Acne and Pregnancy

Acne and Pregnancy: Is it safe to use oral or topical agents for treating acne in pregnancy?

Acne is a condition that affects women in different stages of life. Though it is possible to use any oral and topical agent you want during puberty and menopause, when pregnant, care has to be exercised in choosing the right treatment for treating acne.

This is because topical acne medications may cause potential toxic and teratogenic effects to pregnant women which cause problems in the fetus. If any such medication has to and is prescribed by the dermatologist, prompt reporting of adverse effects should be advised to the patient.

Oral tetracycline is one of the drugs prescribed for treating acne. However it is said to be related to maternal liver toxicity and produces deciduous tooth staining in the infant while tetracycline is associated with other congenital anomalies. Even maternal isotretinoin ingestion is associated with craniofacial and cardiac deformities, along with other congenital anomalies. Of the lot, erythromycin appears to be safe.

This is why doctors usually suggest topical therapy for treating acne in pregnancy. Specific categories of topical erythromycin, clindamycin and benzoyl peroxide are all considered safe for use in pregnancy. However topical tretinoin of category C is not advised for use as there are reports of congenital deformities in infants after their mother used tretinoin in the first three months of pregnancy.

Even the use of adapalene of category C and tazarotene of category X are not suggested for use in pregnant women. As topical metronidazole (category B) and Azelaic acid (category B) is minimally absorbed, it is quite safe for use in pregnancy. Though tetracyclines (category D) may cause deciduous tooth staining if taken in the first trimester of pregnancy, along with decreased bony growth and maternal liver toxicity, its inadvertent exposure in the first trimester is not that harmful.

Another topical treatment for acne, oral isotretinoin (category C) is a famous teratogen. If a woman takes this medication for treating acne, it is safe to conceive after a month of stopping the medication.

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