AFNO: Ingredients Best to Avoid During Pregnancy

I think pregnancy skincare can be so overwhelming for some people. There is so much information out there nowadays that we don’t always know what’s real, what’s outdated and what’s somebody on TikTok deciding that an ingredient is going to kill us all.

When it comes to skincare, there are a few ingredients that we (being all us therapists) generally recommend clients avoid or treat with caution during pregnancy. Some have very clear evidence behind the advice, whereas with others the potential risk is actually very low and the recommendation is more precautionary because, of course, it’s not exactly ethical to test skincare ingredients on pregnant women.

Please bear in mind that I’m a facialist and aromatherapist, not your doctor, so this isn’t intended to replace medical advice. Pregnancy is also incredibly individual, so I always recommend checking anything you’re unsure about with your GP, midwife or doctor. How cautious you personally want to be with ingredients where the evidence is limited is of course your personal decision.

So, with that in mind, I’ve put together a list of the main skincare ingredients that are best avoided or treated with caution during pregnancy, along with some alternative options you can use instead.

1. RETINOIDS AND VITAMIN A

This tends to be the main one we talk about during pregnancy.

Oral isotretinoin is completely contraindicated during pregnancy. This includes medications such as Roaccutane and there are very strict pregnancy prevention measures in place when it is prescribed because of the established risk of serious birth defects.

Topical retinoids are slightly different because the amount absorbed through the skin is much lower, but they’re still recommended to be avoided during pregnancy as a precaution. The risk of a topical retinoid causing a birth defect appears to be very low, but personally, it’s definitely not something I would want to risk.

This means no SkinBetter Science AlphaRet products or Nimue Retinal Power+ Serum while you’re pregnant, sorry! There are other options though. I love the Nimue Active Lotion and Active Rejuvenating Wipes for skin rejuvenation, and they’re actually some of my favourite products anyway.

2. HYDROQUINONE

This is another big one, mainly because quite a significant amount of hydroquinone can be absorbed through the skin compared with many other topical skincare ingredients, and we don’t have enough pregnancy safety data to know what effect that could potentially have.

Why is this one particularly relevant during pregnancy? A lot of women can develop melasma because of fluctuating hormones, so understandably there can be a temptation to start throwing everything at the pigmentation there and then.

It’s worth remembering that melasma can sometimes improve after pregnancy, so personally, I wouldn’t be reaching for hydroquinone to try to treat it while pregnant. Or at all really!

Your best bet is a really well-formulated, high-quality SPF every single day to help prevent the pigmentation from becoming worse. Nimue Sun-C SPF 40 is one of my all-time favourites, and there is also the Nimue Environmental Shield SPF 50 if you prefer a higher factor.

3. SALICYLIC ACID

This one is a little less scary and there is quite a bit of confusion around it.

You might have heard that salicylic acid is a complete no during pregnancy, but that’s not necessarily the case. When it’s being used topically in low concentrations and on small areas of the skin, it’s generally considered low risk. Think of something like a spot treatment rather than covering your entire body in a high-strength salicylic acid product.

I personally wouldn’t be using high concentrations or applying it over large areas of the body while pregnant. As with so many things, concentration, dose and how you’re actually using the ingredient make a difference.

So if salicylic acid happens to be lurking towards the bottom of the ingredient list of one of your skincare products, you don’t necessarily need to panic and immediately throw it in the bin.

4. ESSENTIAL OILS

Now, when I originally trained in aromatherapy more than twenty years ago, I was taught that mandarin was pretty much the only essential oil we would use during pregnancy. I think things have definitely become a little less restrictive since then, but one thing I would always say as an aromatherapist is that natural doesn’t necessarily mean safe.

Essential oils are incredibly concentrated and some definitely aren’t appropriate to use during pregnancy. I certainly wouldn’t be treating a pregnant client with a full-body aromatherapy massage using oils such as rosemary or clary sage ever, even if they are 'natural'.

I personally take a much more conservative approach when treating pregnant clients with aromatherapy because there are so many variables involved. Using a tiny amount of a properly diluted essential oil on the face is very different from covering the entire body in a massage blend, and inhalation, topical application and ingestion are completely different again.

If you’re pregnant and want to use essential oils at home, I would always recommend checking the individual oil with a properly qualified aromatherapist and speaking to your midwife or doctor if you’re unsure.

5. SUPPLEMENTS

Supplements are another slightly grey area because a lot of brands will recommend avoiding their products during pregnancy simply because they haven’t actually been tested on pregnant women. That doesn’t automatically mean they’ve been shown to be harmful, but it does mean we don’t necessarily have the evidence to say they’re safe either.

