Your Pregnancy Matters

Prevent pimples and avoid ‘maskne’ with pregnancy-safe acne treatments

Melissa Mauskar, M.D., a dermatologist, experienced acne during her pregnancy and shared some safe and effective treatments.

If the pimples you thought you left behind in junior high have come back with a vengeance during pregnancy, you’re not alone. Hormonal changes in the first two trimesters can cause the skin to produce excess oil – a primary cause of acne – along with bacteria, stress, and hair follicles that get clogged with oil or dead skin cells.

Wearing face coverings during the COVID-19 pandemic has also contributed to a bump in breakouts. Friction from the cloth can irritate your skin and built-up humidity under your mask can trap oil and bacteria in your pores. Though masking is essential to stop the spread of COVID-19, research has shown that long-term mask wearing can cause mask-related acne flares (“maskne”).

Pregnancy acne, also known as adult or hormonal acne, can affect any pregnant patient. Celebrity Ashley Iaconetti from “The Bachelor” recently discussed her symptoms and shared photos with US Weekly and on social media.

My colleague Melissa Mauskar, M.D., founder and director of UT Southwestern’s Gynecologic Dermatology Clinic, knows the challenges of dealing with acne during pregnancy firsthand.

How a dermatologist cleared up her pregnancy acne

Patients often say their acne is as frustrating as it is painful. I feel their pain! During my current pregnancy, I have been dealing with inflammatory acne nodules, which run deep below the skin’s surface. Larger and more painful than zits or blackheads, these hot, red nodules are more common during pregnancy. They also can leave post-inflammatory pigmentation behind.

Although masks can help cover up some of this acne, they also make things worse. This isn’t a great look for a dermatologist – part of my job is to help people keep their skin looking good, but even we can have problems with pregnancy acne and maskne!

In a recent study of women with acne, almost half of patients reported that appearance-related concerns negatively affected their social, professional, and personal lives. Many of them noted symptoms of depression, anxiety, and social isolation. Add these feelings to the other body changes in pregnancy and it can significantly affect your mental health.

But the good news is acne in pregnancy can be treated safely. Here are four tips to help clear up and prevent pregnancy-related acne breakouts.

1. Take a hands-off approach.

When acne first appears, our natural instinct is to:

  • Pick, pop, or touch, which will only further clog the pore, damage the skin, and spread the outbreak.
  • Try too many treatments, which can cause further skin irritation.

Instead of playing Dr. Pimple Popper or racing to the drugstore for creams and abrasive cleansers, call the dermatology clinic and we can help you figure out what is causing your breakouts. We’ll also work with your prenatal care provider to recommend pregnancy-safe treatments that will be less irritating and more effective.

Related reading: Why we touch our faces so much – and how to break the habit

2. Get a spot-on treatment.

Depending on the severity of your acne and what’s causing it, I usually first recommend spot treatments containing agents such as:

  • Benzoyl peroxide, which kills the acne-causing bacteria beneath the skin while clearing the outer skin of excess oil and cells.
  • Topical clindamycin or erythromycin, which eventually stops the acne-causing bacteria from growing.
  • Azelaic acid, which helps heal the increased pigmentation that acne spots can leave behind.

If you do tend to pick at your spots, applying the pimple patches that have grown increasingly popular may help you break this habit, which can cause scarring. These little stickers contain hydrocolloid, a gel-like material that dries out superficial whitehead pimples but isn’t strong enough to effectively treat the deep, painful red spots you’re likely to experience while pregnant.

3. Don’t scrub – be gentle.

While several face washes contain these ingredients, they also typically contain harsh chemicals that irritate the skin. Gentle washes are better at fighting stubborn acne. Even a mild bar of soap is better than an aggressive cleanser.

If you prefer a wash over a spot treatment, choose one that contains ceramides, fatty acids that already exist within your skin and keep it from drying out.

4. Be open to alternative treatments.

Many skin medications and external therapies are safe to use during pregnancy. If topical treatments alone aren’t enough, your dermatologist and Ob/Gyn may recommend one of these options instead of, or in combination with, your skin care routine.

  • Intralesional steroid injections: A dermatologist can provide these treatments to reduce pain and swelling from inflamed nodules. Injections typically work best for people who have just a few deep, painful bumps.
  • Oral medication: Erythromycin or metronidazole are antibiotics that fight infection, such as bacteria in the skin. Low doses are safe for short-term use for most pregnant patients.
  • Chemical peels: Lactic acid and glycolic acid peels are safe to use during pregnancy, since the levels of chemicals in these products are so low.
  • Laser and light therapy: Patients with severe acne or many inflamed nodules can benefit from this treatment, which uses light energy to reduce inflammation and repair damaged skin.

For my nodules, getting a few intralesional steroid injections in combination with using a gentle cleanser helped me look and feel better in a few days. Once I head into my third trimester, I expect my acne to settle down as my hormone levels even out – at least until I welcome the stress and excitement of having a newborn at home!

Related reading: 6 skin problems that can develop during pregnancy

Maskne prevention tips

As wearing a mask continues to be a vital way to reduce the spread of COVID-19, follow these steps to help prevent a maskne outbreak:

  • Wash replaceable masks daily.
  • Replace your mask immediately if it gets wet.
  • Use a mild face wash once or twice daily.
  • Before going to bed, apply a moisturizer that contains ceramides.
  • Wear little to no makeup under your mask.

If you’re not already, apply sunscreen to your face daily – even when wearing a mask. Choose a sunscreen that is light and oil-free to reduce the risk of pimples and look for a formula with an SPF of at least 50. Wearing sunscreen is the best way to prevent wrinkles, skin cancer, and darkening of sunspots or acne scars.

Related reading: How to avoid pandemic skin problems

If pregnancy acne is affecting your self-esteem or quality of life, we can help. To visit with a dermatologist, call 214-645-2400 or request an appointment online.