skin care

How to Adjust your Skin-care Routine During Pregnancy and Postpartum

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Along with the existential changes that come with incubating a human, rampant hormonal fluctuations take your skin on quite a ride. If you’ve stood in front of the mirror wondering whether that should go on your face right now, rest assured, you’re not the only one. “It can be really difficult to determine what products are ‘pregnancy-safe’ without an understanding of skin care,” says Shereene Idriss, M.D., board-certified dermatologist at Idriss Dermatology in New York City. “Even as a derm, I experienced the same confusion.”

There are plenty more dermatologists, doulas, and OB/GYNs who know these roads personally, so we asked them how to build a pregnancy skin-care routine — and what ingredients to jettison from the first to the fourth trimester.


How does your skin change during pregnancy?

“During pregnancy, we experience changes in sex hormones, our immune system, and the cardiovascular system, which all, in turn, affect our skin,” says Dr. Idriss. Here are the changes to get familiar with:

Melasma: “Pigmentation can become a problem during pregnancy, particularly the start of a condition called melasma,” says Elyse Love, M.D., FAAD, a board-certified dermatologist in New York City. Dr. Idriss says the so-called mask of pregnancy tends to develop in the second half of pregnancy for a staggering 70 percent of women. Melasma looks like darkened, irregularly shaped brown patches on the forehead, cheeks, and upper lip. Lindsey Zubritsky, M.D., FAAD, a board-certified dermatologist in Pittsburgh, says this condition is more common in those with darker skin tones but that it can be controlled with proper sun protection and topical treatments.

Acne: Oh, you thought high school was hard? “Some may notice increased oiliness and acne during pregnancy, particularly in the first trimester,” says Love. This cystic acne is relatively short-lived, as most people notice an improvement in the second trimester, but Dr. Zubritsky notes that people of color are at a higher risk of developing post-inflammatory hyperpigmentation and keloid scars from said acne.

Growths: Love says it’s common to notice an increased number of harmless skin growths: “This includes skin tags, cherry angiomas, seborrheic keratosis, and dermatosis pigmentosa nigra.” Like melasma, she says, these will also persist after delivery but can be treated cosmetically.

Spider veins: Love says that owing to an increase in blood volume, some women may notice spider veins on the lower legs. “Most of these will reverse after pregnancy, but compression socks can be helpful to minimize their occurrence during pregnancy.”

Stretch Marks: Wherever your skin is expanding, like your breasts and belly, you may get stretch marks — no matter how diligently you lather up in oil.

It’s not all bad: “Because of all of the hormone changes and increase in blood volume, often, pregnant mamas notice their skin is glowing,” says Mara Weinstein Velez, M.D., FAAD, board-certified dermatologist and director of cosmetics and laser surgery at the University of Rochester Medical Center in New York. Dr. Idriss reminds us that “on a more positive note, certain autoimmune conditions like psoriasis can improve during pregnancy, so reap those benefits while you can.”

What skin-care ingredients should you avoid when pregnant?

All of the derms we spoke to said the top ingredient to avoid is any kind of retinoid, topical or prescription, including tretinoin, retinol, retinal, and retinyl. These are followed by hydroquinone, which is a common ingredient used to treat hyperpigmentation but has far too high of an absorption rate for pregnancy or breastfeeding. Most derms also said to avoid salicylic acid and benzoyl peroxide unless prescribed by a physician and used in moderation.

“When there’s any doubt or question about the safety of an ingredient, I recommend taking for the safer option and skipping it altogether,” says Banafsheh Bayati, M.D., OB/GYN, FACOG. For those who want to look deeper into what to avoid, Dr. Bayati — alongside panel members of the women’s vitamin brand Perelel — created “Unclean 15,” a list to help women easily identify potentially toxic ingredients during pregnancy, while breastfeeding, or when trying to conceive.

So … what skin-care products are safe to use while pregnant?

“Most people should stick to gentle, fragrance-free cosmetics,” says Love. For those experiencing acne breakouts or pigmentation, she says alpha hydroxy acids (AHAs) can be helpful but that you should see a board-certified dermatologist before using them.

Birth doula and founder of C & The Moon Carson Meyer suggests running your products through an ingredient database to double-check their safety or finding a shop like the Detox Market, which does a lot of the vetting for you. She adds, “Pregnant or not, staying away from endocrine-disrupting chemicals, toxic heavy metals, and harsh fragrances is going to have a positive impact on your health and skin.” Whatever you switch to, Jordan suggests, “start out slowly, but consistently, with a goal of being fully immersed in your new regimen by the end of your first trimester.”

Do I need to keep this new beauty routine up postpartum?

Love says it’s important to note that a pregnancy-safe routine is not the same as a breastfeeding-safe routine. Don’t worry: This will make life easier, since the rules let up a little once the baby is Earthside. “Products that do not pass into breast milk and products that are safe to use on babies are typically considered ‘breastfeeding-safe,’” says Love. If you’re not breastfeeding, Dr. Idriss says your postpartum routine can simply revert to your pre-pregnancy skin-care routine.

