Pregnancy comes with a minefield of advice from doctors, midwives, well-meaning friends and family, not to mention social media and other mothers.
There are foods and unapproved medicines to avoid. However, skin care is not so clear cut. Some products are OK, while others are not recommended.
For example, a family of ingredients known as retinoids has skyrocketed in popularity in skin care products, but there is conflicting advice about their safety for pregnant women.
What are retinoids?
Retinoids are a general term for vitamin A derivatives that treat all kinds of skin concerns, from acne to wrinkles, fine lines, and pigmentation.
“They’re the gold standard ingredient in skin care because they’re good for so many things,” says Michelle Wong, a Sydney-based chemist and science communicator.
Retinoids come in different forms.
The most powerful are prescription-only acne medications, such as isotretinone, which is taken orally, and tretinoin, which is applied to the skin to treat severe acne.
Isotretinol packages are clearly labeled. (Provided by: Sam Yearwood)
In addition, pharmacist-only products containing adapalene and various “over-the-counter” retinoids found in topical creams applied to the skin, such as retinal and retinol, are found in much lower concentrations.
it is widely accepted Oral retinoids are not safe for pregnant women and may cause birth defects — and it is clearly labeled on the packaging and drug information leaflet. Topical retinoids, which are available only by prescription and only by pharmacists, also have warnings.
But what about over-the-counter (OTC) topical retinoid products?
Confusing advice for pregnant women
NSW Health Mother SafeNSW Health’s maternal service, OTC creams, are safe for pregnant women to use as they are applied topically and in small doses, but they advise against using prescribed topical treatments.
Dr. Wong agrees.
“If you look at standard retinol products on the market, they should be safe during pregnancy unless people are using them in strange ways,” she says.
However, many medical professionals advise against using topical retinoids of any kind.
Retinoids are often used to treat acne. (Pixabay: Sharon McCutcheon/ABC Life: Daniel Mee)
Laura Garhadi, a maternal-fetal medicine expert who studies the effects of drugs during pregnancy, says there aren’t enough studies to make a firm call about using topical retinoids during pregnancy.
“Part of the reason is that most people who use topical retinoids do so for conditions that don’t need to be treated during pregnancy, such as acne.”
There are no mandatory standards for the labeling of cosmetic skin care products containing retinoids such as retinal or retinol. The only nonprescription topical products that require labeling are those containing adapalene. These products have recently been downgraded from being prescription-only and are now available as over-the-counter products in pharmacies.
Dr. Gerhadi says there is no clear labeling because there are no specific guidelines for what is safe and what is not.
“for [all] There’s no significant information on topical retinoids, but the message is that if you use them, they’re probably OK.
“It’s very difficult to convey that in one sentence on the package. It’s easy with oral retinoids. They are certainly harmful during pregnancy.”
“But the topics are even more difficult because there is no data,” she says.
Retinol is a type of retinoid that treats fine lines. (unsplash)
Research on both prescription drugs and over-the-counter topical retinoids is limited, so guidance from health care professionals is usually interchangeable.
Deshan Sevaratnam, a dermatologist at Liverpool Hospital, said he advises pregnant patients to avoid the use of all retinoids, including retinol, as a precaution.
“Like alcohol, avoiding retinol during pregnancy is the safest choice, but the absolute risk is low,” he says.
Similarly, The American College of Obstetricians and Gynecologists says: Neither prescription nor over-the-counter products are recommended, even if the amount absorbed by the body is small.
What if I accidentally use a topical retinoid during pregnancy?
Dr. Wong says pregnant women who may have unknowingly used topical retinoids don’t need to worry.
“Using topical retinoids during pregnancy is generally not recommended, but there’s no need to panic if you accidentally use one or two,” she says.
“When applied topically, the amount of product that enters the body is very small.
“This includes from prescription creams,” she says, but adds, “There’s still a hierarchy of risks. For example, tretinoin has the highest risk.”
a A large-scale Nordic study published last year They found that although the use of topical retinoids has increased significantly over the past 20 years, there was no evidence of an increased risk of birth defects in infants exposed to topical retinoids during pregnancy.
The authors say these study results are “the strongest evidence to date for the safety of topical retinoids during pregnancy,” but also acknowledge that the studies may have underestimated the risks and that more research is needed.
If you are considering using a topical retinoid product, please consult your doctor for advice.
Other notable skin care ingredients
Professor Sevaratnam recommends avoiding minoxidil and hydroquinone, which treat age spots.
“Most other over-the-counter beauty products are probably safe,” he says.
“But mothers should consider whether they really need to use it.”
Other products that Dr. Wong recommends being careful of are online products that may be unregulated or may use high doses of salicylic acid, a cleanser that is also a chemical exfoliant.
Mothersafe NSW says salicylic acid is safe when used in small amounts, but “in certain circumstances the amount of salicylic acid absorbed can be high and the safety of use should be checked with MotherSafe or your healthcare provider”.
Dr. Wong also warns against using beauty products purchased online without verified information.
“I would be cautious about these kinds of products that are really cheap and incredibly good,” Dr. Wong says.
For most pregnant women, the safest approach is to stick to simplicity. Use well-regulated products and consult your doctor.