Skincare educator Cigdem Kemal Yilmaz explains the considerations for recommending topical skincare to pregnant clients, ingredients to avoid and safe swaps...
An evolutionary life experience, pregnancy comes with an influx of body changes. The skin is no exception, and with studies suggesting that 90% of pregnant women experience some form of skin changes that need special care and treatment, navigating skincare during pregnancy requires a delicate balance between safety and efficacy.
From hormonal fluctuations to increased sensitivity, pregnancy presents specific challenges and considerations when recommending skincare products and treatments.
It’s therefore imperative that skin professionals understand the unique physiological changes expectant mothers undergo and how they impact skin health. By staying informed about pregnancy-specific skincare concerns, and equipping yourself with robust skincare science knowledge, you can confidently provide guidance and support to adapt your client’s skin regimens accordingly and ensure the wellbeing of both mother and baby throughout this transformative journey.
Consultation and education
A thorough consultation and skincare science knowledge is integral to formulating an effective treatment plan for clients to ensure you make accurate decisions based on scientific facts. This allows you to develop a fully faceted treatment plan that acknowledges the client’s medical history and skincare journey in its entirety as opposed to focusing solely on the indication.
During consultation, you should consider hormonal changes that can affect the condition of the skin, as well as awareness of common dermatological issues associated with pregnancy, such as hyperpigmentation (melasma), acne and stretch marks.
You should also consider skin sensitivity in this time. Pregnant women may experience increased skin sensitivity, making them more prone to irritation or allergic reactions. Even if the patient is well known to you, nothing should be assumed as the skin may react differently so conduct a patch test to determine any potential issues and how the skin will react.
In some cases, you may need to consult with the client's obstetrician or healthcare provider to ensure that recommended treatments are safe and appropriate during pregnancy. Collaboration between skincare professionals and medical professionals can help ensure the best possible outcomes for pregnant clients.
Safe ingredients
Safety of both mother and foetus a priority when it comes to pregnancy skincare, and it is common for skincare professionals to advise avoiding certain ingredients that may pose potential risks. While the evidence regarding the safety of certain ingredients during pregnancy is not always conclusive, it’s generally recommended to err on the side of caution.
It’s also important to take into consideration the concentration percentage of the ingredient that you are using as this can also have an effect.
Here are some skincare ingredients that are advisable for pregnant women to avoid and some alternative, yet effective options.
OUT… Retinoids
Retinoids, including retin-A (tretinoin) and retinol, are derivatives of vitamin A commonly used in skincare for their anti-ageing and acne-fighting properties. However, high doses of vitamin A derivatives have been associated with an increased risk of birth defects when taken orally. While the risk of birth defects from topical retinoids is less clear, many healthcare providers advise pregnant women to avoid them as a precaution.
SWAP FOR …
Using skincare products that contain gentle exfoliants such as alpha hydroxy acids (AHAs) including glycolic or lactic acid in concentrations of 10% or less, or beta hydroxy acids (BHAs) like salicylic acid in concentrations of 2% or less, can provide effective, yet safe alternatives to retinoids.
Ingredients such as niacinamide, and antioxidants such as Vitamin C, can help brighten the skin and improve texture. Products containing sulfur have antimicrobial properties and can help control acne without the potential risks associated with retinoids. Gentle ingredients such as colloidal oatmeal or witch hazel are also good alternatives for soothing inflamed skin.
Bakuchiol is touted to be a natural alternative to retinol but as there is no data to say whether it’s safe or unsafe to use for this group, I would limit use to 1%.
Additionally, consider using products containing azelaic acid, which is effective in treating acne and hyperpigmentation and is generally considered safe during pregnancy.
OUT … Hydroquinone
Hydroquinone is a skin-lightening agent used to treat hyperpigmentation disorders such as melasma. While topical use of hydroquinone is generally considered safe in low concentrations, its safety during pregnancy is uncertain. Some studies have raised concerns about potential risks to foetal development, leading many healthcare providers to advise against its use during pregnancy.
SWAP FOR …
Natural skin-lightening ingredients such as liquorice extract, vitamin C, or kojic acid, can help reduce the appearance of hyperpigmentation without the potential risks of hydroquinone.
OUT … Arbutin
Another skin-lightening ingredient, alpha arbutin is commonly used in skincare products to reduce the appearance of hyperpigmentation and dark spots. Many healthcare providers advise pregnant women to avoid it as a precautionary measure.
SWAP FOR …
Similarly to the above, skin-lightening ingredients such as liquorice extract, vitamin C, or kojic acid, can be used as an alternative to arbutin.
OUT … Chemical sunscreens
Pregnancy can heighten the risk of developing or exacerbating skin pigmentation issues such as melasma due to increased sensitivity to ultraviolet (UV) radiation. It’s essential, therefore, that as professionals, we emphasise the importance of good sun-protection protocols and recommend a broad-spectrum sunscreen with high SPF for daily use.
However, some chemical sunscreen ingredients, such as oxybenzone and avobenzone, have raised concerns about potential hormone-disrupting effects. While the evidence is limited and the risk of systemic absorption is low, some pregnant women may prefer to use alternatives.
SWAP FOR …
Physical (mineral) sunscreens containing ingredients like zinc oxide or titanium dioxide provide broad-spectrum protection against UVA and UVB rays without the potential risks associated with chemical sunscreen ingredients and can be used as an alternative to chemical sunscreens. Look for sunscreen formulations specifically labelled as "pregnancy-safe" or "safe for sensitive skin."
Client-healthcare professional collaboration is key when formulating a pregnancy skincare regimen so that the client’s entire skincare history is considered and they can prioritise skincare practices that promote safe skin health and comfort during this important phase of life.
Cigdem Kemal Yilmaz is a chemical engineer and founder of the CPD-accredited skin specialist course Skin Masterclass Pro.