Pregnancy Acne: Causes, Treatments, and More

Jeff Hautala
By Jeff Hautala, Co-Founder of Exposed Skincare

If you have pregnancy acne, you’re in good company: over 50% of expecting mothers develop it at some point during their pregnancy. In this article, we discuss the medically reviewed causes behind these skin changes, as well as ways to treat pregnancy acne successfully 🤰.

Pregnancy acne is just regular acne caused by the hormonal fluctuations involved in pregnancy.

We want to clarify this first—pregnancy acne isn’t a failure on your part in any way. If you’re feeling guilty or confused or upset about your acne, just know that you’re doing fine. Breakouts during pregnancy are normal, and you haven’t done anything wrong that has caused them.

Then What Does Cause Pregnancy Acne?

The medically reviewed cause of acne vulgaris in pregnancy is the same as teenage acne—hormonal changes in the body. In your teens, your sex hormones start playing a more prominent role in your biology, and your testosterone and estrogen levels shift a lot. During pregnancy 🤰, the same fluctuations take place. However, when it comes to breakouts, there are two types of hormones to blame:

  1. sex hormones
  2. stress hormones.

Stress Hormones and Acne Skin Changes

Stress hormones can cause acne because of our fight, flight, or freeze response. When we face emotional stress brought on by fears, anxiety, etc., our bodies respond as though we are facing a real, physical threat, and releases stress hormones like cortisol and adrenaline. These hormones prepare the body for any threat, and one way it does so is through inflammation 🔥.

Inflammation

Systemic inflammation, like that caused by a generic, stress-related inflammation response, leads to minor swelling, also of the skin. This causes the pores to constrict slightly, and any oil, dead skin cells, or bacteria 🦠 in that pore get trapped.

This is the primary cause of all acne, from blackheads to cysts. During high-stress times, like pregnancy, you’re prone to increased inflammation 🔥 and thus, an increased possibility of acne.

Sex Hormones and Acne Skin Changes

The two hormones most related to acne are testosterone and estrogen. Although you may have heard that boys produce testosterone and girls produce estrogen, the truth is, everyone produces both. However, no matter how much of either hormone you typically produce, neither one inherently causes acne. It’s when your own natural levels start to change that acne becomes a possibility.

It’s All About Ratios

How these hormones affect acne all depends on the ratio between testosterone and other, balancing hormones, like estrogen. If your body produces more testosterone than normal, you can see an increase in acne. If you start producing more estrogen, acne may start to disappear.

However, if your normal estrogen levels drop, no matter what they were originally, you’re likely to have more acne. This is because there’s less estrogen to balance out your normal levels of testosterone, whether they’re high or low 📉.

What Happens To Cause Acne During Pregnancy?

Women typically see a rapid increase in estrogen during the first trimester. This then plateaus in the second and third trimesters, and a slow, steady increase in testosterone follows throughout the rest of the pregnancy 🤰.

The initial increase in estrogen can cause that “pregnancy glow” people talk about, but it can also cause acne or something known as “the mask of pregnancy.” This gives the skin a dark or grayish hue.

Pregnancy acne is most likely to occur toward the end of the second trimester, and throughout the third trimester, because estrogen levels even out as testosterone levels continue to rise.

Pregnancy acne usually starts at the end of the second trimester due to the increase in testosterone.

How Exactly Do These Shifts Lead to Acne During Pregnancy?

Shifting hormones contribute to one of the main causes of acne: excess oil production. Whenever testosterone increases (or estrogen decreases), the body produces more oil, which can lead to blackheads, whiteheads, pimples, and even cysts.

Blackheads and Whiteheads

Oil creates blackheads and whiteheads in much the same way because they’re very similar. The only difference between a blackhead and a whitehead is whether or not the pore is closed.

A whitehead forms when oil and dead skin cells get trapped in a closed pore, and a blackhead forms when a clogged pore is open. Blackheads develop their dark color as the oil in an open pore gets oxidized by the air and turns brown in the pore. Excessive oil clogs pores more easily, leading to an increase in blackheads and whiteheads.

