How can I get rid of acne during pregnancy?

 Your doctor or dermatologist will likely still prescribe you benzoyl peroxide or azelaic acid if you have mild to moderate acne during pregnancy [9].

These are topical agents and generally considered safe, though it’s worth knowing that small amounts still get into your body. Up to 5% of benzoyl peroxide is absorbed through your skin, but your kidneys quickly get rid of it. Around 4% of azelaic acid is absorbed too [10].

Many other conventional acne treatments are off the table during pregnancy. This restriction is generally for one of two reasons:

– Some anti-acne medications have been found to harm the developing baby. We know that isotretinoin (Roaccutane) can cause foetal abnormalities, which is why you have to use two forms of contraception while taking it. Some antibiotics can cause problems too [11].

– Other medications and substances simply haven’t been studied enough in pregnant women [10]. This means it’s safer not to use them than to risk it. After all, no one wants their baby to be an experiment.

If you have any questions about taking medications during pregnancy, you should always speak to your doctor.

Acne during pregnancy: natural approaches

Due to concern for their developing baby (and increased awareness of their own health), many women prefer to explore natural options to deal with their pregnancy acne.

When it comes to getting that pregnancy glow, there are four key strategies:

1) Optimise your diet

2) Get serious about sleep

3) Use fewer products

4) Get smart about supplements

Let’s take a closer look at each.

Pregnancy acne strategy 1: Optimise your diet

Let’s be real: between morning sickness and cravings, it can be hard to eat well during pregnancy. That’s totally understandable—but even small tweaks can make a big difference.

As much as you can, focus on the following:

Balance your blood sugar

A stable blood-sugar level can not only help to settle some of the hormones that drive acne pathways in the body [12], but it can also help to reduce pregnancy-related nausea. It’s a win-win.

In practice, balancing your blood sugar means choosing complex carbohydrates as much as you can (think brown rice rather than white), and eating a source of protein or healthy fat with every meal or snack. Cramming in as many fruits as vegetables as you manage can help too [13], and you can blend them into smoothies to make them easier to get down.

Minimise sugary drinks

Excess sugar can drive acne, whether you’re pregnant or not [14]. And a 2020 study found sugary drinks to be especially acne-triggering [15]. An easy win here is to stay away from fizzy drinks and fruit juices, as these contain a hefty dose of the sweet stuff. Flavour your water with fresh fruit and herbs instead.

 A low-added-sugar diet is preferable at all times—but it’s also important you do what’s right for your body. Sometimes during pregnancy, a ginger biscuit is the only thing that can stop you feeling queasy, and that’s okay!

Consider your dairy intake

Like sugar, dairy can play a role in acne in some people [16]. But pregnancy is not the time to cut out food groups, as you need all the nourishment you can get for you and your growing baby.

Forms of dairy that are less likely to contribute to acne include yoghurt, kefir and hard cheese [17]. Instead of milk, trying having natural yoghurt with your morning cereal and see if it makes a difference to your skin.

For a step-by-step guide to creating the best diet for you, check out The Happy Skin Roadmap.

Pregnancy acne strategy 2: Get serious about sleep

You’ve probably had countless comments about how you should sleep as much as you can before your baby arrives, especially if it’s your first. This may or may not prepare you for the sleepless nights to come, but it may help your skin!

Sleep is not only a time for growth and repair, but it’s also a powerful de-stressor. As stress is a known driver of acne [18], anything you can do to minimise it can help to support a clearer complexion.

To get a good night’s kip, go to bed well before midnight, and make sure your room is cool and dark. As your bump grows, it will become more important than ever to make sure your bed is comfortable too. If you struggle to get to sleep (or find yourself waking in the night), a pre-bed mediation could become your secret weapon.

Pregnancy acne strategy 3: Use fewer products

Acne in early pregnancy can make you panic and think you need to clean your face repeatedly, or use harsh products to dry the spots up.

Neither is likely to help. More and more research is showing that your skin’s acid mantle (its naturally acidic barrier) and its microbiome (its community of naturally occurring microbes) play a role in warding off acne [19]. Using too many products too often can damage this acidic barrier and strip your skin of friendly microbes—making acne worse.

Consider these questions:

– Do you need to use a cleanser in the morning? Or could you just rinse your face with water instead?

– Do you need to exfoliate in the evening? Or can you just use a gentle, pH-balanced cleanser to clean your face before bed?

