Treatment of acne in pregnancy

Acne can appear or worsen during pregnancy. Refer to a dermatologist or specialist if unsure of appropriate treatment.

The main treatment options for acne in patients who are pregnant include over-the-counter products such as benzoyl peroxide, and topical clindamycin (including benzoyl peroxide+clindamycin combination); see Treatment of mild acne for recommendations and doses. Oral erythromycin can be considered in patients with moderate to severe acne who are pregnant; see Treatment of moderate to severe acne for doses.

Physical therapies (eg laser therapy, blue light therapy, microneedling, dermabrasion, chemical peels, sebaceous gland ablation) may be considered in patients with acne who are pregnant. They may provide transient improvement in acne, but maintenance treatments are usually required. The risk of complications is significant from some types of physical therapies. Safe use of these therapies requires skilled practitioners (eg dermatologists, practitioners trained by and working under guidance of dermatologists).

Retinoids are teratogenic. Avoid topical and oral retinoids in patients who are planning to become pregnant, or who are pregnant.

Spironolactone is contraindicated in pregnancy because of the risk of defective virilisation of the male fetus.