How to Spot-Treat a Pimple When Pregnant According to Dermatologists

Woman looking into a close-up mirror, examining her skin.

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As if pregnancy wasn’t challenging enough, the changes it produces in your body can prompt your skin to behave and appear abnormally, too. In other words, pimples can pop up.

Hormonal spikes may cause acne, as it is known, for example, that estrogen and progesterone increase during pregnancy. Atypical stressors at this time can also spur on a surge of the hormone cortisol, which has been known to cause an angry pimple or two, notes Elizabeth Hale, MD, board-certified dermatologist, and clinical associate professor of dermatology at the New York University Langone Medical Center.

And consider this: Dietary changes might also be occurring at this time and contributing to the changes in complexion, Dr. Hale says. All or none of these things may play a part in acne during pregnancy. A universal cause isn’t quite solidly known.

When it comes to treating the occasional pimple during pregnancy, well, that gets a bit more complicated. Some skincare ingredients, like retinol, are widely considered best kept off-limits. There are other ingredients that slough or dissolve pore-clogging debris which cause controversy among experts. Much of the discussion centers around the idea of absorption into the skin. With some studies conducted on the topic, one could make the argument for minimal absorption posing little to no risk during pregnancy. But today, many doctors and dermatologists will still advise patients to avoid certain topical solutions during pregnancy out of caution.

So, yes, this topic is a tricky one. But there are still certain guidelines that can help you banish the pimples that appear during your pregnancy. Here, top dermatologists share suggestions on how to safely spot-treat and keep your skin in the clear.

Why is Treating a Pimple During Pregnancy More Complicated?

First, there’s the fact that pimples may appear differently during pregnancy. Over these months, says Dr. Hale, pregnant people have increased blood flow. That means a stress-induced blemish, which at another time might have presented as a small spot, might now look more red and inflamed. “This is most common actually in the second trimester when the circulation starts to expand and then [carries] into the third,” Dr. Hale says.

Then there’s the question of ingredients. If pregnant, you’re likely taking a closer look at the topical treatments and supplements you’re using. “Certain ingredients in topical skincare products are more controversial when it comes to use during pregnancy because of the concern that these ingredients might penetrate into the bloodstream and adversely affect a growing embryo or fetus,” says Whitney Bowe, MD, board-certified dermatologist based in New York. Some ingredients are believed to be best avoided when pregnant, but there are others that are commonly believed to be effective and safe in banishing blemishes.

Let’s take a look at what ingredients you might want to skip first, then hear about those that can help treat pimples during this time of change.

Ingredients to Avoid When Spot-Treating Pimples During Pregnancy

Before we share some recommendations here, it's worth mentioning that studies conducted on pregnant women using controversial skin-care ingredients can be hard to come by. Meaning you may find conflicting information and varied recommendations when it comes to what you should or shouldn't use on your skin while pregnant.

Take a read of the research, talk to your healthcare provider, then use your judgement to make the right decision for you. Now, a look at what two ingredients might be worth saving to use after you've delivered.

Retinoids

There’s a reason dermatologists often site retinoids as go-to skincare ingredients: The variations of vitamin A have the ability to smooth and clear the surface by way of speeding up the shedding of old skin cells, and protecting stores of skin-firming collagen.

However, it’s generally been advised that retinoids, and the common skin-care ingredient retinol, be avoided during pregnancy. Such ingredients may be listed on product ingredient labels as retinoic acid, retinyl palmitate, retinaldehyde, adapalene, tretinoin, tazarotene, trifarotene, and isotretinoin, says Rachel Maiman, MD, board-certified dermatologist at Marmur Medical in New York, who prefers to steer clear of all forms when advising pregnant people.

Salicylic Acid

This pore-clearing ingredient commonly used to target pimples can dissolve dead skin cells and is also said to be anti-inflammatory. However, during pregnancy, some doctors prefer to skip it, often due to the potential for, or questions surrounding, absorption into the body.

“Some ingredients that are considered controversial during pregnancy include retinoids, salicylic acid, and [benzoyl] peroxide,” says Dr. Bowe, who notes that the risk of absorption is quite low, especially for a spot-treatment, but that most of her patients prefer to be on the safer side.

