As we put on serums, creams, and lotions day today, we don’t always think about what may be being absorbed into our bodies. Although many of these products are safe to use since they have low absorption rates, the more powerful medications require a greater deal of scrutiny. Listed below is a list of ingredients and products that are most frequently questioned regarding their safety and use in pregnancy and nursing.
Retinoids
Retinoids are typically found in anti-aging skincare and are targeted for reducing wrinkles and fine lines, treating acne, as well as improving skin tone. Retinoids are a class of Vitamin A that speeds up cell turnover and prevents collagen from breaking down.
There are four published case reports of birth defects in the literature associated with the topical retinoid tretinoin. Oral retinoids, such as isotretinoin (found in Accutane), are also known to cause birth defects. Therefore, ALL retinols should be avoided in pregnancy and nursing.
What to look for on the label:
- Differin (adapalene)
- Retin-A, Renoval (tretinoin)
- Retinoic acid
- Retinol
- Retrinal
- Retinal
- Retinyl linoleate
- Retinyl palmitate
- Retinaldehyde
- Tazorac (Tazarotene)
Salicylic acid
Salicylic acid is a mild acid that is used to treat acne. Salicylic acid is in the aspirin family, so it can help decrease inflammation and redness. BHA is also a form of salicylic acid, and is used in some topical exfoliants geared toward anti-aging.
There is some controversy on whether or not this ingredient is 100% safe to use during pregnancy, and likely depends on how it is being used, the amount being used, and the pH. High doses of salicylic acid taken orally has been shown to cause birth defects and various pregnancy complications. When applying salicylic acid to the skin, small amounts are deemed safe to use during pregnancy. However, face and body peels containing salicylic acid are concerning, and should be discussed with your doctor before use. Although small amounts of salicylic acid may be safe, we do not recommend using it in pregnancy or nursing.
What to look for on the label:
- Salicylic acid
- Beta hydroxy acid (BHA)
Topical Antibiotics and Acne Agents
Topical clindamycin and erythromycin are typically used alone or alongside other topical medications to treat acne, and have shown no increased risk of use during pregnancy or while nursing.
Benzyol peroxide is another agent used to treat acne, and when applied topically, is only 5% absorbed through the skin. No studies have been published in the literature; however, it is deemed safe to use in small quantities while pregnant or nursing.
Lastly, glycolic acid is found in many topical skincare products targeted at treating acne. Studies examining the use of glycolic acid during pregnancy have not been conducted, however, topical application is not suspected to be of concern since the amount expected to be absorbed is minimal.
Soy
Many moms like to choose skincare products labeled as “organic” with the assumption and hope that they are safe to use during pregnancy. This is not necessarily the case; so soy-containing products should be carefully examined.
Soy-containing skincare products are generally safe to use during pregnancy, however, these products can make skin problems like the “mask of pregnancy” worse (darkened skin splotches found on the face). Soy has estrogenic effects, which can make those dark patches worse. Soy is also an ingredient to avoid in pregnancy and nursing.
What to look for on the label:
- Lethicin
- Phosphatidylcholine
- Soy
- Textured vegetable protein (TVP)
Hair Removers
Hair removal products (depilatories) and hair-bleaching creams generally get the OK to use during pregnancy. If you have in the past, however, experienced any sort of allergic reaction or irritation, you should avoid using them in pregnancy as well.
What to look for on the label:
- Potassium Thioglycolate (depilatory)
- Calcium Thioglycolate (depilatory)
- Sodium Hydroxide (minimizer)
- Sanguisorba Officinalis Root Extract (minimizer)
- Hydrolyzed Soy Protein (minimizer)
Skin lighteners
Hydroquinione is a skin de-pigmenting agent used to treat conditions like melasma. Hydroquinone is estimated to be 35-45% systemically absorbed following topical use. Due to substantial absorption compared with other products, we do not recommend hydroquinone to be used during pregnancy or nursing.
Sunscreens
Sunscreens are used commonly to protect the skin from the sun’s harmful rays and are necessary for everyone. Sunscreens have very limited absorption and are considered safe to use during pregnancy. Sunscreen is also smart to use to prevent the pregnancy mask (melasma). It’s important to note that sunscreens have recently been under scrutiny. To find the safest sunscreen, please visit the Environmental Working Group’s website page on safe sunscreen.
What to look for on the label:
- Titanium dioxide
- Zinc oxide
- Avobenzone (Parsol 1789)
- Oxybenzone
- Dioxybenzone
- Benzophenone
- Octyl methoxycinnamate (OMC)
- Para-aminobenzoic acid (PABA)
- Octocrylene
Self Tanners
Self-tanning products contain an ingredient called Dihydroxyacetone (DHA), which produces a dark pigment on the topmost layer of the skin. DHA is only minimally absorbed through the skin (1-15%), and therefore use during pregnancy or nursing should not be of concern.
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