One ingredient I would be particularly careful with is vitamin A. High doses of preformed vitamin A can be harmful during pregnancy, so definitely check the label if you’re taking skin, hair or beauty supplements alongside a pregnancy multivitamin.

I also wouldn’t assume that something is safe simply because it’s herbal or natural. There are so many supplements around now containing herbs, adaptogens and botanical extracts, but pregnancy isn’t really the time I’d be experimenting with these without checking first.

If you’re already taking a skin supplement, take a photograph of the ingredients and show it to your GP, midwife or pharmacist. It’s also worth showing them everything you’re taking together rather than checking each supplement individually, as you don’t want to inadvertently double up on certain vitamins or minerals.

SO WHAT CAN I USE?!

After reading all of that you’re probably staring at your bathroom cabinet wondering what on earth you’re actually allowed to put on your face. The good news is… plenty!

Pregnancy doesn’t mean nine months of cleanser, moisturiser and absolutely nothing else. Most of the time we can still create a really effective skincare routine, we might simply need to swap a few of your usual products around.

If you’ve had to stop your retinoid, for example, there are still plenty of ingredients we can use to support skin rejuvenation. Depending on your skin, we can look at things like peptides, vitamin C, niacinamide, antioxidants and gentle acids such as lactic or glycolic acid.

If pigmentation is your main concern, I would concentrate heavily on SPF alongside pregnancy-appropriate brightening ingredients rather than trying to aggressively treat the pigmentation while your hormones are all over the place.

And if your skin has suddenly become sensitive, dry or generally decided it hates everything you’ve ever put on it, don’t panic. Pregnancy can change your skin enormously. Sometimes the best thing we can do is simplify everything and concentrate on hydration, gentle cleansing and supporting the skin barrier rather than introducing loads of new actives.

WHAT ABOUT FACIAL TREATMENTS?

There are certain treatments I personally wouldn’t perform during pregnancy either.

Microneedling is one of them. There isn’t evidence that having microneedling itself would harm your baby, but it is an elective treatment that deliberately creates thousands of tiny injuries in the skin. That brings an unnecessary risk of infection, inflammation and pigmentation, and pregnancy can also affect the way your skin responds and heals. For me, it can wait.

I would also be cautious with stronger chemical peels, lasers and energy-based treatments during pregnancy. Again, some of this comes down to a lack of safety data rather than evidence that every one of these treatments is dangerous, but personally I don’t think pregnancy is the time to be pushing your skin with aggressive cosmetic treatments.

There is plenty we can still do with a lovely facial without getting the big guns out.

AND WHAT ABOUT BREASTFEEDING?

This is where things get a little more complicated because pregnancy and breastfeeding aren’t the same thing, and you don’t necessarily need to continue every pregnancy restriction until you stop breastfeeding.

Oral isotretinoin should still be avoided while breastfeeding. With topical retinoids, the situation is slightly different because very little is absorbed through the skin, but recommendations can vary between products and healthcare professionals. Personally, I would always check with your GP or dermatologist before reintroducing one while breastfeeding.

Hydroquinone doesn’t have great breastfeeding safety data either, so again, I’d personally err on the side of caution. Personally not a huge fan of this anyway.

Essential oils need to be considered individually too, particularly because anything you’re putting on your body could potentially come into contact with your baby’s skin or mouth.

So rather than assuming everything that was off limits during pregnancy is automatically off limits while breastfeeding, check the individual product and ingredient.

FINALLY, DON’T PANIC!

I think this is probably the most important bit.

If you’ve been using your retinol every night and then suddenly discover you’re six weeks pregnant, please don’t immediately go down a Google rabbit hole and scare yourself half to death.

Using a topical retinoid before you knew you were pregnant is very different from taking oral isotretinoin during pregnancy. Stop using the product and speak to your GP or midwife if you’re concerned, but don’t automatically assume that you’ve caused harm.

Pregnancy doesn’t mean you suddenly need to become terrified of your skincare. For most people it’s simply a case of switching out a few products, making a couple of sensible swaps and concentrating on keeping your skin healthy while your hormones do whatever they fancy for the next nine months.

And if you’re currently staring at your bathroom cabinet thinking, I have absolutely no idea what I’m allowed to use anymore, fill out my free Skin Check-In form and I can help you work out what stays, what goes and what we can swap it for.

Thank you so much for reading,

Emmaline