Skin changes during pregnancy - acne

What is acne?

Acne is a common skin condition that usually begins during adolescence. If you have acne, it is likely to flare up during the first trimester of your pregnancy. If you have acne, your hair follicles and their associated oil glands become blocked and inflamed. This causes symptoms such as white heads, black heads and inflamed pus-filled spots (pimples, papules and pustules) to develop in areas where your oil glands are largest and most active. These areas include your face, neck, back and chest.

What causes acne?

There are several causes of acne. Hormones, particularly androgens, can contribute to the development of acne. Your adrenal gland produces androgens, and the amount produced increases slowly during adolescence. Your sebaceous glands (oil glands) respond to increasing levels of androgens by producing more sebum (an oily, waxy substance). When these sebaceous glands become blocked, the skin cells lining the hair follicle duct are not shed as normal but rather collect and form a plug. This causes oil to be trapped in the skin, causing pimples.

Bacteria and inflammation are other causes of acne. Acne bacteria accumulate in the hair follicle duct causing inflammation and pimples.

Other causes of acne include genetics. You are more likely to have acne if someone in your family has acne. Stress can also make acne worse. When you are stressed, your body makes more androgens, which can worsen your acne.

Can acne be prevented?

Acne can’t be prevented entirely but there are things that you can do to help reduce flare-ups and decrease acne scaring.

Good skin care is very important. Washing your face twice a day with a gentle PH balanced soap free cleanser is recommended. Shampooing your hair regularly and pulling your hair back from your face and neck is also helpful.

When using makeup, use oil free or matte-finish products or a mineral powder. These products won’t block your skin pores. Remove your make-up every night with a mild soap free cleanser. Avoid makeup remover wipes.

When using moisturiser, use oil-free non-comedogenic (‘pore-clogging’) products. Only use moisturiser in acne areas if the area is dry and irritated. Using too much moisturiser can make acne worse.

Avoid picking, popping or scratching your pimples.

Practise good sun protection and sun avoidance.

Acne is generally not caused by the foods that you eat. However, some people notice that their acne flares up when they eat certain foods. If this is the case for you, try and avoid the foods that may worsen your acne.

Will acne affect my pregnancy or my baby?

Acne will not affect your pregnancy or your baby. However, it is important to only use acne treatments that are safe during pregnancy.

How is acne treated during pregnancy?

The main treatment options for acne during pregnancy include over-the-counter products such as benzoyl peroxide and topical clindamycin (a type of antibiotic you use directly on the pimple). If your acne is moderate or severe, your doctor may consider treating you with an oral (tablet or capsule) antibiotic called erythromycin.

There are certain medications that must be avoided during pregnancy since they may cause harm to your baby. These medications include spironolactone and retinoids (both topical and oral). It’s best to avoid products containing vitamin A (also called retinol). Ask your pharmacist if you’re not sure if a product is safe.

Physical therapies such as laser or blue light therapy, micro-needling and chemical peels can be good options for pregnant women with acne. These treatments usually provide temporary improvement in acne, but usually other ongoing treatments are needed as well. It is important that these therapies are done by skilled practitioners.

When should I see my doctor about acne?

You should see your doctor about acne if your acne is not well controlled by non-prescription medications or if your acne is moderate to severe. You should also see your doctor if your acne is causing you emotional distress. If you are unsure about which medications you can use during pregnancy to treat acne, ask your pharmacist before starting treatment, before you start trying for a baby, or as soon as you find out you are pregnant.

Will I still have acne after I've had my baby?

Your acne may flare up during the first trimester of pregnancy. Fortunately, pregnancy acne usually improves significantly or even disappears entirely during the last trimester. After giving birth, breastfeeding can help you keep acne away.

Will I have acne in future pregnancies?

You may have acne in future pregnancies. However, many women notice that their acne is progressively less severe or even disappears in future pregnancies.