Before we jump into our list, we must point out that evidence-based data on the safety of specific products in pregnancy is limited. In almost all cases, clinical trials on pregnant people that could even start to prove that certain ingredients are harmful are an ethical no-no.
But some animal, anecdotal, or case-specific studies have shown some serious fetal effects related to a few common skin care ingredients. That’s the basis for our recommendations.
The Food and Drug Administration (FDA) requires cosmetic products to be “safe” based on their specific uses and labeling, but they don’t need FDA approval to be sold on the market.
All of that brings big questions about what cosmetics are truly safe during pregnancy. On this basis, most experts (and therefore, we) err on the side of caution.
Vitamin A is a crucial nutrient that’s required for optimal skin, immune, reproductive, and eye health. Once consumed or absorbed through skin, your body converts it to retinol.
Some pro-aging skin care products use a type of retinol called retinoids, which have become a holy grail because they can help reverse acne and reduce fine lines. Retinoids do this by helping surface-level skin cells exfoliate faster and boosting collagen production to rejuvenate skin.
OTC products have lower levels of retinoids, while prescription medications — such as Retin-A (tretinoin) and Accutane (isotretinoin) — contain much higher doses.
The amount of retinoids absorbed by topical products is likely low, but birth irregularities have been linked in higher doses. As such, all retinoids are advised against during pregnancy.
Prescription retinoids like isotretinoin have been widely documented for posing a 20% to 35% risk of severe congenital irregularities, with about to 30% to 60% of children showing neurocognitive conditions with exposure in utero.
Because of this, it’s recommended that people who can become pregnant take the following precautions while using isotretinoin:
- Use two forms of contraception.
- Be frequently monitored by their doctor for pregnancy and compliance.
- Stop the medication 1 to 2 months before trying to become pregnant.
Your doctor will discuss the iPLEDGE program with you before prescribing isotretinoin. This is a federal monitoring program intended to reduce the chance of pregnancy in people taking isotretinoin.
High dose salicylic acid
Salicylic acid is a common ingredient to treat acne due to its anti-inflammatory capabilities, similar to that of an aspirin. But a 2013 study concluded that products that deliver a high dose of salicylic acid, such as peels and oral medications, should be avoided during pregnancy.
That said, lower dose topical OTC products that contain salicylic acid have been reported safe by the American College of Obstetricians and Gynecologists (ACOG).
Hydroquinone is a prescription product to lighten skin or reduce skin pigmentation that occurs from melasma and chloasma, which can be brought on by pregnancy.
There’s no proven link between severe congenital defects or side effects and hydroquinone. But because the body can absorb a significant amount of hydroquinone compared with other ingredients (35% to 45%), it’s best to limit exposure (if any at all) during pregnancy.
Phthalates are endocrine-disrupting chemicals found in many beauty and personal products. In animal and human studies, serious reproductive and developmental dysfunction has been linked to phthalate exposure.
Endocrine disruptors are becoming increasingly studied by the FDA and professional medical organizations, such as the American Academy of Pediatrics, for their potential role in negatively affecting congenital reproductive health.
Cosmetics are a top source of phthalate exposure. The most common phthalate you’ll find in beauty products is diethylphthalate (DEP). Phthalates commonly found in plastic packaging can also leach into personal care products.
Formaldehyde is rarely used as a preservative and disinfectant in beauty products anymore because it’s a known carcinogen, and, according to the Centers for Disease Control and Prevention (CDC), can increase the risk of infertility and miscarriage.
But there are formaldehyde-releasing chemicals commonly found in cosmetics with a similar potentially dangerous effect. These include the following, as noted by the Environmental Working Group (EWG):
- bronopol (2-bromo-2-nitropropane-1,3-diol)
- DMDM hydantoin
- diazolidinyl urea
- imidazolidinyl urea
Oxybenzone and its derivatives are the most frequently used ultraviolet (UV) filter in sunscreens. It’s proven effective for skin protection, but the potentially adverse health and environmental effects of oxybenzone are bringing it into a more unfavorable light.
A 2019 review suggested that certain chemical UV filters may have negative effects for water sources, fish health, and food chains worldwide. These include:
Because oxybenzone is a known endocrine-disrupting chemical, the concern for use in pregnancy is that it could disrupt hormones and cause permanent damage to both you and your baby.
A 2018 study in animals concluded that oxybenzone exposure during pregnancy at levels humans would commonly use made permanent changes to mammary glands and lactation.
Other animal studies have linked the chemical to permanent fetal damage, possibly associated with developing neurological conditions in adulthood, such as schizophrenia and Alzheimer’s disease.
Oxybenzone exposure has also been associated with Hirschsprung disease, a birth irregularity affecting the large intestines.