Pregnancy-Safe Skincare: Ingredients You Can Use And What To Avoid

Pregnancy can be a strange time for your skin. Breakouts, new patches of pigmentation, sensitivity and dryness are all common, driven by changes in hormones, blood flow and immunity [1] [3] [14]. At the same time you are often told that half of your usual routine is “not safe in pregnancy”, which can feel confusing and a bit unfair. This guide walks through which ingredients are generally considered safe, which ones are better avoided, and how prescription skincare needs to change during pregnancy and breastfeeding.

It is general information only and does not replace personalised medical advice from your own doctor or midwife. At services like Prescription Skin, your prescribing doctor will always ask about pregnancy and breastfeeding so they can adjust your routine or let you know if a prescription product is not suitable right now. If you become pregnant while using a custom prescription skincare subscription, your plan can be re-tuned to focus on pregnancy-friendly options.

Key takeaways

• Many topical ingredients are considered compatible with pregnancy when used on limited areas as directed, including azelaic acid, benzoyl peroxide, glycolic and lactic acid, niacinamide, hyaluronic acid and vitamin C [1] [2] [5].
• Topical and oral retinoids (such as tretinoin, adapalene, tazarotene and isotretinoin) are not recommended in pregnancy or when you are trying to conceive, and should be stopped and reviewed if you become pregnant [2] [4] [10] [11].
• Hydroquinone has relatively high systemic absorption, so most experts advise avoiding or minimising it in pregnancy and using alternatives such as azelaic acid for pigmentation [1] [2] [7] [8].
• Short-contact, low-strength salicylic acid products are generally considered acceptable for small areas, but prolonged or large-area use is usually avoided as a precaution [1] [2] [5].
• Prescription skincare can still play a role in pregnancy, but formulas should be simplified and built around pregnancy-friendly ingredients such as azelaic acid, niacinamide, gentle exfoliants and barrier-supporting moisturisers [1] [2] [13].

Why does skin change so much in pregnancy?

Hormonal changes in pregnancy affect almost every layer of the skin. Oestrogen, progesterone and other hormones influence pigment production, hair growth, sweat and oil glands, connective tissue and blood vessels [1] [3] [14]. Many people notice darker nipples and genital skin, a line down the abdomen (linea nigra), more obvious veins and a “pregnancy glow”. Others develop new or worsening acne, patches of melasma, sensitivity or itch [1] [3] [14].

These changes are not your fault and often improve after delivery, but some, such as melasma and post-inflammatory hyperpigmentation, can persist and need longer term management [1] [3]. Having a safe, simple routine and good information about ingredients makes it easier to balance skin comfort, appearance and safety during this time.

Ingredients that are generally considered safe in pregnancy

Because most skincare sits on the surface of the skin rather than entering the bloodstream, many topical ingredients can be used in pregnancy, especially when they are applied to limited areas at usual strengths [1] [2]. Dermatology and obstetric resources focus on choosing ingredients with low systemic absorption and reassuring safety data, and on avoiding very strong peels or aggressive at-home treatments while you are pregnant [1] [2] [13].

Azelaic acid

Azelaic acid is a multitasking ingredient that can help with acne, clogged pores, redness and pigment. It has anti-inflammatory and antibacterial effects and also gently slows pigment production, which makes it useful for pregnancy acne and melasma [1] [2] [9]. Reviews and guidelines describe topical azelaic acid as a preferred option in pregnancy, with animal data and human experience suggesting low risk when used as directed [1] [2] [9].

At Prescription Skin, azelaic acid is one of the backbone ingredients in many routines for acne, rosacea and pigment concerns such as melasma and hyperpigmentation. During pregnancy it often replaces retinoids or hydroquinone in custom prescription formulas.

Benzoyl peroxide

Benzoyl peroxide is widely used for acne. It reduces acne-causing bacteria, helps keep pores clearer and has a mild peeling effect. Only a small fraction is absorbed and it is rapidly broken down to benzoic acid and excreted, so expert groups consider low to moderate strength benzoyl peroxide acceptable for pregnancy acne [1] [2] [5] [6].

It can be drying and irritating, so it is usually used as a thin layer on affected areas only and paired with a bland moisturiser. If your acne is scarring or very distressing, it is worth discussing prescription options with a doctor, as pregnancy-safe plans often combine benzoyl peroxide with azelaic acid or short courses of certain topical antibiotics [2] [4] [5].

