The journey of pregnancy is a magical time with the expectation of new life, but it’s also a complex time. It’s a period where the safety of everything, including skincare products becomes a primary concern. Skincare during pregnancy is a maze of choices. Where understanding the safe and risky products is a matter of utmost importance. Let us explore making sense of skincare safety in pregnancy.
As you peruse through skincare aisles, it’s crucial to recognise that even skincare experts like dermatologists and aestheticians do not all agree on which skincare actives are fair game during pregnancy and which aren’t. This uncertainty stems from the diverse range of skincare ingredients and their varying effects. Some products or actives may be safe under certain conditions. Such as limited concentration, minimal use, or when used in rinse-off formulations, but figuring out these safe limits can be perplexing.
Regulation Of Skincare Products
One might expect that regulatory agencies oversee skincare safety in pregnancy, a precious time in your life. However, the nuanced regulation of personal care products depends on whether authorities categorise them as cosmetics or drugs. So, what’s the difference.
A cosmetic beautifies and cleanses e.g., moisturisers, perfumes, lipstick, fingernail polish, makeup, shampoo, toothpaste, deodorant. While cosmetics must legally be safe when used as per product labelling. They typically do not undergo approval before entering the market.
A drug on the other hand treats or prevents disease or affect the structure or function of the body e.g., treatments for acne or dandruff, sunscreen, antiperspirant, diaper ointment. Drugs generally are subject to premarket approval.
A personal care product can be both a cosmetic and a drug e.g., a moisturiser with sunscreen, an antidandruff shampoo, an antiperspirant deodorant, toothpastes that contain fluoride.
This distinction is vital, as many skincare products claiming to treat various skin conditions straddle the line between cosmetics and drugs. Often existing in a grey area. These formulations contain skincare actives at such low concentrations that they, at most, fall under the category of over the counter (OTC). Allowing their placement on the market without the need for an approved drug application. With minimal regulatory stringency for skincare products, figuring out skincare safety in pregnancy becomes a critical consideration. How can you then actively assess their suitability for use during this crucial period.
Understanding FDA Pregnancy Categories
The U.S Food and Drug Administration (FDA) provides the Pregnancy and Lactation Labelling Rule (PLLR). Which offers detailed information on the potential risks and benefits of drugs to the mother and baby. And how these risks may change during the course of pregnancy. Yet, the majority of skincare products, classified as OTC drugs, remain unaffected by the new FDA pregnancy labelling. As it does not extend to them. To navigate this complexity, the FDA’s risk categories (A, B, C, D, X) based on the potential impact on the unborn child becomes a crucial tool to determine skincare safety in pregnancy.
Category A:
Controlled studies during pregnancy have failed to demonstrate a risk to the unborn baby in the first trimester and there is no evidence of the risk in later trimesters. The possibility of foetal harm appears remote. Pregnancy-safe skincare actives in this class include well-known examples like vitamin C and E, affirming their safety for use during pregnancy.
Category B:
Animal-reproduction studies have demonstrated no foetal risk and there are no controlled studies in pregnancy. OR animal studies have demonstrated risk to the unborn baby that was not confirmed in controlled studies in the first trimester of pregnancy and there is no evidence of risk in later trimesters. Pregnancy-safe use is generally attributed to actives in this class, such as azelaic acid.
Category C:
Studies in animals have revealed adverse effects on the unborn baby and there are no controlled studies in pregnancy. OR studies in pregnancy and animal-reproduction are not available. During pregnancy, the use of drugs from this class is permissible if the benefits to the mother outweigh the risks to the unborn baby. Notable examples of actives in this category include hydroquinone, adapalene.
Category D:
Evidence of human foetal risk has been documented, but the potential benefit to the mother may be deemed acceptable despite the associated risk to the unborn baby.
Category X:
Studies in animals or humans have demonstrated human fetal risk. The risk to the unborn baby outweighs any potential benefit to the mother. Avoid using drugs in this category during pregnancy, such as tazarotene.
Experts universally affirm the safety of using only category A and B skincare actives during pregnancy. While it may be challenging to analyse ingredient lists of your skincare product. It is comforting to note that most of these actives act topically and therefore produce minimal systemic effects. The minimal absorption into the body means reduced chance of impacting your developing baby. Leveraging this knowledge enables safe treatment or management of pregnancy-induced skin conditions. That may worsen during pregnancy, all without compromising the safety of the unborn child.
Skincare Ingredients to Avoid During Pregnancy
Hydroquinone and topical retinoids such as tretinoin, isotretinoin, tazarotene and adapalene stand out as the most commonly agreed-upon actives that experts recommend avoiding during pregnancy. Avoid hydroquinone due to its notably high absorption rate (35%- 45% absorption). Steer clear of retinoids, known to cause birth defects when taken orally.
Pregnancy- Safe Skincare Alternatives
Actives considered safe to use during pregnancy include vitamin C, azelaic acid, niacinamide, AHAs such as glycolic acid, lactic acid, mandelic acid especially when used in concentrations not more than 10%. Benzoyl peroxide and salicylic acid though both category C are still both considered safe to use in pregnancy. Though certain precautions may be taken to minimise any possible risks or side effects. Such as using lower concentrations, 5% or less for benzoyl peroxide and 2% or less for salicylic acid. Using rinse-off formulations as opposed to leave-on treatments especially when they are to be applied on the body not the face. Using sparingly instead of daily.
Customising Your Skincare During Pregnancy
Transitioning to pregnancy-safe skincare routine doesn’t mean sacrificing effectiveness. It might not be easy to give up your beloved skincare actives, but it is worth it to protect your little bundle of joy, and there are many safe alternatives that would still enable you radiate with confidence while making healthier choices for your unborn child. Always consult with your OB-GYN or dermatologist for tailored advice, considering your unique pregnancy skincare concerns, needs and goals.
In conclusion, navigating skincare during pregnancy involves understanding the nuances of product safety & regulation and skincare safety in pregnancy. It’s time to be cautious but also to embrace the changes with confidence and knowledge. By choosing the right products and seeking expert advice, expecting mothers can enjoy this special time with peace of mind. Knowing they are making the best choices for themselves and their little bundle of joy.
