Is Salicylic Acid Safe To Use On Skin During Pregnancy?

There’s a lot of talk about that elusive “glow” when you’re expecting. But in reality, many will instead experience acne during pregnancy, which is caused by changing hormones levels. When you’re pregnant and trying to banish a stubborn breakout, you may look to your pre-pregnancy acne-fighting products and wonder if salicylic acid is safe for pregnancy. There’s some conflicting info out there, so it’s a good question to ask.

If you’re wondering if it’s safe to use the powerful acne-fighting ingredient during pregnancy, the answer may depend on which dermatologists you ask; some experts say it is safe while others, like Dr. Sandy Skotnicki, dermatologist and author of Beyond Soap, may say it’s best to avoid salicylic acid while pregnant out of an abundance of caution .

“My stance on salicylic acid in pregnancy is that there are many other choices to treat acne and warts so it is best just to avoid it,” Skotnicki tells Romper. But on the flip side, dermatologist Dr. Anna Karp says that salicylic acid is pregnancy-safe in “low over-the-counter doses.”

Here we’ll talk about salicylic acid in pregnancy, and what you can use instead if you decide to skip the ingredient, because no one wants a breakout to last longer than it needs to.

What is salicylic acid?

Salicylic acid is one of the best known beta hydroxy acids (BHAs), which are compounds often found in skin care products. Yes, putting an acid on your face may sound unpleasant, but in fact, there are some great benefits to using salicylic acid. Salicylic acid chemically exfoliates the skin, so instead of manually sloughing off dead skin like you would with a textured face scrub (which she doesn’t recommend), salicylic acid dissolves dead skin, leaving skin soft and smooth without irritating the skin barrier the way a harsh scrub can. The ingredient has anti-inflammatory and antibacterial properties, so it calms skin down and helps to treat certain skin conditions, like acne or warts.

One of the biggest benefits of salicylic acid is that it’s oil-soluble, meaning instead of sitting on top of the skin, it’s able to travel inside pores and help clear them of bacteria, dead skin, sebum and more. This is why it’s so effective on acne.

Pregnancy acne is generally caused because of an increase in hormones called androgens; these hormones cause the skin to produce more sebum which clogs pores, often causing pimples. Given that salicylic acid helps to unclog pores, it can be helpful for stubborn pregnancy acne, but there are a few things to be aware of before slathering it on.

Is salicylic acid safe to use while pregnant?

The American College of Obstetricians & Gynecologists (ACOG) categorizes over-the-counter (OTC) topical skin care products with a salicylic acid concentration of 2% or less as safe for use in pregnancy.

“Salicylic acid 2% or below is safe [for pregnancy],” Karp says, echoing ACOG’s recommendations. She adds that any recommendation for avoiding salicylic acid during pregnancy is based on the potential side effects of taking aspirin (which actually contains salicylic acid), orally, but “there is no actual oral salicylic acid indicated for any skin use.” So basically, if you’re not planning to eat your skin care product, you’re in the clear, though some doctors will take a more black and white approach and advise patients to steer clear from salicylic acid during pregnancy. “I prefer not to confuse patients, it's easy to avoid [salicylic acid in pregnancy] because we have other choices for treatment,” Skotnicki says, referring to the abundance of pregnancy-safe ingredients that help combat acne.

For some women, it may be easier to skip salicylic acid all together. But if you love your OTC product (or your salicylic acid treatment seems to be the only thing that actually clears your acne) you do not have to ditch it all together, as long as they contain 2% salicylic acid or less. If you use multiple products that contain the ingredient (salicylic acid may be found in cleansers, serums, spot treatments, and masks) you may want to cherry pick your faves, not because it’s a pregnancy risk, per se, but more because of the potential irritation. “I don't think using multiple products with low concentrations (2% or less) of salicylic acid is an issue for pregnancy but you may develop irritation,” Karp tells Romper. Even if you used several salicylic acid products before you got pregnant, many people notice that their skin is more sensitive during pregnancy due to hormonal changes.

And while 2% is the sweet spot for it to be considered low-dose and pregnancy-safe, don’t just assume that your product contains 2% or less of salicylic acid as there are products out there that contain as much as 9%. Typically the percentage will be clearly labeled on the front of the bottle, and if not, on the ingredient list itself. To avoid the irritation that Karp mentions, try keeping your usage to once a day or less.

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What can you use instead of salicylic acid during pregnancy?

So basically the short answer is if your salicylic acid product contains 2% or less of the ingredient, you can keep using it even while pregnant or breastfeeding. But if you prefer to err on the side of caution, there are pregnancy-safe ingredients that fight pimples. “For acne, azelaic acid, zinc, glycolic acid, and niacinamide are all [pregnancy] safe,” Dr. Cybele Fishman, dermatologist with Advanced Dermatology PC tells Romper. If you can stand the smell, sulfur masks are also great for drying acne and safe to use during pregnancy.

“I typically suggest glycolic acid in less than 10% concentrations which are safe in pregnancy,” Skotnicki says. “Also azelaic acid can also be used. In severe cases of cystic acne during pregnancy oral antibiotics in the second and third trimester can be used.”

Depending on who you ask about salicylic acid in pregnancy, you may get different answers (this is frustratingly the case with so many pregnancy topics) but if you want to keep using your trusty spot treatment or cleanser, rest assured that there are zero studies on humans showing any adverse effects of using low doses of salicylic acid topically.

Experts:

Dr. Anna Karp, M.D., dermatologist with SINY Dermatologist

Dr. Cybele Fishman, M.D., dermatologist with Advanced Dermatology PC

Dr. Sandy Skotnicki, M.D., dermatologist and author of Beyond Soap