A Dermatologist’s Guide to Safe Skincare During Pregnancy | As Seen in Goop

Navigating skincare during pregnancy can feel overwhelming, especially when so many popular ingredients suddenly land on the “avoid” list. Dr. Mona Foad, breaks down exactly which ingredients and devices to skip during pregnancy, what safe alternatives actually work, and how to simplify your routine without sacrificing results, featured in Goop. From retinoid replacements to sunscreen swaps, here’s everything you need to know to keep your skin healthy and protected while pregnant.

How does pregnancy change the way skin behaves — and how does it affect the way your skin absorbs topical ingredients?

Pregnancy can change the way the skin behaves in several ways because of hormonal shifts. Many patients notice increased oil production, changes in pigmentation, or heightened skin sensitivity during this time. The skin barrier can also become more reactive, which means products that were previously well tolerated may suddenly feel irritating. While the skin still functions as an effective barrier, dermatologists tend to be more cautious with certain ingredients during pregnancy. Even though systemic absorption from topical products is usually minimal, we try to minimize exposure to ingredients that may carry theoretical risks. For that reason, I typically recommend simplifying skincare routines and focusing on gentle, well-studied ingredients during pregnancy.

Why are vitamin A derivatives (retinoids) generally discouraged?

Dermatologists typically advise against retinoids during pregnancy largely because of what we know about oral isotretinoin, which causes birth defects when taken systemically. Because topical retinoids are also vitamin A derivatives, there has historically been concern about the possibility of systemic absorption, even though the amount absorbed through the skin is generally very small. Out of an abundance of caution, most dermatologists recommend discontinuing topical retinoids such as retinol, tretinoin, and adapalene during pregnancy. The safety data in pregnant patients is limited, so we prefer to err on the side of safety. Fortunately, there are several alternative ingredients that can help address common concerns like acne or uneven tone during this time.

Which alternative ingredient(s) do you recommend in place of retinoids, and why?

There are several ingredients that can serve as helpful alternatives to retinoids during pregnancy. One that I frequently recommend is azelaic acid, which can help address both acne and pigmentation while also calming inflammation. It’s generally well tolerated and has a strong safety profile. Niacinamide is another excellent option because it supports the skin barrier, helps regulate oil production, and can reduce redness. Some patients may also benefit from gentle exfoliating acids, such as lactic acid, but I would stay under 10%.. During pregnancy, I usually encourage patients to focus on maintaining a healthy skin barrier rather than aggressively targeting multiple concerns at once. A simplified routine that supports hydration and skin balance can often go a long way.

What ingredients are safe and effective for managing breakouts during pregnancy?

Hormonal fluctuations during pregnancy often lead to increased oil production, which can contribute to breakouts. Topical prescription Erythromycin and metronidazole are category B in pregnancy. They are considered safe to use if needed for break outs in pregnancy. Azelaic acid is also a preferred ingredient in these cases because it helps reduce inflammation, unclog pores, and improve post-acne discoloration. Gentle exfoliating acids, such as glycolic acid or lactic acid, can also help prevent pore congestion and improve overall skin texture. Niacinamide can be very beneficial, since it helps balance oil production while calming redness and supporting the skin barrier. Overall, the goal during pregnancy is to use consistent but gentle treatments that support the skin’s natural balance rather than relying on stronger acne medications.

During pregnancy, should you switch to a mineral sunscreen?

During pregnancy, many dermatologists recommend mineral sunscreens that contain zinc oxide or titanium dioxide. These ingredients sit on the surface of the skin and physically reflect UV rays rather than absorbing into it. While chemical sunscreens carry a strong safety record, many patients prefer mineral formulas during pregnancy because they offer an extra level of reassurance and sensitive skin tends to tolerate them better. Mineral sunscreens also offer excellent broad-spectrum protection against both UVA and UVB rays. Daily sun protection is particularly important during pregnancy because hormonal changes can increase the risk of hyperpigmentation.