Can I Use Azelaic Acid While Pregnant?

Woman putting azelaic acid cream on face



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Can I Use Azelaic Acid While Pregnant?

We sacrifice a lot for our kids—starting from a time before they’re even born. Since the day you first learned of your little one’s existence, you were likely bombarded with a seemingly endless list of things to avoid while pregnant. While it’s true that a lot of foods, drinks, activities, and products are off limits during pregnancy, we have some good news: There are still a lot of alternatives. One skincare ingredient, in particular, not only gets a green light during pregnancy, its use is often encouraged. It’s called azelaic acid.

Ahead, learn all about using azelaic acid while pregnant—or at any point in your life, for that matter. We asked two board-certified dermatologists to explain what this skin-loving ingredient is, as well as its many benefits. You may just become a fan of using it yourself.

What Is Azelaic Acid?

Azelaic acid is a topical skincare treatment that can help tackle multiple skin concerns. You’ll find it in various creams, foams, serums, and gels. For starters, it can help treat mild to moderate acne. Daniel Belkin, MD, FAAD, a board-certified dermatologist at the New York Dermatology Group in NYC, explains further: “Azelaic acid is a naturally-occurring acid produced by certain plants and yeasts,” he says. “Its an antimicrobial, and it has activity against multiple types of bacteria.” This antimicrobial capability, along with its ability to clean out your pores are what make it such an excellent acne-fighting ingredient.

But treating acne blemishes isn’t all azelaic acid can do. It can also help improve the appearance of rosacea. And, since it’s an antioxidant, it helps with inflammation and protects your skin from damaging free radicals too. Dr. Belkin adds another perk by pointing out that it can also reduce melanin production, meaning it can help with discoloration and brightening your skin. 

Now that you know what azelaic acid is, let’s get down to the reason we’re all here.

Is It Safe to Use Azelaic Acid During Pregnancy?

Like we discussed, the list of things you need to avoid while pregnant can be daunting. But we’re happy to report that azelaic acid is on the list of things you can use. Research on animals hasn’t shown any sign of birth defects when it was used during pregnancy. This makes azelaic acid a pregnancy category B, which means it’s generally safe, there’s just no data on its use in pregnant people. 

Joshua Zeichner, MD, a board-certified dermatologist, Director of Cosmetic and Clinical Research in Dermatology, and an Associate Professor of Dermatology at Mount Sinai Hospital in NYC, agrees that it’s safe to use azelaic acid while pregnant. “Unlike most [skincare] treatments, azelaic acid is considered to be safe to use during pregnancy and breastfeeding,” he shares. “In fact, it is a go-to cream for pregnant women.”

With all the no-nos people who are pregnant face throughout their trimesters, rest assured, incorporating azelaic acid into your skincare routine is a great (and safe) way to give your skin some TLC.

Every pregnancy is different. Be sure to consult with a healthcare provider about your circumstances if you have any questions about using azelaic acid while pregnant.

Benefits of Azelaic Acid During Pregnancy 

Now, let’s get into the good stuff—the benefits of azelaic acid. Mother Nature really knew what she was doing when she made this powerhouse ingredient. Below, find out what it can do for your skin.

Acne-Fighting

As mentioned, azelaic acid packs a punch when it comes to acne. It can treat both mild and moderate non-inflammatory (blackheads and whiteheads) and inflammatory acne (papules, pustules, nodules, and cysts).

“Azelaic acid has been shown to be effective for acne by killing acne-causing bacteria,” explains Dr. Belkin. “It is a great pregnancy-safe acne topical that I prescribe to my patients.” Though, we should note that you can find less potent azelaic acid acne products over-the-counter as well.

Anti-Inflammatory

Another reason azelaic acid can help handle acne blemishes and other skin conditions is that it has anti-inflammatory effects. These can help soothe irritated skin and reduce redness—such as the kind that accompanies rosacea.

