Acne during pregnancy: what to stop, what dermatologists suggest, and a simple routine
Pregnancy acne often flares early on. Which acne treatments to stop, which ones dermatologists consider, and a gentle routine to take to your doctor.
Short answer
For acne during pregnancy, dermatologists usually suggest azelaic acid, benzoyl peroxide in limited amounts and, with a prescription, topical clindamycin. Glycolic acid and low-strength salicylic acid are other options. Stop isotretinoin and tazarotene straight away, and most experts advise stopping tretinoin and adapalene too. Check every acne product with your doctor or pharmacist, including over-the-counter ones.
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What this means for you
Start with what you notice
Calm breakouts that flared with pregnancy, without using an acne treatment you should have stopped.
The ingredient names, translated
Pregnancy hormones can make acne worse, most often in the first months. Several of the strongest acne treatments, the retinoid creams and gels (tretinoin, adapalene, tazarotene) and the isotretinoin pill, are ones to stop, because they are linked to birth defects. That leaves gentler treatments: azelaic acid, which calms redness and blemishes; benzoyl peroxide, which kills acne bacteria; and mild exfoliating acids such as glycolic acid. A doctor can add a prescription antibiotic cream if those aren't enough.
How to decide
- If you were using an acne gel or cream with a retinoid in it (adapalene, tretinoin or tazarotene), stop it and tell your doctor. Our product pages show a red pregnancy note for retinoids.
- If your breakouts are mild, ask your doctor about azelaic acid or a small amount of benzoyl peroxide, plus a gentle cleanser and an oil-free moisturizer.
- If you use salicylic acid, keep to low-strength products such as washes, and ask before using anything above 2% or a peel.
- If you have painful, deep or widespread acne, see your doctor or a dermatologist. Prescription options exist that suit pregnancy.
What to expect
DermNet notes that acne often gets a bit worse in early pregnancy and then improves as pregnancy goes on, though a few people flare throughout. Gentle treatments usually take weeks to show a difference. The sources describe treatments in general; they do not test the products named here.
General guidance, not a test of these products: Is any acne treatment safe to use during pregnancy? (American Academy of Dermatology); Acne in pregnancy (DermNet); Dermatologist-approved pregnancy skin care (American Academy of Dermatology); Chien AL et al. Treatment of acne in pregnancy. J Am Board Fam Med. 2016. Each product's label source is linked on its product page.
Pregnancy acne can feel unfair. You might not have had a breakout in years, and now there are spots along your jaw just as you’ve been told to put half your acne products away. It’s common, it’s usually temporary, and there are still real options.
The tricky part is that the most effective acne creams, the retinoids, are the ones to stop. This guide covers which treatments to pause, what dermatologists consider instead, and a simple routine you can take to your next appointment. For the wider list of skincare ingredients to check, see our pregnancy skincare guide.
Why does acne flare during pregnancy?
DermNet says it’s common for acne to get a bit worse in early pregnancy and then improve as pregnancy progresses, which may relate to higher estrogen levels. A few people have severe flares throughout. The American Academy of Dermatology (AAD) lists acne among the usual skin changes of pregnancy.
Pregnancy acne tends to look like hormonal acne elsewhere: red bumps and tender spots, often on the lower face. Our hormonal acne guide explains that pattern, though several of the treatments it covers, including spironolactone, are ones to stop during pregnancy.
Skin Realist check: pregnancy acne isn’t a sign your routine failed. Your hormones changed the rules halfway through the game.
Which acne treatments should you stop while pregnant?
The AAD’s page on acne treatment during pregnancy is direct about these:
| Treatment | What the AAD says |
|---|---|
| Isotretinoin (pill) | Stop immediately; it can cause serious birth defects |
| Tazarotene (prescription cream or gel) | Stop immediately |
| Spironolactone (pill) | Stop immediately |
| Tretinoin and adapalene (creams and gels) | Most experts recommend stopping during pregnancy |
| Doxycycline, minocycline, tetracycline (pills) | Stop by the 15th week of pregnancy |
DermNet adds high-concentration salicylic acid to the avoid list. Adapalene is the one most people miss, because it’s sold over the counter in the US as an acne gel.
Retinoids also appear in skincare that isn’t sold for acne, such as retinol serums and retinyl palmitate in moisturizers. Our product pages show a red pregnancy note when a recorded label lists one. If you take a prescription, talk to your prescriber rather than stopping a pill without a plan.
Which acne treatments do dermatologists consider during pregnancy?
From the AAD and DermNet pages, these are the options doctors usually discuss. “Considered usable” isn’t the same as proven safe for everyone, so check each one with your doctor or pharmacist first.
- Azelaic acid. The AAD says it’s thought to be safe during pregnancy. It helps with blemishes and with the redness and marks they leave behind. Read our azelaic acid guide.
- Benzoyl peroxide. The AAD says experts consider it usable in limited amounts. It’s in many over-the-counter washes and spot treatments.
- Topical clindamycin. A prescription antibiotic gel the AAD describes as thought to be safe in pregnancy. A 2016 review recommends pairing topical antibiotics with benzoyl peroxide rather than using them alone, to limit antibiotic resistance. Our clindamycin vs benzoyl peroxide guide explains why.
- Glycolic acid and low-strength salicylic acid. DermNet lists both among topical treatments most experts agree can be used.
- For severe acne, a doctor may prescribe certain oral antibiotics, or suggest light or laser treatment. The AAD advises seeing a dermatologist first, partly because some procedures use numbing medicine.
