Acne is very common in pregnancy. Apart from dealing with all the hormonal changes of pregnancy, over 50% of women will develop significant skin changes associated with pregnancy.
Skin changes include acne, increased pigmentation called melasma, as well as increased blood vessels.
Fortunately the Specialists at Westside Laser Dermatology are experts in treating all these conditions.
We use a combination of creams, natural chemical peels and phototherapy to treat pregnancy related acne. This combination is effective, but most importantly pregnancy safe.
Specialist Perspective on Acne Solutions
Dealing with pregnancy is difficult enough, but dealing with acne breakouts can really be frustrating. Pregnancy causes skin changes such as increased oil production as well as increased pigmentation, a condition known as melasma, or the mask of pregnancy. Most of the skin changes occur within the first trimester, and can carry through pregnancy. The most important thing to consider with acne treatment in pregnancy is safety. As a rule I only use creams, washes, lotions and low-level light treatment. Red or Blue light therapy, such as Omnilux can reduce the bacterial counts, and decrease acne lesions. Most importantly acne phototherapy is safe for both mum and the unborn child. Dermatologists do not like to use Omnilux phototherapy as a stand-alone treatment because this is only a temporary fix for acne at best. The use of this method in pregnancy is adjunctive, essentially holding the acne back until delivery. Chemical peels with fruit acids, such as medium strength Alpha Hydroxy Acid peels can be very effective in blackhead acne, and can have a mild to modest improvement in acne scarring. Like acne phototherapy, AHAs are safe in pregnancy.
The primary cause of acne during pregnancy is the increased levels of hormone during the first trimester. This increase of hormones also elevates the production of natural oils from your sebaceous (acne) glands. If you are acne free during your first 3 months of pregnancy, you have a good chance you will be acne free for the remainder of your pregnancy.
Some acne treatments (vitamin A creams and tablets) are unsafe in pregnancy, however there are safe and effective treatment methods to help reduce acne and minimise acne scars.
Medication that is applied to the skin or swallowed can enter your bloodstream so it’s important that you only use safe medications in pregnancy. Safe treatments options for acne in pregnancy include-
Such as Proactive and Benzac AC wash and gel. Benzac AC is stronger and cheaper than Proactive.
Light treatments including OMNILUX phototherapy
Super safe as light treatments are directed on acne prone areas, this can eliminate the need for medications, and can hold back acne for a few months. Never use this as a cure for acne, because it doesn't work! Specialists use this treatment as adjunctive, especially in the setting of pregnancy. Omnilux Blue phototherapy treats more superficial lesions, whilst red light phototherapy penetrates to deeper acne lesions. Acne phototherapy is safe, painless and can be effective in holding back acne. Sessions start at $45.
Clindamycin and Erythomycin tablets are safe, however most Specialist will try to avoid them if possible.
Gels and lotions
Eryacne or Clindatech as well as Azelaic acid (Finacea) are absolutely safe in pregnancy.
You have head that in some cases diet can improve acne, especially if you are on a high sugar diet. Most commonly acne in pregnancy is not diet related, however being on the acne diet can marginally help your condition.
Unfortunately the best treatments for acne either target the oil gland or inhibit the hormones that promote acne in the first place. Additionally the best antibiotics are unsafe in pregnancy.
Unsafe treatments in pregnancy include the following medications-
- Roaccutane or Oratane. This is a tablet that has revolutionized the way we treat severe scarring acne, and remains as the best tablet to treat acne, however this is absolutely contraindicated in pregnancy. That is because the drug can have very serious effects on the developing baby, and in the majority of times will cause birth defects.
- Creams containing Vitamin A, such as Differin, Zorac, Epiduo , Retreive and Stifel A. No scientific evidence that creams cause birth defects in humans, but on the side of caution, you should not use Vitamin A products during pregnancy.
- Antibiotics such as Tetracyclines, Minocycline are not indicated in pregnant women with acne
- Hormone treatments such as Cyperterone Acetate and Spironolactone are not safe in pregnancy.
Your specialist will guide you as to what can be taken safely after the delivery of your baby.
Simple tips can minimise acne scarring during this difficult time of your life, however they can make a dramatic difference.
- Wash your face twice a day. Use a gentle cleanser such as Cetaphil wash, or QV wash. Avoid harsh exfoliants.
- After cleansing, avoid rubbing your face with a towel. Pat dry instead.
- Above all - avoid scratching, picking or popping your pimples. This can lead to infection and is the number one cause of scarring.
- If you use cosmetics ensure that they are oil free and non-comedogenic. Mineral make up is a good starting point.
- Avoid toners and alcohol based lotions- they can strip your skin of protective oils and cause unwanted skin irritation.
The first step is to minimise scarring (see above). Treating acne scarring during pregnancy can be tricky. Laser treatment has no adverse effects on the developing baby, however the procedure can cause unwanted stress in some mothers. As Specialists we make it a policy not to treat pregnant women with laser. Solutions however are possible-
Fruit acids called AHAs are 100% safe in pregnancy and can be a modest way of treating acne and early scarring
The Clear Skin Program
A safe and modest method of treating both acne and acne scarring in pregnancy. This uses Red Light as a natural method of scar revision (called low level laser treatment). Red light also activates porphyrins found in bacteria associated acne. This reaction can kill unwanted bacteria associated with acne lesions.
Can be effective and decrease acne lesions to varying degrees. Obviously 100% safe in pregnant women.
Phototherapy using non-laser light can improve acne lesions and can suppress up to 90% of pimples and outbreaks. Two wavelengths of light can be utilized to treat acne lesions.
Blue light phototherapy
Devices such as OMNILUX BLUE, Crystalite Blue LED, and BBL Blue filtered light delivers blue light in the 405-415 nm spectrum. This targets superficial lesions of acne by destroying acne-forming bacteria.
Red light phototherapy
Devices such as OMNILUX RED, Crystalite Red LED and Aktalite delivers red light in the 630 nm range. This wavelength of light targets deeper acne lesions compared to blue light phototherapy.
Acne phototherapy treatment takes a few painless minutes to perform, and is safe to both mum and baby, and is the ideal method of treating acne in pregnancy. Sessions start from $45.
Hard to make a call on this one! In some cases acne subsides when hormone levels return to normal, however at least 50% of patients will have persistent acne. What acne treatments are suitable will depend whether you breast-feed or not.
Acne phototherapy sessions can be carried forth through out breastfeeding, and the majority of creams are safe during this period.
Lots! Even though treatments such as laser therapy are safe in pregnancy we do not perform any scar revision during pregnancy due the potential stress of the procedure for some patients. By seeing a dermatologist during pregnancy, we can place you on a program to minimise your acne scarring prior to delivery.
Post pregnancy treatments such as fractional lasers and vascular laser can be used to treat red acne scars, depending on the type of acne scars your have. Solutions are always possible.
Specialist Dermatologists can assist you thru this difficult time. We can combine safe treatment methods such as creams, lotions, and low-level light treatment such as phototherapy to improve your acne during pregnancy. We also co-ordinate with your GP and your obstetrician in regards to your treatment and will come up with a solution no matter how difficult the situation.