“Azelaic acid helps calm inflammation in the skin, and is useful if you have sensitive skin or rosacea,” notes Dr. Zeichner. It may seem like it would be counterintuitive for an acid to help with inflammation. But, fun fact: Another holy grail acid of skincare, hyaluronic acid, soothes skin too—specifically, parched skin.

Evens & Brightens Skin Tone

If you have post-acne marks, dark spots, or hyperpigmentation—or are simply looking to tone and brighten up uneven skin—azelaic acid may be worth a shot. “[Azelaic acid] has skin-brightening benefits, so it is commonly used to address dark spots and hyperpigmentation,” explains Dr. Zeichner. “It blocks production of abnormal pigmentation to even skin tone.”  So, with regular use, your skin will look more uniform and radiant.

It isn’t just beneficial for your skin, regardless if you’re pregnant. People who are pregnant may actually reap a particularly helpful perk. Dr. Belkin elaborates: “[Azelaic acid] is particularly helpful in pregnancy, when melasma (a.k.a. ‘the mask of pregnancy’) commonly arises.” It’s so common, in fact, that anywhere from 15% to 50% of pregnant people get it, usually between the ages of 20 and 40 years old, as well as 1.5% to 33% of the general population in that age range.

Dr. Zeichner also cautions that managing discoloration isn’t just about treatment with azelaic acid or a product with similar effects. It’s important to take preventative measures, like making sunscreen a non-negotiable part of your daily skincare routine.

Safety Precautions 

Although the current science and both Dr. Belkin and Dr. Zeichner all agree that it’s safe to use azelaic acid while pregnant, that doesn’t mean you shouldn't still take some basic precautions. Be sure to take the following into consideration.

Use as Directed

It’s important to always follow the instructions on your product’s package, as well as any other guidance your healthcare provider has given you regarding azelaic acid. We know all of its skin benefits are exciting, but try not to get overzealous in its use.

Always go by the recommended amount, frequency, and duration. If you don’t, it may backfire and actually end up irritating your skin. Be careful not to get it in your mouth, nose, or eyes—if you do, immediately rinse it off, and talk to your healthcare provider if your eyes get red and sore.

Give Your Skin Time to Adapt

Whenever you start using a chemical exfoliant, like azelaic acid, it can initially make your skin a bit sensitive. But Dr. Belkin assures us that your skin will likely adapt to it. “Unlike with tea tree oil, azelaic acid has never been shown to cause a contact allergy,” he says. “Irritation can occur, but is typically temporary when you first start using it.”  So, start off by using it only a few days a week, then see how your skin reacts and slowly progress to daily use. 

Avoid Harsh Ingredients

Similarly, since it can make your skin sensitive at first, avoid using products that contain harsh ingredients like alcohol, peeling agents, astringents, or abrasives.

Limit Your Intake of Spicy Foods, Hot Drinks & Alcoholic Beverages

Eating spicy food or drinking hot beverages or alcohol can make you flush or redden, so talk to your healthcare provider to see if you should stay away from them while using azelaic acid.

Keep Azelaic Acid Foam Away From Fire

If you’re using the foam version of azelaic acid, be sure to keep it away from flames, as it’s flammable.

Be Aware That It Can Be Pricey

We know. This one’s not actually a safety precaution, but we’d be remiss not to mention that azelaic acid can get a little expensive—between $50 and $100 to be exact. However, there are more affordable, albeit less potent, azelaic acid options out there such as Typology’s Mattifying Serum 10% Azelaic Acid ($18) and The Ordinary Azelaic Acid Suspension 10% ($8). If you want to just tip your toes into this ingredient trend, they may be the way to go to start.

A Word From Verywell

So, can a pregnant person use azelaic acid? The answer is a resounding yes. You can use it to help clear up both mild and moderate acne breakouts and prevent new ones from forming. In the same vein, it can help soothe inflammatory skin conditions such as rosacea, as well as irritation or redness.

Lastly, it’s also beneficial if you have dark spots, hyperpigmentation, melasma, or other skin discolorations. Of course, always talk to your healthcare provider before starting or stopping any treatment while pregnant.

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8 Sources
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