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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

Published March 9, 2009. Last updated March 27, 2018.
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 [email protected].

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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  • Ang

    March 9, 2009 at 3:52 pm

    I used Neutrogena On-the-Spot Acne Treatment during my recent pregnancy, which for me was a huge improvement over all the salicylic acid products I’d tried before. It is a low (2.5%) benzoyl peroxide cream that I didn’t find horribly drying like salicylic acid. Beware that peroxides bleach…I ruined several towels that I used to dry my hands AFTER I’d washed the cream off my fingertips.

  • Erin

    March 9, 2009 at 4:10 pm

    Hi Ashley! Ask your ob-gyn for advice as well. I’m 22 weeks pregnant, and you sound exactly where I was weeks 12-17 (and oh, I’m so sorry for you, but it does get better!). There are a few topical prescription strength treatments that you can use when you are pregnant — Clindagel is what I’m on now (it’s an antibiotic for your skin if I understand correctly and very mild), and it has helped so much. Also, the philosophy line made my pregnant sensitive skin, freak the hell out, so if that doesn’t work for you, try the neutrogena oil free acne wash cleanser. Good luck and congrats on the baby!

  • Alison

    March 10, 2009 at 11:37 am

    My ob recommended Purpose cleanser (she’s of the school that even teeniest benzoyl peroxide or salicylic acid cleanser is Bad). But, to tell the truth, the Purpose cleanser seems to work better than the other acne ones. And it’s super gentle, so it doesn’t irritate gentle skin. Also, I use the Purpose liquid cleanser, rather than the bar, which may be too drying.

  • Jess

    March 10, 2009 at 12:38 pm

    I was under the assumption that using anything with Benzoyl Peroxide when you’re pregnant is bad (namely ProActiv).
    Also…I gotta say that “Bianca”‘s comment sounds to me like she’s a spammer or works for that company…sooo…there is that.

  • Stephanie

    March 10, 2009 at 1:44 pm

    I actually use the acne medication from Not so keen on their moisturizer or cleanser (I use DML lotion and Philosophy’s Purity). This stuff seriously turned my skin around. I’ve always had persistent acne forever and this was the first stuff that actually cleared my face. I don’t use as much as they recommend working up to, but the small amount I put on my face really works wonders.

  • Amalah


    March 10, 2009 at 2:21 pm

    The big problem with pregnancy skincare, as we’re already seeing in the comments, is that there is a LOT of conflicting information out there.
    Benzoyl peroxide is GENERALLY recommended instead of salicylic acid (like here:, however…
    “Topical application of salicylic acid has not been reported to cause problems during pregnancy or nursing, but studies in animals have shown that salicylic acid causes birth defects in animals when given orally (by mouth) in doses about six times the highest dose recommended for topical use in humans. Therefore the FDA has established guidelines of a limit of 2% salicylic acid for topical products and pH (acidity) no less than 3.0.”
    (From and Salicylic acid should NOT be used in higher concentrations than 2% and should not be used on large parts of your body. Many books and sites and doctors will tell you that a little bit on your face is fine, while plenty of others will recommend not using it at all.
    The problem is that no pregnant woman would offer herself up to a hardcore clinical study to “prove” that topical acne meds are safe. Therefore, without clinical studies, your doctor may always tell you to err on the side of caution and not use benzoyl or glycolic or salicylic or even a lot of natural remedies because THOSE are technically untested as well.
    And there is nothing wrong with that, since OBVIOUSLY a healthy baby is way more important than clearing up some pimples. And I would never tell anyone to go against her doctor’s orders, oh my hell.
    But I do believe that pregnancy doesn’t melt our brains and we can read and think and make up our own minds. Be aware that there is wildly conflicting info out there and proceed with caution accordingly. My doctor felt that the 2% and under OTC concentrations of salicylic acid posed no danger, but would never recommend anything prescription strength. Yours may feel differently. (I mean, look at the comments here already — we’ve got doctors saying “nay” to everything and doctors recommending prescription strength creams and doctors falling somewhere in the middle.)
    Basically, it’s up to you to find a compromise that YOU feel comfortable with — hopefully something that will clear your skin AND let you sleep well at night with no worries about dangers. You may find, like Alison did, that you don’t even need anti-acne ingredients, but just something gentle and balancing.

