Skincare in pregnancy can be a minefield. This is partially due to a change in skin needs and behaviour for many women, but it’s just as much due to pregnancy scaremongering in beauty marketing. It is profitable to spook consumers into thinking that they need an entirely new wardrobe of skincare during pregnancy. While there are some ingredients to avoid while you’re pregnant, the reality is that most over-the-counter products are fine to use.
I asked Galway-based GP and clinical director of the Dr Laura Clinic, Dr Laura Lenihan, who specialises in skin and aesthetics, for her advice on approaching your skin’s changing needs during pregnancy.
“Acne in pregnancy is unfortunately very common and something we see in clinic all the time,” says Lenihan. “The increase in progesterones produced in the first trimester leads to increased oil levels.” In some people – even those with no history of hormonal breakouts, acne can occur. Lenihan says that many women dismiss skin issues in pregnancy as something they just have to put up with. Many “women somehow think it can’t be treated, when in fact it can, and quite easily”, Lenihan says. “There are lots of over-the-counter products that can be used as well as prescription creams”, so it is worth seeing your doctor if you’re suddenly struggling with acne, or other common pregnancy-related skin concerns such as rosacea or melasma – a form of hormone-induced pigmentation. “Itchy skin is another really common complaint due to increased blood flow and skin stretching,” says Lenihan. “It’s important to keep skin nourished and moisturised to help with this.”
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Lenihan attests that skincare scaremongering is very real. “The issue,” she says, “is that pharmaceutical companies and even skincare companies don’t test their products on pregnant women.” This doesn’t mean there is necessarily any risk to using a product, however. “We know from clinical studies that ingredients such as benzoyl peroxide, salicylic acid, tretinoin are not detected in the blood after topical application. This is very reassuring ... my advice in clinic is that all over-the-counter products are safe in pregnancy, with pretty much no exceptions that I have yet to come across.”
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Prescription products are another matter, Lenihan says. “The only things that you cannot use in pregnancy are prescription tretinoin and hydroquinone. Oral vitamin A can cause birth defects, and although it’s thought not to be absorbed topically, we typically stay clear of topical vitamin A prescription strength – so tretinoin or adapalene. Hydroquinone is a prescription bleaching cream that is absorbed systemically by up to 35 per cent, so it is something that we avoid in both pregnancy and breastfeeding, though no adverse effects have ever been found.” It is essential, she says, to see your doctor to discuss which prescription skincare is right for you.
Lenihan recommends using a gentle cleanser to support your skin’s barrier. “Skingredients PreProbiotic Cleanse [€29 at skingredients.com] is my absolute favourite,” she says. In terms of hardworking ingredients, she recommends “azelaic acid for everything from acne and rosacea to pigmentation. It’s one of my go-tos” for pregnant patients “and I use it at prescription strength quite a lot. Niacinamide is another great ingredient in pregnancy. Metacell Renewal B3 from SkinCeuticals [€135 at stockists nationwide] is my holy grail product [whether pregnant or not]. It’s a potent antioxidant but also works to balance oil levels, reduce inflammation and improve overall skin health.”
For a changing body, Lenihan recommends good quality, simple oil-based products to help support skin as it stretches and may become drier. “Bioderma Atoderm Shower Oil [€19 for 1 litre at selected pharmacies] is one of the most nourishing, hydrating” washes and is supremely gentle on skin. She recommends moisturising with an oil after your shower – Aveeno Skin Relief Body Oil Spray (€10 at pharmacies nationwide) is ideal, cost effective and easy to apply.
One key piece of advice? Lenihan says “don’t fall for the ‘products that stop stretch marks’ spiel. It won’t work. You are either susceptible or not, unfortunately.” Stretch marks are normal. What you can do is moisturise daily to help your skin meet the new demands upon it, maximise your comfort and prevent itching. “La Roche-Posay Lipikar Balme AP+M [€25 at Boots] is another one of my favourite body moisturisers, with some of my favourite ingredients like glycerine and niacinamide. It’s nourishing enough to soothe dry, itchy irritated skin.”