Niacinamide

Niacinamide is a form of vitamin B3 that supports the skin barrier, reduces redness and helps regulate oil production. It has very low systemic absorption and is a nutrient we get from food, so topical niacinamide is considered safe for use in pregnancy and breastfeeding [1] [2]. It can be helpful for pregnancy-related acne, sensitivity and general skin resilience.

Many routines at Prescription Skin use niacinamide alongside prescription actives. When pregnancy changes what can be used, niacinamide often becomes one of the “anchor” ingredients. You can read more in our niacinamide ingredient guide.

Vitamin C (ascorbic acid) and other antioxidants

Topical antioxidants, especially vitamin C, are used for brightening, supporting collagen and helping to protect against environmental damage. Reviews of topical products in pregnancy describe vitamin C, vitamin E and similar antioxidants as compatible options at usual cosmetic strengths, with no evidence of harm in pregnancy [1] [2].

Vitamin C serums can be a good way to keep working on fine lines and early ageing while retinoids are on hold. You can learn more about how it works in our overview of ascorbic acid.

Hyaluronic acid and moisturisers

Hydration becomes more important when your active routine is simplified. Hyaluronic acid is a water-binding molecule that helps skin feel plump and comfortable. Topical hyaluronic acid and common moisturiser ingredients such as glycerin, ceramides and plant oils are considered safe in pregnancy [1] [2].

If you are using prescription creams from Prescription Skin, your doctor may recommend pairing them with a simple moisturiser that includes hyaluronic acid or niacinamide to support the barrier and minimise irritation.

Gentle exfoliants (glycolic and lactic acid)

Alpha hydroxy acids such as glycolic and lactic acid can help with dullness, clogged pores and mild pigmentation by speeding up cell turnover at the surface. Pregnancy reviews suggest that low to moderate strength glycolic acid, particularly in leave-on products or light chemical peels, is acceptable in pregnancy because systemic absorption is minimal when used appropriately [1] [2].

The key is to stick to sensible strengths, avoid large or repeated high-strength peels and always use sunscreen, especially if you are prone to melasma or pigmentation [1] [3].

Short-contact, low-strength salicylic acid

Salicylic acid is related to aspirin. In high oral doses it can affect the fetus, but for skincare the situation is different. Dermatology and teratology resources suggest that low concentration topical salicylic acid, such as a 2% cleanser or short-contact mask used on small areas, is acceptable in pregnancy, while prolonged or large-area use is usually avoided as a precaution [1] [2] [5].

If you are unsure about a particular product, it is reasonable to choose azelaic acid or glycolic acid instead during pregnancy, especially if you have more extensive areas to treat.

Ingredients that are best avoided in pregnancy

Some ingredients are avoided in pregnancy because of known risks, higher systemic absorption or simply a lack of reassuring data. Your own doctor or dermatologist may have their own cut-off points, but the ingredients below are widely treated with caution.

Retinoids (including retinol, tretinoin, adapalene and tazarotene)

Retinoids are vitamin A related drugs used for acne, photoageing and pigmentation. Oral retinoids such as isotretinoin are known to cause birth defects and are strictly contraindicated in pregnancy [2] [10]. Even though topical retinoids have much lower systemic absorption, multiple guidelines and teratology services recommend avoiding all forms of topical retinoids in pregnancy and in people trying to conceive [2] [4] [11] [12].

A review of topical retinoids notes that some human studies have not shown a clear increase in birth defects with topical tretinoin, but because benefit is largely cosmetic and safer alternatives exist, the conservative approach is to avoid retinoids in pregnancy and to stop them if pregnancy occurs [2] [4] [11]. Regulatory bodies in Europe and elsewhere advise that topical retinoids should not be used during pregnancy or when planning pregnancy [10] [11].

For this reason, prescription services like Prescription Skin do not use topical retinoids in patients who are currently pregnant or actively trying to conceive. If you become pregnant while on a retinoid, you should stop the product and let your doctor know so you can switch to safer alternatives.

Hydroquinone

Hydroquinone is a pigment-regulating ingredient used for melasma and other hyperpigmentation. It can be very effective, but it has relatively high systemic absorption compared with many other topicals, with estimates around one third or more of a topical dose absorbed across the skin [1] [2] [7].

