How to Safely Treat Your Postpartum Acne
After pregnancy, you’ll have a lot to deal with (understandably). And that’s only made more frustrating when you’re dealing with something in the postpartum period that you thought you left long behind in your teenage years: acne.
Credit: Academic Alliance in Dermatology
Having those uncomfortable bumps all over your face can be both annoying and confusing. Is this stuff different from the acne you got before pregnancy? Will your old products work? And if you’re breastfeeding, will they be safe?
Here’s what experts want you to know about postpartum acne, as well as safe ways to treat it.
What causes pregnancy-related acne?
It’s not a secret that pregnancy can change your skin—including causing acne. But why does this happen? The short answer: hormones.
The long answer: When you become pregnant, your body releases a surge of progesterone, the hormone that helps to line the uterus and prepare for the egg. “The rapid surge of progesterone in the first trimester is typically what brings about acne in pregnancy,” Meghan Dickman, M.D., clinical assistant professor of dermatology at Stanford University, tells SELF.
That bump in progesterone causes your body to ramp up the production of sebum, an oil that clogs pores. That also increases the chances that your pores and hair follicles will get clogged with oil, bacteria, and dead skin cells instead of being shed. That leaves you with bumps on your face.
And, Dr. Dickman explains, progesterone hits its peak in the third trimester, so after the initial surge in the first trimester, you might see even more oiliness and acne later on.
If you experienced acne as a teen or dealt with it frequently before pregnancy, it’s possible that you’re someone who just naturally produces more sebum, making it more likely that you’ll deal with acne during and after pregnancy as well. Having hormone-related health conditions (like polycystic ovary syndrome) also increases your risk.
After giving birth, your progesterone and estrogen levels plummet until, thanks to those classic hormone fluctuations, you start menstruating again. So, whether or not you breastfeed can also factor into your chances for postpartum acne. “When women lactate, they normally still aren’t menstruating,” Ashley Crew, M.D., assistant professor of clinical dermatology and residency program director at USC, tells SELF. But, she says, when their periods start to come back, they may see acne again.
After pregnancy, it could take as many as six to eight weeks for your hormones to settle down. “I’d say most hormonal acne clears up [at the] end of the third trimester and a few weeks after pregnancy,” Dr. Dickman says. If your acne persists beyond that, you may have an underlying hormone-related issue or another cause of acne that can’t be attributed to pregnancy. Plus, of course, stress can contribute to breakouts at any time.
How can you treat it safely?
If you’re not breastfeeding, you only really have to worry about what your skin can handle. A dermatologist can help you figure out what’s going on and guide you through your treatment options—especially if this is a new issue for you or your acne is more severe or different from what you dealt with before pregnancy. But you have a little more room to experiment.
But because there are concerns about some acne products getting into your breast milk and putting your baby at risk, they aren’t recommended if you’re nursing. However, it’s important to recognize that many of these treatments haven’t been studied extensively in breastfeeding people, so the recommendations you may get are based on a careful weighing of what we know, what we don’t know, and the severity of the symptoms you’re dealing with. That’s why it’s always a good idea to speak with your dermatologist, doctor, or paediatrician who’s familiar with your individual circumstances before trying a new acne product.
For example, retinoids such as tretinoin and isotretinoin are a no-no during pregnancy because they have been linked to birth defects. However, tretinoin “is considered a low risk to the nursing infant” with a topical application, according to the U.S. National Library of Medicine. But because so little is known about the use of these medications while breastfeeding, your dermatologist will likely suggest milder options first.
Dr. Dickman also prefers to avoid benzoyl peroxide (the active ingredient found in many acne products). As SELF explained previously, benzoyl peroxide is generally considered safe during pregnancy because so little is absorbed through the skin. And the amount of benzoyl peroxide found in most over-the-counter products is “generally pretty low,” Dr. Dickman says. But if you can, your dermatologist may still recommend you avoid using this while breastfeeding.
Over-the-counter topical products that contain azelaic acid, salicylic acid, glycolic acid, or sulfur are generally milder, yet effective, options. For instance, Dr. Crew recommends the CeraVe Renewing SA Cleanser, $14. And Dr. Dickman suggests checking out the brand Belli, which has several products that are safe during pregnancy and while breastfeeding.
When it comes to prescription options, some antibiotics are known to be safer than others. Topical clindamycin, for instance, can help safely manage the bacteria that contributes to acne. But other types, such as erythromycin and tetracycline, may not be recommended or may be reserved only for more severe cases or short-term use.
In general, you should check in with your derm before trying any new acne product while breastfeeding, just because every case can be different.
By Nikhita Mahtani
This article first appeared in SELF.