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Safe Way to Treat Pregnancy Pimples?

By Amalah

Hi Amy!

I’m not sure if you can be of any help since you seem blessed with perfectly smooth-as-a- baby’s-butt skin, but unfortunately, I was not! I’ve always had a minor problem with acne (SERIOUSLY! MINOR! Like a little T-zone problem about once a month, ya know?) but now I am 13 weeks pregnant with baby #2 and my face looks like the 16 year old boy who lives next door, who I’m always afraid of standing too close to, for fear something will explode on me. I know, that’s really mean, but it’s SO TRUE.

Anyway, I never had this problem when I was pregnant with my son, which leads me to believe I’m having a girl (THIS IS MY THEORY. DON’T DROWN MY HOPES!) Everyone keeps telling me I can’t use over the counter acne meds because they contain CHEMICALS! THAT WILL CAUSE MY BABY TO BE BORN WITH 3 ARMS AND A CYCLOPS EYE! So I’m desperate for help! I’ve heard that benzoyl peroxide is safe, but what exactly is benzoyl peroxide? Is it an ingredient in something else? Or do I just get a vat of it and play bob-for-apples in there? I’m currently using the Neutrogena facial bar and I think the problem is getting worse.

Please help if you can, Amy! I swear, yesterday a woman at the grocery store backed away from me when I was asking where they moved the Flinstones vitamins, and I know she was scared something was going to explode on her!


I cannot even GUESS how many questions JUST LIKE THIS ONE are sitting in the question queue. I chose to publish yours as the representative sample, Ashley, because your first sentence made me laugh for a good 10 minutes.

You know how pimples and breakouts are often associated with and blamed on PMS? Same principle applies to pregnancy. Hormones go blibbliggity, skin freaks out, the problem usually goes away once your hormones settle down.

The problem with pregnancy breakouts is knowing when, exactly, your hormones will ever “settle down.” For some women, it’s the end of the first trimester, around week 13 or 14 (this was true for me, more or less). For others, it’s more like the third trimester. For even others, it’s a problem alllll the way until the birth, and even for few weeks afterwards. Not gonna lie: that sucks, because pregnancy is both long and short and just all around not a great time to be trying skincare regimen after skincare regimen, trying to get a grip on skin that is just defying all logic and reason.

But! Let’s talk about the Big Bad Scary Chemical Stuff. Every doctor and book and advice-y type person has a different take on pregnancy risks. Some doctors will tell you to avoid anything and everything that has the teensiest, tiniest bit of an unknown, even if there really isn’t any documented proof of actual risk. Sounds like you may have stumbled into that crowd, because over-the-counter topical acne medications really are nothing to be afraid of. You do not want to take PRESCRIPTION acne meds, either topical or oral. Accutane, for example. Seriously Bad. Documented, proven Bad. Prescription-strength topical meds, with very high percentages of the active ingredient (salicylic acid, benzoyl peroxide, etc.) are not quite so Bad, but still best to be avoided.

But in the small amounts found in most creams and moisturizers? Which are then applied in a small amount on your face once a day? Please. These things barely do that much to begin with (which is why we all have tubes and bottles of Crap That Didn’t Work littered around our bathrooms), much less enter your bloodstream in massive amounts and then work through your system and cross the placenta and pickle your baby’s brain. This is not to say you should throw out your doctor’s warnings and start bathing in the stuff, but if you want to treat your zits with a topical, non-prescription strength serum or cream, you can likely do so with peace of mind.

I used Philosophy’s Hope in a Bottle (no longer available) (an oily-skin moisturizer with a bit of salicylic acid) and their On a Clear Day Blemish Serum (different formulation as of the original writing) as needed during both of my pregnancies. Neither product is crazy hardcore, but I do have this crazy theory that even the most poorly behaved skin should be treated as gently as possible. Pregnant skin especially, since if you immediately bust out the big guns and go all nuclear on your acne, you can easily make things worse (think scarring, discoloration, etc.)

You asked about benzoyl peroxide. I did a sort-of primer on the three most popular OTC acne medications here, and some tips on how to figure out which ingredient will work best for YOUR individual flavor of acne without spending a ton of money on an expensive but useless regimen.

Benzoyl peroxide is in Proactiv, for example, but also in other acne creams you can easily find at the drugstore, like Clearasil. (I really love this reference guide from, which tells you exactly what acne med is found in the most popular OTC products.) A couple drawbacks: it’s really drying AND your skin will be more prone to burning in the sun. Which already happens in pregnancy, so FOR REAL, you must wear sunscreen when using OTC acne meds. (And…I KNOW. Sunscreens can also cause breakouts and aaaaeeeiiiiii vicious cycle.) But unless you want to deal with the dreaded mask of pregnancy and sunburns and long-term sun damage, make sure you’re using something with at least 15 SPF everyday. (Regardless of the acne meds, really. But it’s just doubly as important if you do use them.)

Now that you’re out of the first trimester, you may see an improvement in your skin. Your pregnancy hormone levels aren’t doubling at such a rapid pace, so things might start balancing out on their own. If not though, stick with a gentle face wash twice a day, followed by an oil-free moisturizer (with SPF, if you can find one), and feel free to spot-treat your pimples with an OTC cream. If you are going to splurge, I do like the Philosophy acne kits, but you could just stick with cheaper products and buy a weekly mask for a deep treatment.

(Watch your diet, too. Pregnancy junk-food cravings don’t help ANYTHING. I say that from Experience. Bitter, greasy, salty, chocolate-y Experience.)

Don’t forget to visit Amalah’s must-read weekly Pregnancy Calendar.

Photo by virexmachina

About the Author

Amy Corbett Storch


Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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