As parting advice, Dr. Bayati says, “When pregnant or breastfeeding, opt for fewer, safer products and ingredients.” To help you find some alternatives, see what dermatologists and doulas incorporated into their own routines.

Dr. Mara Weinstein Velez’s Routine

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“My skin goals were to prevent hyperpigmentation and stay clear of acne,” says Dr. Weinstein Velez. First, she stopped using medicated products with retinoids, benzoyl peroxide, and salicylic acid, then switched to an all-pregnancy-safe routine. “I used a glycolic acid cleanser (Glytone) in the morning, followed by a vitamin C serum (SkinCeuticals), and then the Hyaluronic Acid Gel Moisturizer from Neutrogena.” She topped everything off with sunscreen, with her favorite being Alastin’s HydraTint. In the evening, she would cleanse with a foaming cleanser, followed by a prescription azelaic acid topical, and La Roche Posay’s Toleraine Moisturizer. “I would also get glycolic acid peels every few months!”

Doula Carson Meyer’s Routine

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“If you don’t already opt for clean skin-care products, pregnancy is a great time to detox your routine,” says Meyer. “Fortunately, I already ditched products with endocrine-disrupting chemicals, synthetic fragrances, and harsh chemicals and established a clean skin-care routine long before pregnancy.” Her advice is to keep it simple: She says to stay away from fragrances unless you know they are made clean and to opt for natural products with a short list of ingredients you recognize. When she was pregnant, Meyer stuck with her company’s C & The Moon scrub and oil; both of which were formulated with moms in mind. She also made herself a shea butter and tallow mix and used Iris & Rome’s Best Skin Days foundation and Evereden’s sunscreen (“[it] contains zinc, a better alternative to oxybenzone for sun protection”) during the day.

Doula Brandi Jordan’s Routine

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I like to keep things very simple by recommending that clients switch to a gentle cleanser to be used day and night, and limit fragrances when possible,” says Jordan. “Next, they can find topical treatments that are deemed safe for use during pregnancy and increase daily hydration to their face and bump.” She recommends daily sunscreen, and being unapologetic in your indulgence in beauty and self-care. As a lactation consultant, she recommends Swehl’s (she is on its board) Nips Duos to help alleviate common pain caused by cracked and sore nipples and especially likes the minimalist packaging. (“Small details like this can make a big difference when there are so many things to learn and a new parent is working hard to take everything in.”) For remedies already in the home, she turns to “good old coconut oil.” Jordan adds that anything you put on your breast or nipples should not need to be wiped off prior to nursing, as it ought to be comprised of food-safe ingredients.

Dr. Lindsey Zubritsky’s Routine

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As a pregnant dermatologist, the first thing I discontinued was the use of my topical retinol,” says Zubritsky. She replaced retinol with azelaic acid and bakuchiol, turned up the hydration, and avoided fragrances to appease her dry and sensitive skin. “I swapped out my previous cleanser for something with hyaluronic acid, like Neutrogena’s Hydro Boost cleanser, which was so soothing on my skin.” (Zubritsky has previously worked with Neutrogena as a sponsor.) She also opted for a moisturizer that not only would hydrate but wouldn’t clog pores and started using a prescription-strength azelaic acid to help with fine lines, discoloration, and acne.

Dr. Shereene Idriss’s Routine

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The first thing I changed in my skin-care routine was switching to bakuchiol as an alternative for retinoids,” says Idriss. “My melasma was out of control towards the end of my pregnancy and postpartum [but] I did not use hydroquinone.” Instead, Idriss incorporated different brightening ingredients to target her discoloration — which caused her routine to balloon to an unwieldy 10 to 12 steps. “Hence why I created the PillowtalkDerm Major Fade Solution System,” she says. Idriss’s label is meant to simplify a routine targeting discoloration, something she personally struggled with staying on top of. Evidently, she’s not alone: the Major Fade system is currently on backorder.

More selects:

It takes a village (sometimes of glass bottles and fancy formulas), so we asked our community for their pregnancy skincare favorites. First up: A nourishing oil or body balm that’ll turn your skin into an elastic waistband.

Acne during pregnancy is particularly brutal for those who previously had a potent regimen; here are some gentle products to guide you through the hormonal shifts.

You heard the doctors: It’s hard to find a pregnancy-safe retinol alternative that actually works. Isdin is loved by dermatologists, but so is this particular formula from The Ordinary for something easier on the wallet.

Lots of moms-to-be in our orbit revamped their entire regimen to “cleaner” products. One of the easiest categories to check off the list proved to be mineral sunscreen.

Our experts:

How to Adjust Your Skin-Care Routine During Pregnancy