Acne and Pregnancy

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If you are pregnant or intend to get pregnant, you and your doctor will have to consider your treatment options carefully, because many of the usual anti-acne treatments are not suitable for use for use during pregnancy.

  • Isotretinoin capsules must not be used if you are pregnant or intending to become pregnant, as isotretinoin can cause abnormalities in the developing foetus. A pregnancy prevention programme for women prescribed isotretinoin is in place in the UK, and you should have a pregnancy test before treatment, every month during treatment and 5 weeks after stopping treatment. You must also continue to use contraceptives for at least a month after stopping the drug. The US government has similar regulations.
  • Tretinoin cream must also be avoided during pregnancy or if you are intending to become pregnant, for the same reason as above; although it is applied to the skin, a small amount will be absorbed into the bloodstream and could reach the foetus in the womb. This does not appear to be an issue with the novel retinoid gel adapalene, which is now available over the counter in the USA.
  • Tetracycline antibiotics should also not be taken by women who are pregnant or who intend to become pregnant. It can damage the developing teeth and bones of the foetus.
  • Spironolactone can lead to feminization of a male foetus so should also be avoided in pregnancy or by ladies who are trying to conceive.

Benzoyl peroxide cream or gel is the usual option for treating acne during pregnancy.
Another possibility is a solution containing salicylic acid. Erythromycin is the only antibiotic regarded as being safe in pregnancy.


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Reviewed and edited by: Fiona Elliott
Last updated: December 2020

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