  • shelley

    March 10, 2009 at 3:03 pm

    I was in the same situation – I was used to the occasional breakout, and then BAM! My face was worse than a pimply teenager. My dr prescribed me Clyndamycin, and my face cleared up in about a week. And, it was cheap since it’s a topical antibiotic. I’m still on my first bottle 3 months later, and it was $8.
    Make sure you use really mild stuff on your face – I love Aveda’s All Sensitive cleanser. Use a light moisturizer day and night and drink lots of water. My face has been basically clear for a while now, thank goodness.
    PS – I also have the same theory about all the hormones meaning it’s a girl! Keeping my fingers crossed for us both…

  • kaelak

    March 10, 2009 at 3:03 pm

    Never been preggers, by I have some seriously temperamental skin, just like you’re describing. What’s worked for me, in order of importance:
    1. Don’t pick at your skin. Ever.
    2. Wash only once a day at night, to get allthe makeup and day’s crud off.
    3. No joke – Lubiderm fragrance-free lotion. Made me feel less weird when i heard NICU doctors recommend this for preemies.
    4. Dermalogica face wash – very gentle and non-drying
    4. Once weekly clarifying scrub like St. Ives or Burts Bees.
    Good luck – I feel for you, sister!

  • miriam

    March 10, 2009 at 3:08 pm

    Neutrogena also has a facial wash with benzoyl peroxide in it (25 or something– mild). I wash my face in the shower with it so I don’t bleach my towels. Supposedly you can wear it like a mask for 5 or 10 min (directions on tube, don’t listen to me) but I’d start low and slow so you don’t dry the crap out of your face. They also make a stridex-like thingie that smells way better and is much less embarrasing to have in your medicine cabinet (2% salicylate).
    But better than that– go to your PCP or a dermatologist who can work with your ob-gyn’s recommendations– at least make appointments so that after you’ve tried a little benzoyl and salicylate, and it’s not working, or maybe it is working but your skin is so dry now that you can’t tell–
    Anyway, if your OB can help you help your skin at this time where you question everything you buy in the drugstore… well, that’s why you’re seeing them, right? It wasn’t just for all the glucola you could drink…

  • Brooke

    March 10, 2009 at 6:05 pm

    well, my doctor (both: gyn an dermatologist) actually allowed to use anything! locally on the skin, and said, that only oral usage can harm an unborn baby. I had some weird skin infection on my chin, and then he gave me a recipe for Fucicort, which even contains hormons. No it is horrifying me reading about your concerns, because I took such a strong local skin medicine during my pregnancy, but thank God, my child is healthy …

  • Jesse M

    March 10, 2009 at 7:16 pm

    I have suffered with acne ever since I turned 21, I’ve tried everything short of Accutane. When I got pregnant (I’m 26 weeks now) I was freaking out that I was going to be suffering like crazy. I did start out breaking out BAD (I’m having a boy). But turns out I just wash my face with Nature’s Plus Natural Beauty Cleansing Bar, use Witch Hazel on a cotton ball and wipe my entire face and once it dries I use Neutrogena’s Fragrance Free, Oil Free moisturizer. Since then I get an occasional zit..I mean seriously, maybe twice a month. I don’t think it’s worth maybe harming my baby by using benzoyl peroxide or salicylic acid which my derm and OB advised me against. And those products just made me break out more prior to my getting pregnant! No thank you!

  • Jessica P

    June 29, 2013 at 12:20 am

    My daughter is already having problems with acne and our dermatologist recommended Citrus Clear – so I tried this and it worked immediately. She is washing her face and using it daily and is a much kinder and gentler than other acne products. She loves it ! 

  • chantz

    September 10, 2014 at 7:14 am

    Hi ash im having same prob as you. But luckily my pimples have stopped but left me with dark brown marks. Anything that will help speed up the mark lightening

  • Unknown

    February 23, 2015 at 8:21 pm

    Obgyn’s say that any topical ointment that gets into your bloodstream is broken down almost entirely before it ever reaches the placenta. People are so scared of everything! Half of these comments should be removed so as not to upset people who have used anitbiotic topical creams to help their acne. ITS ENTIRELY FINE.

  • stef

    April 8, 2015 at 1:40 pm

    So glad I found this article and website. I have been feeling awful about using some acne products after some of the articles I read online.