A safety review and pregnancy-focused summaries suggest that the limited human data available have not shown a clear increase in major birth defects or adverse pregnancy outcomes in women using hydroquinone, but because of the comparatively high absorption and the lack of large, controlled pregnancy studies, experts recommend avoiding or minimising hydroquinone in pregnancy [1] [2] [7] [8].

At Prescription Skin, doctors generally avoid prescribing hydroquinone for people who are pregnant or breastfeeding, and instead focus on pregnancy-friendly pigment routines using azelaic acid, vitamin C, niacinamide and careful sun protection for melasma and dark spots.

High-strength peels and in-clinic procedures

Medium to deep chemical peels, strong at-home peels, some laser procedures and injectable cosmetic treatments are usually postponed until after pregnancy [1] [2] [13]. This is partly because safety data are limited and partly because pregnancy is a time of increased pigment risk and more reactive skin, which can make strong treatments unpredictable [1] [3].

If you are considering a procedure for issues like ageing or scarring, most dermatologists will recommend focusing on gentle home care and sun protection during pregnancy and breastfeeding, then revisiting in-clinic options later [1] [2].

What about prescription skincare in pregnancy?

Prescription skincare is still possible in pregnancy, but the palette of ingredients changes. Instead of retinoids, high-strength peels or hydroquinone, your prescriber will lean into safer actives such as azelaic acid, niacinamide, gentle exfoliants and moisturisers that support the barrier [1] [2] [13].

At Prescription Skin, every patient completes a detailed questionnaire and photo upload, and you are asked directly about pregnancy, breastfeeding and plans to conceive before any medicine is prescribed. For many people who are pregnant or breastfeeding, a simplified, prescription-supported routine might include:

• A gentle cleanser, bland moisturiser and high SPF mineral or hybrid sunscreen for daily protection [1] [13].
• Azelaic acid for acne, clogged pores, rosacea-like redness or melasma [1] [2] [9].
• Niacinamide and hyaluronic acid for barrier support and hydration.
• Vitamin C or other antioxidants for dullness and early changes in tone and texture, as part of long-term care for fine lines and wrinkles [1] [2].

You can see how this works in practice and what is currently offered through our custom prescription skincare subscription, and you can find answers to common questions about eligibility and safety in our Frequently Asked Questions.

Common pregnancy skin concerns

Some of the most frequent questions in pregnancy clinics relate to acne, pigment and redness. The overview below is general only and not a substitute for your own medical care.

• Pregnancy acne. Hormonal acne can flare, improve or change location in pregnancy. Guidelines favour topical options such as benzoyl peroxide, azelaic acid and certain topical antibiotics, while oral medications and retinoids are avoided [2] [4] [5] [6]. If acne is scarring or very distressing, it is worth seeking review by a doctor rather than only using over-the-counter products. You can read more background in our article on acne.
• Melasma and pigmentation. “Mask of pregnancy” melasma often shows as brown patches on cheeks, forehead and upper lip [1] [3]. Safe strategies focus on daily broad-spectrum sunscreen, hats, azelaic acid, antioxidants and gentle exfoliants, with stronger depigmenting agents usually postponed until after pregnancy [1] [2]. Our guides on melasma and hyperpigmentation explain how these are treated outside pregnancy and what to expect long term.
• Rosacea and redness. Flushing and visible veins can worsen with pregnancy hormones [1] [3]. Simple routines with fragrance-free skincare, azelaic acid and good sun protection can be helpful [1] [2]. You can read more in our overview of rosacea.

When to see a doctor

Always seek medical advice urgently if you develop a sudden widespread rash, blistering, severe itching without a rash, yellowing of the skin or eyes, or any other worrying general symptoms in pregnancy. Some pregnancy-related skin conditions are linked with risks for the baby and need prompt assessment and monitoring [1] [3] [13].

For everyday issues like acne, melasma or dryness, it is still worth speaking to a doctor, pharmacist or dermatologist before starting or continuing products if you are pregnant or breastfeeding. They can help you weigh up the benefits and risks for your specific situation and tell you when it is better to pause a product until after pregnancy. If you are already a patient of Prescription Skin, you can message your prescribing doctor through your account to ask whether your current routine is still appropriate.