The Angst of Adult Acne
Zap Those Zits
Fortunately, a slew of recently approved acne treatments are coming onto the market. Unfortunately, many of these are off-limits to pregnant and nursing women. That's why it's vital to discuss acne treatments with your obstetrician as well as a dermatologist who knows that you're pregnant or breastfeeding, even if you plan to use an over-the-counter (OTC) preparation. A look at your treatment options:
The clean routine. The first line of attack is unclogging the pores -- and that doesn't mean popping. "Picking, squeezing, or scrubbing can irritate inflamed skin and make acne worse," Carr warns. "Plus, it can lead to scarring." Instead, wash your face twice a day with a mild cleanser, such as Neutrogena Cleansing Lotion or Cetaphil.
Topical solutions. If acne is stubborn, the safest treatments for expectant or nursing moms are OTC gels or lotions that contain salicylic acid, glycolic acid, or benzoyl peroxide -- which help dry up surface oil and increase the shedding of skin cells. If these don't work, a dermatologist may prescribe a topical antibiotic, such as T-Stat or Emgel, that contains erythromycin to curb inflammation or a new medication (Azelex) with azelaic acid, a skin-bleaching agent that speeds cell shedding and kills bacteria.
Other drugs called retinoids -- tretinoin (Retin-A) and adapalene (Differin) -- can be applied to the skin to stop oil plugs from forming. But dermatologists don't prescribe them to pregnant women, since their oral formulations can cause birth defects and it's unknown whether topical retinoids pose a similar risk. For the same reasons, doctors don't prescribe gels or lotions that contain the antibiotics clindamycin, sulfur-resorcinol, and metronidazole.
Oral medications. Like retinoids, oral antibiotics -- such as tetracycline, minocycline, doxycycline, and amoxicillin -- can cause birth defects and contaminate breast milk. The only oral antibiotic that's considered relatively safe is erythromycin, but many doctors are still reluctant to recommend it to expectant or new mothers. "If the acne is causing emotional distress, I might prescribe it in pregnancy -- but only after the first trimester, when the early stages of fetal development are completed," says Carr.
And although taking birth control pills containing estrogen often helps to clear up acne, that's not an option for women who are pregnant or breastfeeding.