What is acne?
Acne vulgaris acne for short is a common skin disorder that persists over many decades. It affects the pilosebaceous units in the skin, and typically appears on regions of the body with the biggest sebaceous glands, and with sebaceous glands that are particularly responsive to hormone levels. Generally, this means in the face, chest, neck, and back. Acne can range in severity from very mild consisting of a few pink pimples with small amounts of pus appearing and disappearing over time, to very severe forms consisting of numerous, large, very pussy nodules concentrated together.
How common is acne during pregnancy?
Acne develops in most people during adolescence, at which time approximately 15-20 percent experience moderate to severe disease. In many cases, moderate or even severe acne can continue into the reproductive years. At the same time, the hormonal changes of pregnancy can trigger acne breakouts in some women who did not previously have more than a mild case, or who may have been completely clear-skinned prior to getting pregnant.
How is acne diagnosed?
Acne is diagnosed based on physical examination of the lesions on your skin, and based on your history including multiple episodes of pus-filled lesions that may be painful. In women, having a history of flare-ups just before your menstrual period flares also aids the diagnosis. Laboratory tests are almost never needed. However, your doctor may wish to run hormone tests to rule out a condition called hyperandrogenism (excessive production of male hormones) as an underlying reason for the acne.
Does acne cause problems during pregnancy?
Acne can lead to scarring and areas of skin that are reduced in color compared with the surrounding skin (called hypopigmentation). The acne lesions, the scarring, and the hypopigmentation can have psychological effects, such as giving you low self-esteem.
Does acne cause problems for the baby?
Acne is limited to the skin and does not cause any problems for the baby.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the acne
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat my acne during pregnancy?
The standard treatment for mild to moderate cases of acne consists of retinoids, antibiotics, and a compound called benzoyl peroxide, all given as creams that are applied topically, meaning that you apply it directly to the skin. Retinoids are medications that are related chemically to vitamin A and the most commonly prescribed one is isotretinoin. More severe cases can be treated with oral antibiotics and in some cases oral isotretinoin. In women, hormone therapy consisting of certain oral contraceptives also can be given. If you are pregnant, however, isotretinoin should be avoided, since it may cause birth defects. Oral contraceptives also cannot be given during pregnancy. Benzoyl peroxide will bleach clothing, towels, and linen, so when using it you might want to be careful to keep it away from any material that you dont want to get bleached. You may want to use white, or old, towels for your hands after you apply the treatment.
Who should NOT stop taking medication for acne during pregnancy?
Somebody who is using benzoyl peroxide and antibiotics topically for acne has no need to stop treatment during pregnancy. If you are taking isotretinoin, however, this medication needs to be changed. Generally, the only way to become pregnant while taking oral contraceptives for acne is not to follow the prescribed schedule for taking the pills, but if you are taking oral contraceptives these too must be stopped during pregnancy. Certain antibiotics given orally are safe during pregnancy, while some antibiotics are subjects of concern. Thus, in some cases, your antibiotic may need to be changed.
What should I know about choosing a medication for my acne during pregnancy?
You may find Pregistrys expert reports about the individual medications to treat acne here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for my acne when I am breastfeeding?
Retinoid medications, such as isotretinoin, must be avoided if you are breastfeeding.
What alternative therapies besides medications can I use to treat my acne during pregnancy?
Mild cases can be treated by washing the face 2-3 times per day with mild, slightly acidic, oil-free soap. However, you should not wash your face more frequently than this, nor excessively. Other treatments include acne surgery and photodynamic therapy (PDT). In PDT, the patient is given a medication called a photosensitizer and the lesions are then treated with light of a specific wavelength (color).
What can I do for myself and my baby when I have acne during pregnancy?
Use your topical and oral medications as directed and comply with your doctors recommendations.
Resources for acne in pregnancy:
For more information about acne during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:
- Mayo Clinic: What’s the best way to treat pregnancy acne?
- What to Expect: Pregnancy Acne
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.