Overview

Acne is a persistent problem for many women, and the fluctuating hormones that accompany pregnancy can make acne worse. While it's tempting to consider a high-powered prescription medication to counteract acne's effects, pregnant women should talk with their health care practitioner. Most may be counseled to avoid acne medications at least through pregnancy; often until they have finished breast feeding.

Medications to Avoid

Accutane (isotrenoin) has been linked to miscarriage and fetal abnormalities when used in the first trimester. It has also been linked with increased risk of infant death if used during pregnancy. Retin-A (tretinoin) is a topical treatment that can pass into your blood stream. This means that only a small amount can reach the fetus. Thus, it is considered low risk. However, it is generally avoided during pregnancy unless the risk to the fetus is outweighed by the benefit to the mother. Tetracycline, an oral antibiotic, has been deemed safe by the American Academy of Pediatrics while breastfeeding. However, its use during pregnancy has been linked with issues in bone growth and discoloration of the teeth.

Medications That Are Safe

There are a number of medications that are safe to use while pregnant. These include benzoyl peroxide, clindamycin, erythromycin and sodium sulfacetamide. However, only the topical form that you rub onto your skin is deemed safe. Oral forms are not recommended while pregnant.

Medications That Are Unknown

Because of the ethics involved with studying the impact on developing fetuses, there are many medications that aren't clearly a risk, but are deemed best to avoid. These include hydrocortisone, azelaic acid, salicylic acid and adapalene. Women who have used these medications in just the topical form report birth defects. And, to add to the confusion, some are safe up until the third trimester. Since the cutoff for when this trimester begins for some women may not be clear, it's best to avoid them altogether.

Time Frame

Generally, acne ends with pregnancy. As your hormones level off, your skin returns to its more normal appearance. If acne continues to bother you, check with your dermatologist and pediatrician before using a prescription if you are breastfeeding.

Warning

If you are taking Accutane and become pregnant by accident, your doctor may counsel you to consider terminating your pregnancy. This is due to the high risk of fetal abnormalities linked to first trimester use of this medication.