– Do you need to layer products? Or are fewer targeted products enough?

One product you may want to include is a vitamin C serum, as research has found this can help to calm breakouts [20]. Unlike retinoids, this is safe to use during pregnancy. Look for a formulation with vitamin C in the form sodium ascorbyl phosphate, and apply it before your moisturiser.

Take the opportunity to re-evaluate your skincare routine. You may well find that doing less helps to create calmer skin.

Pregnancy acne strategy 4: Get smart about supplements

Like medications, some supplements are best avoided during pregnancy, while others are fine to take. The below are considered safe during pregnancy, and they can help to support clear skin. Please note, you should always consult your doctor before taking supplements (whether you’re pregnant or not).

A multi-nutrient (including a range of vitamins and minerals)

Growing a baby is a demanding task, and your body will draw on all your stores of vitamins and minerals to ensure your little one is as healthy as possible.

A high-quality multi-nutrient can give your body a helping hand. A broad spectrum of vitamins and minerals is important, but look for one in particular that contains beta-carotene and vitamin D. Here’s why:

– Beta-carotene is a pregnancy-safe form of vitamin A, which plays a key role in keeping skin healthy. Many pregnant women have been found to be deficient in vitamin A [21].

– Vitamin D tends to be low in people living in the northern hemisphere, and it’s particularly low in acne sufferers [22]. Vitamin D3 is a form that’s easy for your body to use.

Most high-quality pregnancy multi-nutrients contain these, along with other important nutrients such as folic acid and iron.

Probiotics

Probiotics are friendly bacteria, which support your digestion, skin and more. A large study of studies found that taking probiotics during pregnancy was safe for both mother and child [23].

Species of bacteria that have been found to be helpful for acne include Bifidobacterium bifidum, Lactobacillus acidophilus and Lactobacillus paracesei [19, 24]. Look for a formulation that contains lots of different strains of bacteria, with 20–50 billion colony forming units per capsule.

A word of caution: a probiotic yeast that’s helpful for acne, Saccharomyces boulardii, has not been studied during pregnancy. Until we know more, it’s best to steer clear of that one.

Fish oil

Essential omega-3 fats in fish oil have been found to reduce acne, perhaps due to their anti-inflammatory action [25].

Omega-3 fats are found naturally in oily fish, but pregnant women are advised not to eat more than two portions of oily fish a week because they contain pollutants. A high-quality fish oil supplement can be a good alternative—both for your skin and your baby­—because any contaminants and pollutants are removed.

Studies have found that taking up to 2.7g omega-3 a day (roughly the amount found in 2–3 fish oil capsules) is fine during pregnancy [26].

Zinc

Zinc is an essential mineral with hundreds of functions in the body. Taking zinc has been found to improve acne, likely because it has anti-inflammatory action and can reduce the production of sebum [27]. Zinc has even been proposed as a safe alternative to antibiotics for the treatment of acne during pregnancy [28].

Pregnant women need 7mg of zinc per day (whether they have acne or not), and this amount may be 50% higher in those eating a plant-based diet [29]. This is because certain substances in plant foods can stop your body from absorbing zinc [30].

If your pregnancy multi-nutrient doesn’t contain zinc (and most do), it could be worth trying a zinc supplement. Take no more than 25mg/day, and reassess whether you need it after three months.

Takeaway points

 Acne is common during pregnancy, but there’s a lot you can do about it. Here’s what you need to know:

– Acne is driven by a combination of factors. Scientists aren’t sure what makes it worse during pregnancy, though it’s likely down to hormones and shifts in the immune system.

– Pregnancy acne can start at any time. You’re more likely to have it if you’ve previously suffered from acne. It most often appears on the face, but it can crop up on the chest and back too.

– Pregnancy acne doesn’t necessarily mean you’re having a girl. There’s still a 50:50 chance!

– Your doctor may prescribe benzoyl peroxide and azelaic acid during pregnancy, but many other medications and products aren’t considered safe.

– You can help acne during pregnancy by monitoring your sugar and dairy intake, prioritising sleep and using fewer products on your face.

– You can also take some anti-acne supplements during pregnancy. These include a high-quality multi-nutrient, probiotics, fish oil and zinc. Always consult your doctor before starting a course of supplements.

Want to learn more? Get your copy of The Happy Skin Roadmap.