How to get rid of pregnancy acne

Is acne a sign of pregnancy? | Acne during pregnancy | Pregnancy-safe treatments | When to see a doctor

Everybody knows the sinking feeling of discovering a zit, or pimple, at just the wrong moment. Acne—the bumps that occur when your follicles become clogged with dead skin cells, oil, or bacteria—can be a real stressor, especially in your teen years, when it’s most common. But imagine getting it when you’re expecting, when your body is supposed to be glowing. It’s unfortunate, but pregnancy acne is a pretty common side effect of having a baby.

Is acne a sign of pregnancy?

About 42% of pregnant women develop acne, according to a 2017 review article. “Some pregnant women don’t get acne,” says Sandy Skotnicki, MD, the founding director of the Bay Dermatology Centre and an assistant professor at the University of Toronto Department of Medicine. “We say you’ve got a 50% chance your acne is going to stay the same and 50% it’s going to get worse. It really depends on if you [had] acne previously.” Meaning, acne isn’t necessarily a sign of pregnancy, but it is a possibility during pregnancy.

When does pregnancy acne start?

Pregnancy acne begins most often “during the first trimester, usually at around six weeks, and even into your second trimester,” says Angie Seelal, RPA-C, a physician assistant specializing in dermatology at Advanced Dermatology in Long Island, New York. Acne can improve during the first trimester, but could worsen during the third trimester due to increased sebum production.

Acne during pregnancy

What causes acne to develop or worsen during pregnancy? When you’re pregnant, your hormone levels are fluctuating. As a result, your skin changes and often oil production increases. “Progesterone, especially, determines the increase of natural oil secretion in the skin (known as sebum), which blocks the pores and determines an accumulation of bacteria,” says Seelal. Also, your immune system experiences changes in order to protect the pregnancy. These changes may result in more inflammation and skin irritation.

You can also be genetically predisposed to pregnancy acne, or you might have had acne prior to being pregnant. Both of those risk factors make you more susceptible to breakouts during pregnancy.

“I’ll often say to women in their early 20s with quite significant acne, we really need to try to shut this off,” Dr. Skotnicki says. “I tell them, if you get pregnant, or when you get pregnant, your acne might get problematic. And we can’t do a lot for your acne in pregnancy. There aren’t a lot of options.”

RELATED: 8 causes of adult acne

What does pregnancy acne look like?

Pregnancy acne looks just like any other standard acne breakout. It’s usually red or pink, your skin is sensitive, and it appears as little bumps on your skin in a rash-like pattern. During pregnancy, there may be more inflammation (redness, swollen lesions) and increased body (chest and back) acne.

Where is pregnancy acne located?

Most commonly, pregnancy acne occurs on your chin, jawline, hairline, neck, chest, and back. But it can appear anywhere on your body depending on the severity.

“Hormonal acne is usually on the jawline,” Dr. Skotnicki says. “Often in women that aren’t pregnant, it’s cyclical. They’ll get cystic acne on their chin and jawline right before their period or during their period. Pregnancy acne is very similar. In cases that are very bad, they can have it all over.”

Do you break out more when pregnant with a boy or girl?

The gender of your child is irrelevant when it comes to pregnancy breakouts. No scientific evidence shows more or less when you’re pregnant with a boy or girl—despite any superstitions to the contrary. The hormone changes producing acne happens with pregnancy in general.

That being said, if you’re pregnant with multiple children, you have a higher hormone load—which means you are a bit more likely to get pregnancy acne than if you were having a single pregnancy.

Pregnancy acne treatment

To treat pregnancy acne, there are a variety of natural and medicinal treatment options available to you. “You shouldn’t use anything other than a cleanser and moisturizer in the first trimester,” Skotnicki says. 

What not to use

It’s also important to avoid certain medications, skincare products, and home remedies altogether during your pregnancy. All of these have contraindications for pregnancy, whether it’s associated with birth defects, hormone disruption, or can cause developmental problems, according to Dr. Skotnicki:

• Lavender oil
• Tea tree oil
• CaroSpir, Aldactone (spironolactone)
• Oral retinoids (isotretinoin) including Absorica, Amnesteem, Claravis, Myorisan, Sotret, and Zenatane
• Topical retinoids including Retin-A (tretinoin), Differin (adapalene) or Tazarotene (Avage, Fabior, Tazorac, and Zorac)
• Hormonal therapy
• Oral tetracyclines (such as doxycycline, tetracycline and minocycline)

Some people recommend taking vitamin A and zinc supplements, but there is no strong evidence to support their use for the prevention or treatment of acne. Talk with your OB-GYN before taking any supplements. Your prenatal vitamin should be sufficient for your needs.

