Here's What Causes Pregnancy Acne and How to Treat It

For some lucky people, pregnancy provides a beauty treatment for skin that trumps anything you can buy in a jar. But many others skip that "pregnancy glow" and instead are faced with pregnancy-related skin problems like acne.

Here's what you need to know about pregnancy acne, including what causes it and how to treat it safely.

What Causes Pregnancy Acne?

A surge of progesterone in the first trimester tends to ramp up oil production in pregnancy. In some, the oil is lighter and hydrating, giving you that famous pregnancy glow. But if your body's unique mix of pregnancy hormones is especially strong, you may find yourself with acne like you haven't seen since high school.

To understand how this increased oil production can cause ance, here's the quick-and-dirty science on how a pimple forms: The skin's oil glands secrete sebum (oil) into pores, and if it's sticky and thick enough, the sebum traps dead skin cells and dirt, clogging pores. Those plugs create an all-you-can-eat buffet and the perfect hiding spot for Propionibacterium acnes bacteria, which then flourish and trigger the zits you see and feel.

Other factors besides hormones can also contribute to pregnancy acne. For example, pregnant people seem more overextended these days, and stress is clear-skin kryptonite, explains Rachel Nazarian, MD, a dermatologist in New York City.

Plus, many people treat acne with combination estrogen-progestin birth control pills, which can heal your skin by stabilizing hormones and lowering levels of circulating androgens, says Amy Wechsler, MD, a dermatologist in New York City. But when you stop taking the pills, acne may rebound.

Tips for Treating for Pregnancy Acne

If your skin usually breaks out during your menstrual period, you'll likely find the same thing happening during the early months of your pregnancy. But this isn't always the case. Some people find that their regular acne problems disappear during pregnancy, while others who were never troubled by pimples find that pregnancy brings them on.

If you're one of those with newfound blemishes, try the following treatment methods for pregnancy acne.

Don’t go crazy with products

Many people who have acne go overboard with products, bombing their skin with harsh formulas and starving it of moisture in an effort to clear pores and dry up oil, says Dr. Nazarian. Be forewarned: That strategy typically leaves you with more inflammation and a weakened skin barrier vulnerable to irritation.

Establish a smart daily routine

To clear pregnancy acne, start with a few gentle over-the-counter products, says Steven Feldman, MD, PhD, professor of dermatology at Wake Forest School of Medicine in Winston-Salem, North Carolina.

The American College of Obstetricians and Gynecologists (ACOG) recommends washing your face twice a day with a mild cleanser and lukewarm water. And don't forget your scalp! As oil production ramps up during pregnancy, you may find your scalp becoming more oily, too.

Try exfoliating

Often, pregnancy acne is caused by pores clogged with oil, so keep them clear with mechanical exfoliants. These products may contain synthetic beads or ground-up nutshells, which help scrub away dead skin.

Whatever you do, don't pop

Adolescents tend to get pimples everywhere and are prone to whiteheads—raised orbs that call out to be squeezed. On the other hand, pregnant people often break out around the jawline, chin, and mouth, and pimples look red and feel inflamed rather than poppable, Dr. Nazarian says. Not only that, your skin heals more slowly as you age, so an errant, scab-inducing "squeeze" can take weeks to vanish.

The American Academy of Dermatology Association (AAD) recommends avoiding pimple popping at any age because doing so can lead to:

• Permanent scarring
• More obvious pimples
• More pain
• Infection

If you have a large, painful blemish, a dermatologist can help you safely extract or drain it.

Visit a dermatologist

If your pregnancy acne doesn't improve within a few weeks of following a consistent routine, or if your acne is severe or really bothers you, go to a board-certified dermatologist rather than trying a slew of new products, says Dr. Nazarian. Adult acne is notoriously hard to treat—what works for one person may not work for you—and a personalized regimen can be effective.

And remember: There’s no shame in pimples!

We're not saying you need to walk around feeling good about your pregnancy acne, but pimples are no reason to hide. In fact, more and more celebs and influencers are posting Instagram photos featuring brightly colored pimple patches or their unfiltered zits.

Dr. Nazarian says the "pimple-positive movement" is helping people realize how common acne really is and that they shouldn't feel bad about it. Isn't it nice to be out of high school?

Safe and Unsafe Pregnancy Acne Medication

If pregnancy acne doesn't clear up with basic changes to your skincare routine, you might be tempted to reach for something stronger. Remember that some common medications are OK to use during pregnancy, while others are unsafe.

Safer pregnancy acne medications

According to ACOG, the following acne-fighting ingredients are safe to use during pregnancy when used topically:

• Benzoyl peroxide
• Azelaic acid
• Salicylic acid
• Glycolic acid

Even so, using these ingredients in the lowest amount and for the shortest time possible is best. Talk to a health care provider for guidance on using these products for pregnancy acne.

Unsafe pregnancy acne medications

Most well-known acne products and medications, including retinoids, oral isotretinoin, spironolactone, oral tetracyclines (a group of antibiotics), and combination birth control pills, are off the table when pregnant or breastfeeding.

According to the AAD, the following should not be used for pregnancy acne:

• Isotretinoin
• Tazarotene
• Spironolactone
• Adapalene

Certain drugs used to treat acne may cause severe congenital disorders when taken during pregnancy, so it's always best to check with a health care provider first. Some topical and oral antibiotics are considered safe; however, tetracyclines can cause fetal tooth discoloration and affect fetal bone growth.