Skincare during pregnancy — what to use, what to avoid.

Pregnancy introduces a practical question for anyone with an established skincare routine: which products are safe to continue, and which should be paused.

The guidance is often inconsistent — some sources flag almost everything; others appear uncritical. Neither is useful. The relevant question is where the evidence of harm is strong enough to justify avoidance, and where it is not.

The ingredients to avoid

Retinoids — high priority to avoid. This category includes retinol, retinaldehyde, adapalene, tretinoin, and prescription-strength retinoids. Oral retinoids (isotretinoin/Accutane) are known teratogens with strong, established evidence of harm. Topical retinoids are absorbed through the skin at much lower levels, but systemic exposure is measurable, and teratogenicity is a category where the standard of evidence required to justify avoidance is low — you do not need to prove harm in humans when the mechanism is understood and the risk is avoidable. Most dermatologists and obstetric guidelines recommend pausing all topical retinoids during pregnancy as a precaution. This is not a contested position.

High-concentration salicylic acid (leave-on, above 2%). Salicylic acid is a relative of aspirin. Oral aspirin at high doses is associated with pregnancy complications, and systemic absorption from high-dose leave-on salicylic acid treatments is a theoretical concern. Wash-off cleansers and low-percentage (0.5–2%) leave-on products are generally considered low-risk by most dermatologists, because systemic absorption is minimal. High-concentration peels and leave-on treatments above 2% are typically recommended to avoid.

Hydroquinone. Used for hyperpigmentation, hydroquinone has high systemic absorption relative to other topical ingredients and limited safety data in pregnancy. Most guidelines recommend avoiding it.

Chemical sunscreen agents — some. Oxybenzone is an ingredient with documented systemic absorption and some endocrine activity in animal models. The clinical significance in humans is uncertain, but many dermatologists suggest switching to a mineral SPF (zinc oxide, titanium dioxide) during pregnancy as a precaution. Both zinc oxide and titanium dioxide are considered safe.

What is generally considered safe

Niacinamide. One of the most extensively used and well-tolerated skincare actives. Niacinamide is a form of vitamin B3 — water-soluble, with a strong safety profile and no established teratogenic risk. It addresses hyperpigmentation (a common pregnancy concern, including melasma), supports barrier function, and is appropriate across trimesters.

Glycerin, hyaluronic acid, ceramides, squalane. Hydrating and barrier-supporting ingredients with no known risks in pregnancy. These are foundational to managing the skin changes — increased sensitivity, dryness, or congestion — that often accompany pregnancy.

Vitamin C (topical). At the concentrations used in skincare (typically 10–20% L-ascorbic acid, or equivalent derivatives), topical vitamin C is considered low-risk. Systemic absorption is minimal. Vitamin C derivatives — sodium ascorbyl phosphate, ascorbyl glucoside — are similarly considered safe and may be better tolerated on more sensitive pregnancy skin.

AHAs at low concentrations. Glycolic acid and lactic acid at typical OTC concentrations (5–10%) are generally considered safe in pregnancy. Systemic absorption is minimal. High-concentration chemical peels are a different consideration.

Azelaic acid. Often particularly relevant in pregnancy because melasma (hormonal pigmentation) is common, and azelaic acid is one of the few evidence-based pigmentation treatments considered safe during pregnancy. It is anti-inflammatory and well-tolerated.

Centella asiatica, panthenol, green tea extracts. All considered safe, with soothing and barrier-supportive functions well-suited to the increased sensitivity many people experience.

Mineral SPF. Daily broad-spectrum sunscreen remains not just safe but important during pregnancy. Melasma is a major concern — UV is its primary trigger, and SPF is the most impactful single intervention. Zinc oxide and titanium dioxide are the preferred filters.

The practical adjustment

A typical routine adjustment for pregnancy:

Pause retinoids. Pause high-dose leave-on salicylic acid if used. Pause hydroquinone if used. Consider switching to a mineral SPF if currently using chemical filters.

Continue: a gentle cleanser, niacinamide serum, vitamin C if used, a barrier moisturiser, daily SPF. These represent the core of an effective routine and have no established risks.

A note on caution

Pregnancy skincare guidance is appropriately conservative because the threshold for risk is different — potential harm to a developing pregnancy warrants more caution than adult-only risk. This does not mean everything in your cabinet is dangerous. For the majority of people with straightforward routines, the adjustment is modest: pause retinoids, check the SPF filter, continue everything else.

If any product contains an ingredient you are unsure about, your midwife or obstetrician is the right person to ask. This is not medical advice, and individual circumstances vary.