Skincare Ingredients Contraindicated in Pregnancy

Introduction to Contraindicated Ingredients

Systemic retinoids, such as oral isotretinoin and acitretin, are absolutely contraindicated in pregnancy due to severe teratogenic risk, while topical retinoids should be avoided despite reassuring safety data, and high-dose salicylic acid should be limited due to theoretical salicylate toxicity risk, as recommended by the American Academy of Dermatology and the British Journal of Dermatology 1, 2, 3

Oral acitretin is contraindicated during pregnancy and breastfeeding, and requires strict contraception for 4 weeks before, during, and for 3 years after treatment cessation due to prolonged elimination, as stated by the British Journal of Dermatology 4
Patients taking oral acitretin must abstain from alcohol, which converts acitretin to etretinate, and undergo medically supervised negative pregnancy testing within 2 weeks prior to therapy, according to the British Journal of Dermatology 4

All topical retinoids, including tretinoin, adapalene, and tazarotene, are classified as Pregnancy Category C by the American Academy of Dermatology, and despite reassuring human data, are contraindicated during pregnancy, as recommended by the American Academy of Dermatology and the British Journal of Dermatology 1, 2, 3

High-dose salicylic acid (>2%) should be avoided during pregnancy due to the risk of salicylate toxicity, particularly on large body surface areas, and is classified as Pregnancy Category C, as stated by the Journal of the American Academy of Dermatology 5
Low-dose salicylic acid formulations (0.5-2%) in limited areas are generally considered acceptable, but should be used with caution, as recommended by the Journal of the American Academy of Dermatology 1, 5

Azelaic acid 20%, topical erythromycin, and topical clindamycin are considered safe alternatives for pregnancy, with a Pregnancy Category B classification, as recommended by the American Academy of Dermatology 1, 3
Benzoyl peroxide, although classified as Pregnancy Category C, has minimal systemic absorption and is expected to have minimal fetal harm, according to the Praxis Medical Insights 3

Dapsone 5% gel is classified as Pregnancy Category C, and has limited safety data in pregnancy, so should be avoided unless benefits clearly outweigh risks, as stated by the Journal of the American Academy of Dermatology 1

The American Academy of Dermatology and the British Journal of Dermatology recommend that topical retinoids should not be assumed to be safe during pregnancy, despite appearing safer than oral isotretinoin 2, 3
The 3-year rule for acitretin is non-negotiable, and alcohol consumption during or after acitretin therapy extends the contraception requirement, as stated by the British Journal of Dermatology 4

Systemic retinoids (oral isotretinoin, acitretin) are absolutely contraindicated during pregnancy because they cause severe, well‑documented teratogenic effects (retinoic‑acid embryopathy). 6

Moisturizers that do not contain retinoids are considered safe for use throughout pregnancy and lactation, according to the American Academy of Dermatology guidelines. 7, 8