Natural remedies

Aside from managing stress and eating an anti-inflammatory diet (so long, processed foods, artificial sugars, refined carbs, and trans fats), you have a few natural skin care options to fight your pregnancy acne. According to the American College of Obstetrics and Gynecology (ACOG), the following steps can help:

• Avoid using hair products such as gels, oils, and pomades that can promote facial acne.
• Cleanse face with a gentle cleanser and lukewarm water twice daily.
• Keep from picking or squeezing blemishes to avoid spreading bacteria and scarring.
• Use only non-comedogenic, oil-free products including moisturizers, makeup, and sunscreens.
• Avoid scented skin care products, scrubs, or harsh treatments such as toners and masks.
• Wash and change pillowcases and towels frequently.

Medical treatments

These acne medications are approved for use during pregnancy, says Dr. Skotnicki. Some acne medications can be expensive. You can use SingleCare to save—even on over-the-counter (OTC) remedies. Just ask your healthcare provider to call in a prescription for the OTC therapy, then bring your coupon to the pharmacy counter.

RELATED: Can I use SingleCare on over-the-counter medication?

When does pregnancy acne go away?

When acne goes away depends on a lot of factors. If you’ve had a risk-free pregnancy and aren’t too stressed, expect it to go away in the third trimester or shortly after giving birth.

“It can linger post-pregnancy because hormones are still fluctuating in the body during these periods,” says Seelal. “Unfortunately, there is no set time frame. Everyone is different and every pregnancy is different as well.”

Anxiety during your pregnancy or after can trigger acne as well, regardless of how far along you are. “It’s not just the fact of carrying a child, it’s all the other things that come along with that,” Skotnicki says. “Some people will find the stress or worry will aggravate their acne, and that can be at different times.”  If your acne persists, and you want to treat acne while breastfeeding, many over-the-counter treatments including benzoyl peroxide and salicylic acid are considered safe. Talk to your pharmacist about what’s right for you.

Try not to stress and remember that the acne, whether you have it and when you have it, isn’t something you can decide—your hormones are leading the charge here.

When to see a provider

Realistically, you don’t need to see a healthcare provider at all for pregnancy acne. The blemishes may be uncomfortable but, Skotnicki says, it’s not harmful to your health or to the viability of your pregnancy. That being said, if severe acne becomes unbearable or it begins to scar, it might be worth speaking to your primary healthcare provider or dermatologist. If you have nodules or cysts or acne in more than 50% of your face, back, or chest, you should seek medical expertise.

Other common pregnancy skin problems

Unfortunately, acne is not the only skin condition pregnancy can cause. You might also experience stretch marks, pigmentation changes, skin tags, and broken capillaries. But on the bright side, most of these skin conditions are temporary, and more treatments are available after you welcome your baby into the world. 

Stretch marks

Rapid weight gain while pregnant (and even when you’re not) can cause stretch marks. They look like long flesh-colored scars. The best way to prevent them, Dr. Skotnicki says, is to control your weight during pregnancy. You cannot prevent them with any creams or lotions.

Pigmentation changes

Melanocytes, the cells that produce skin pigmentation, have estrogen receptors. Because of that, you may see a darkening of the skin on your nipples, in a vertical line from your belly button down to your pubic area, on your moles, and on your cheeks and jawline. The face darkening is called the “mask of pregnancy.” All this hyperpigmentation typically fades after delivery.

Skin tags

You may develop skin tags (little flaps of skin) around the neck, under your arms, or under your breasts. Some of them will shrink or resolve after you give birth and your hormones calm down. If they don’t go away on their own, there are OTC kits to remove them, or your dermatologist can take them off for you by freezing or cutting the skin tag.

Broken capillaries

When you’re pregnant, you have extra blood flow throughout your body. That can lead to broken capillaries, or broken blood vessels, on your legs, chest, or face. They’re called spider veins and show as red splotches or red spider-web-like lines. These should clear up after giving birth, but see a healthcare provider if they don’t.

Unless you’re really concerned, or one of these conditions becomes unbearably uncomfortable, you don’t need to go to a doctor. They’re perfectly normal and will run their course without treatment.