"Lower-dose topical over-the-counter products that contain salicylic acid have been reported safe by The American College of Obstetricians and Gynecologists (ACOG)," shares Dr. Maiman.

Given the information, if you want to look into using salicylic acid while pregnant, it might be a good idea to consider using it in a wash-off formula, rather than leave-on treatment to minimize the potential for absorption or deep penetration.

What Acids Can You Use to Spot-Treat a Pimple When Pregnant?

Alpha hydroxy acids and beta hydroxy acids are often recommended to remove dead skin cells and clear pores to prevent acne. They can be found in cleansers and spot treatments. But again, some are commonly recommended during pregnancy, and others (like salicylic acid) are sometimes not.

When shopping for an acid-fueled treatment to use on a pimple during pregnancy, there are two great options you can consider: glycolic acid and azeliac acid.

Glycolic Acid

Glycolic acid can be considered a safer choice in pregnancy than salicylic acid, says Dr. Hale. It helps dissolve dead cells, smooth the surface, and get rid of grime that might otherwise clog pores. Clearer pores lead to fewer blackheads and breakouts. And glycolic acid can be found in a number of wash-off and leave-on skincare products.

Azelaic Acid

Another ingredient to look for is azelaic acid, also widely considered safe to use on pimples during pregnancy. “Azelaic acid has been well-studied, it’s completely safe during pregnancy,” says Dr. Hale, who also notes it can help with post-inflammatory hyperpigmentation, which is the darkness, discoloration or redness that is often left behind after a pimple fades.

If you're shopping for a spot treatment with one of these acids, remember that often multiple acids are grouped together in topical treatments. So always read ingredient lists carefully before applying one.

What Spot Treatments Can You Use on a Pimple When Pregnant?

You can find a solution with glycolic or azelaic acid to apply to pimples during pregnancy. You can also check out a couple dermatologist-recommended treatments like these.

Erythromycin

In terms of topical treatment formulations as a whole, there are a few you can shop to spot-treat a pimple. The topical treatment Erythromycin is safe during pregnancy, says Dr. Hale, which is an anti-bacterial solution you can dab on top of a breakout. Talk to your dermatologist about whether or not a prescription for Erythromycin can help you.

Hydrocolloid Patch

Another all-in-one option is a hydrocolloid patch. Varieties like Hero’s Mighty Patch actually cover a blemish while allowing it to develop and fully come to the surface.

“My favorite spot treatment for my pregnant patients is a hydrocolloid patch,” says Dr. Bowe. “The hydrocolloid material absorbs fluid and helps pimples to flatten and even come to a head overnight.” 

This topical sticker also keeps users from attacking and picking at pimples with their (sometimes dirty) fingers. “Picking can increase your risk for hyperpigmentation and scarring,” says Dr. Bowe, “so simply acting as a barricade to your fingers can work wonders for helping your skin heal."

How Exactly to Spot-Treat a Pimple When Pregnant

Dr. Hale recommends first washing the affected area, then placing a warm compress over the pimple. “Make sure your face is clean,” says Dr. Hale. However, be careful not to over scrub or over-exfoliate the area. Afterward, apply the clean compress. Then you can spot-treat with antibiotic gel, Dr. Hale says.

After leaving a warm compress on your pimple for a few minutes, you could apply a dab of your Erythromycin, or a leave-on spot-treatment with azelaic acid, or your hydrocolloid patch. And remember, while it may be incredibly tempting, don't pick at a pimple with fingers or tools. “I would try to encourage people not to self-manipulate it, not to try [to] squeeze it,” says Dr. Hale. “You don’t want to lead to pigmentation or scarring.”

A Word From Verywell

Like many things in pregnancy, the choice of what to apply onto your skin is personal. While there are some studies available in terms of ingredient absorption into skin, you may find that experts still offer varying opinions as to which ingredients may pose a potential risk. Always try and speak with your healthcare providers to come to a decision that works for you. And remember: Your skin can change during and after pregnancy. So can your skincare products.

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