil production (called sebum) and that hormonal surge plus the sebum can start the acne cascade."

Some hormones level out during the course of pregnancy, which can help acne. This is not always the case, though. "Often, these breakouts decrease as the pregnancy continues into the third trimester, but the response is unpredictable," says Rachel Nazarian, MD, FAAD, a faculty member at Mount Sinai’s Department of Dermatology who practices at Schweiger Dermatology Group in New York City. "Many people experience no acne at all, or acne throughout their entire pregnancy."

Often, these breakouts decrease as the pregnancy continues into the third trimester.

— Rachel Nazarian, MD, FAAD

If you do experience better skin in your third trimester, keep in mind that hormone fluctuations are not over. This may mean your acne will reappear.

"Hormones continue to fluctuate during the fourth trimester after the baby has arrived," says Natalie Aguilar, a dermatological nurse and celebrity aesthetician. "Nursing a baby also stimulates hormones so that our body can continue to make milk. Even if one decides that nursing is not for them, it takes a while for our once-elevated pregnancy hormones to return to normal." This can delay your return to clearer skin.

Additionally, lifestyle factors while pregnant or while caring for a newborn can also lead to breakouts. "Fatigue can cause our skin to become sluggish and prone to breakouts that may not be hormone-related," says Aguilar.

Though a surge in hormones during pregnancy can also lead to a "pregnancy glow," it is also what causes acne. "It is a double-edged sword," explains Dr. Gohara. "Some women are glowing and some women are more predisposed to acne. Some women have zero acne before and then acne during pregnancy. Some people have acne before then no acne in pregnancy." In other words, there is no rhyme or reason for acne during pregnancy. "You can't predict whether it is going to happen to you," she says. Which means it can be nearly impossible to prevent.

You also can't predict what type of acne you will have, or where it will occur. "I have seen it occur both on the chin, and everywhere, and also in different forms," says Dr. Gohara. She has seen pregnant people experiencing everything from whiteheads and blackheads, to deep cystic acne and inflammatory acne. "It is all acne at the end of the day," says Dr. Gohara.

The good news is that the lifestyle changes many people make naturally when they become pregnant, like eliminating alcohol and highly processed foods and drinking more water, also decrease your likelihood of acne and inflammation during pregnancy, says Dr. Gohara.

Like with any breakout, there are ways to treat hormonal acne during pregnancy. However, it is important that you carefully consider the products and ingredients you use. Some traditional acne treatments are not safe during pregnancy.

Non-pregnant people with acne may typically reach for products that contain retinoids, salicylic acid, or benzoyl peroxide to treat their breakouts. Studies have shown that small concentrations of salicylic acid and benzoyl peroxide (in a face wash that does not stay on the skin, for example) are pregnancy-safe. Still, proceed with caution with over-the-counter remedies, and note that retinoids are never recommended during pregnancy.

Always ask your healthcare provider about pregnancy-safe topical medications. If your case is severe, there are prescriptions available as well. "Clindamycin and topical erythromycin are pregnancy-safe medications," says Dr. Gohara.

You can also find non-medicated treatment options. Aguilar recommends using full-fat, non-flavored Greek yogurt as a face mask. "Yogurt is cooling, the probiotics contain good bacteria, and it contains the most gentle exfoliant of all, lactic acid," she says. "This face mask can be done twice a week. Apply it to a clean face for five to 10 minutes. Rinse and follow with moisturizer and sun care."

“Blue LED therapy has also been an effective treatment," says Aguilar. "There are no ingredients involved, it can be done safely at home, and it is quick."

Before starting any treatments, though, talk with your healthcare provider (like an OB/GYN or dermatologist) to see what works for you.

The good news is that pregnancy acne is common, and there are treatments for everyone.

A great place to start (whether you have acne or not) is with gentle skincare. "I love Avène's Tolerance line," suggests Dr. Gohara. "That is a really great line because it has just seven ingredients in it, and no preservatives. It actually gives pregnant women a lot of peace that there are minimal ingredients—plus they are calming and soothing—and no preservatives. A really gentle cleanser is important."

Dr. Nazarian agrees that using the right skincare from the get-go is important. "Some of my favorite products include a gentle acne cleanser like the Proactiv Renewing Cleanser, which includes benzoyl peroxide, and the Differin Pore Minimizing Toner with Witch Hazel, which is a safe and gentle option even for sensitive skin," says Dr. Nazarian. "It contains no alcohol, and has an effective combination of aloe, witch hazel, and glycolic acid."

As irresistible as it can be, picking pimples or over-exfoliating your skin is not the right idea. "I always say, [pregnant patients] start to bug out, and then they scrub," says Dr. Gohara. Try to avoid that. Do not overdo any treatments in an attempt to heal your acne. It could just make it worse. "It destroys the skin barrier—your protective mechanism—and just enflames things a hundred times worse," says. Dr. Gohara.

Plus, picking just gives the bacteria that lives in acne more opportunities to spread, says Sylvia Brownlee, an esthetician, holistic acne specialist, and founder of Skin by Brownlee Co., a Cincinnati, Ohio-based spa. "This can just lead to more breakouts!" she shares.

Makeup can be the first line of defense. Concealer and foundation can camouflage hormonal acne and discoloration. "I recommend non-comedogenic products that are oil-free, and I encourage diligent cleaning-off of any makeup each night before bed," says Dr. Nazarian.

Be sure to pick products that do not contain irritating ingredients. "I suggest avoiding parabens, fragrance, oils, and alcohol, as these ingredients can further irritate the skin," says Aguilar. "Mineral-based foundation powders offer a breathable yet lightweight coverage."

If you prefer to forgo makeup completely, you can try other at-home tricks. "Ice your breakouts morning and night for one to two minutes to reduce the inflammation and help with painful cysts," says Brownlee. She also recommends changing your pillowcases daily or every other day and washing them with a laundry detergent designed for sensitive skin.

Hormonal acne during pregnancy does not happen to everyone. If it happens to you, take comfort knowing you are not alone and that there are pregnancy-safe treatments available. Talk to your healthcare provider to figure out which treatment options may be the best for you.