Pimples and Cysts

Oil can also lead to pimples and cysts, even though these types of acne are most commonly attributed to the third cause of acne: bacteria. Propionibacterium acnes bacteria 🦠, for instance, always live on the surface of our skin, and as long as they don’t grow to especially large numbers or get trapped in the pores due to inflammation 🔥, they typically don’t cause any problems. With more nutrition, the bacteria can multiply very quickly and cause minor infections that lead to pimples and cysts.

Medically Reviewed: How To Treat Hormonal Acne

When you’re pregnant, hormonal acne treatments are forbidden. There isn’t really any medically reviewed way to treat acne during this time, simply because there’s no way to clinically test which products are safe or risky to use.

However, all hope isn’t lost, and you don’t have to be a prisoner of your breakouts. For treatment options, let’s start with what you should not do.

Medications with Which Not To Treat Pregnancy Acne

During pregnancy, acne treatment should be even safer than usual, and the three acne medications the American Academy of Dermatology warns against when you’re pregnant include:

  1. isotretinoin (commonly called Accutane)
  2. tazarotene
  3. spironolactone.

All of these drugs have been proven to cause birth defects 👶. Chances are your doctor won’t even prescribe them without also prescribing birth control, and having you sign a pledge to use two forms of birth control at all times.

Isotretinoin and tazarotene are both retinoids (vitamin A derivatives), but they’re incredibly strong ones. Milder topical retinoids, like Differin, have not been studied extensively in pregnant women, but they may be worth discussing with your doctor 👨‍⚕️.

However, if your acne presents problems like anxiety or depression, you should definitely talk to your doctor about your options, because your mental health is important for your baby, too.

Are There Acne Medication Options That Don’t Cause Birth Defects?

In short—doctors aren’t sure if any drug use during pregnancy is 100% safe for all women. This includes all prescription acne medications. Although some antibiotics 💊 are deemed safe during pregnancy, more and more research suggests that antibiotics aren’t really effective acne treatments.

As previously indicated, very few drug studies have been conducted on pregnant women, exactly because there’s no practical and ethical way to ascertain the dangers of various medications during this time.

What About Home Remedies as Acne Treatments?

One of the safer options to consider would be home remedies, but always consult with your doctor or dermatologist first. In very large doses, even essential oils can be harmful, and some, like lavender oil, are known to affect hormone levels. To date, there are no recorded birth defects or miscarriages due to their use, but this isn’t a time in your life to experiment with potentially risky treatments.

The safest approach would definitely be to keep your skin clear, and avoid breakouts with topical, over-the-counter treatments, or products you can order online. If you doubt the wisdom of any purchase—talk to your dermatologist or doctor 👨‍⚕️.

The Best Treatment for Pregnancy Acne

The best acne treatments for women during pregnancy are very simple, as you may have surmised. The Exposed Skin Care Basic Kit has only four products and three steps , which will take you less than five minutes each morning and night. Our products use the best ingredients for fighting acne 💪 while protecting your skin and your baby.

Pregnancy acne is a pain, but taking on an intensive skin care regimen to get rid of it isn’t always feasible. Our Basic Kit is designed to be quick, easy, and effective.

Benzoyl Peroxide

Benzoyl peroxide can treat acne during pregnancy because it effectively kills P. acnes bacteria 🦠. The compound carries oxygen below the surface of the skin so it can come into contact with the bacteria. P. acnes are anaerobic, meaning they can’t survive long in the presence of oxygen.

Many over-the-counter products and acne treatments contain this chemical, but our products contain lower concentrations that aren’t harsh on the skin.

Green Tea Extract

In order to prevent any irritation or inflammation 🔥 in acne skin during pregnancy, harsh acne-fighting products should be avoided. Therefore, we have added gentle and safe green tea extract 🍃 to our line of products for its anti-inflammatory properties.