Skin Realist check: “limited amounts” of benzoyl peroxide means a dab on the spots, not a mask over your whole face. It also bleaches towels, which is a separate tragedy.
A simple pregnancy acne routine
This is a starting point to discuss with your doctor, not a prescription:
- Morning: gentle cleanser, oil-free moisturizer, mineral sunscreen.
- Evening: gentle cleanser, then your treatment (azelaic acid, or benzoyl peroxide on spots), then moisturizer.
- Spots that come to a head: a hydrocolloid patch overnight instead of squeezing.
- One new product at a time, a week or two apart, so you can tell what helps and what irritates.
The products below list none of the ingredients we flag for pregnancy. That’s a statement about their recorded labels, not a safety clearance.
COSRX Azelaic Acid 10 B5 Redness Soothing Cream
COSRX Azelaic Acid 10 B5 Redness Soothing Cream lists 10% azelaic acid with panthenol, niacinamide and a centella complex, in a fragrance-free cream. COSRX positions it for visible redness, blemishes and post-blemish marks.
It’s a cosmetic strength. Prescription azelaic acid is stronger, so if this isn’t enough after a couple of months, ask your doctor about the prescription version rather than layering more products.
CeraVe Hydrating Facial Cleanser
If your usual cleanser is a salicylic acid wash and you’d rather pause it, CeraVe Hydrating Facial Cleanser is a simple, fragrance-free cream cleanser with ceramides and hyaluronic acid. Benzoyl peroxide and azelaic acid can be drying, and a non-stripping cleanser helps you tolerate them. It’s made for normal to dry skin, so very oily skin may prefer a gel.
→ See the CeraVe Hydrating Facial Cleanser on Amazon
CeraVe Ultra-Light Moisturizing Gel
CeraVe Ultra-Light Moisturizing Gel is a fragrance-free, oil-free gel moisturizer with ceramides, niacinamide and hyaluronic acid, for morning and night. It suits oily, acne-prone skin that still gets dry and tight from acne treatments.
CeraVe Blemish Barrier Patches
CeraVe Blemish Barrier Patches are ultra-thin hydrocolloid patches in 10 mm and 12 mm sizes, 22 per pack, worn for at least six hours. They list ceramides and niacinamide, and no salicylic acid, which some other patches contain. They work best on spots that have come to a head; see our pimple patch guide.
→ Read reviews and check price on Amazon
Sunscreen for the marks
Acne marks darken with sun, and pregnancy makes melasma more likely too. CeraVe Hydrating Mineral Sunscreen SPF 30 Face Lotion uses titanium dioxide and zinc oxide, the physical filters the AAD suggests in pregnancy. If you want an exfoliant for marks as well, CeraVe Skin Renewing Nightly Exfoliating Treatment lists a 5% glycolic and lactic acid blend; use it on different nights from benzoyl peroxide to limit irritation.
→ Check the mineral sunscreen on Amazon
Mistakes to avoid
- Keeping an adapalene gel in the routine. It’s over the counter, so it’s easy to forget it’s a retinoid.
- Using benzoyl peroxide all over, twice a day. The advice is limited amounts.
- Reaching for a strong salicylic acid peel. High-concentration salicylic acid is on DermNet’s avoid list.
- Squeezing. It makes marks more likely, and they’re slow to fade.
- Waiting out severe acne. Painful or scarring acne needs a doctor, and there are prescription options that suit pregnancy.
The bottom line
Stop retinoids, including adapalene, and ask your doctor about azelaic acid and benzoyl peroxide in small amounts. Keep the rest gentle. If you only buy one product, make it COSRX Azelaic Acid 10 B5 Redness Soothing Cream, after checking the label with your doctor or pharmacist. If acne is severe or painful, read when to see a dermatologist and book the appointment.
Sources
- American Academy of Dermatology: Is any acne treatment safe to use during pregnancy?: which treatments to stop, and the advice on azelaic acid, benzoyl peroxide, clindamycin, oral antibiotics and lasers.
- DermNet: Acne in pregnancy: how acne changes during pregnancy, usable topical treatments, and retinoids and high-concentration salicylic acid to avoid.
- American Academy of Dermatology: Dermatologist-approved pregnancy skin care: acne as a common pregnancy skin change, and the physical sunscreen suggestion.
- Chien AL et al. Treatment of acne in pregnancy. J Am Board Fam Med, 2016: benzoyl peroxide and azelaic acid as baseline treatments, and pairing topical antibiotics with benzoyl peroxide.
These sources give general guidance. They don’t test any product named here, and they don’t replace advice from your own doctor, midwife or pharmacist.
Common questions
Can I use adapalene (Differin) while pregnant?
The American Academy of Dermatology says most experts recommend stopping tretinoin and adapalene during pregnancy, and DermNet says not to use topical retinoids, including adapalene. Adapalene is sold over the counter in the US, so check acne gels for it.
Can I use benzoyl peroxide while pregnant?
The AAD says experts consider benzoyl peroxide usable in limited amounts during pregnancy, after you've talked with your clinician, and DermNet lists it among topical treatments most experts agree can be used. Use it on spots or affected areas rather than all over.
Is azelaic acid safe during pregnancy?
The AAD says azelaic acid is thought to be safe to use during pregnancy, and DermNet lists it among usable topical treatments. Prescription azelaic acid is stronger than cosmetic creams. Ask your doctor or pharmacist before starting any acne product.
Does pregnancy acne go away?
DermNet says acne commonly gets a bit worse in early pregnancy and then improves as pregnancy goes on, likely related to higher estrogen levels. A few people have severe flares throughout, and they should see a doctor rather than wait it out.