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 salicylic acid during pregnancy, the answer may depend on which derm you ask, but the safest, most by-the-book answer is that you should not use salicylic acid when pregnant.
“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,” Dr. Sandy Skotnicki, dermatologist and author of Beyond Soap tells Romper. Here we’ll talk about why it makes sense to stop using salicylic acid in pregnancy, and what you can use instead, 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 a type of hormone 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 seems like it would be a helpful ingredient, but it should be used with caution.
Is salicylic acid safe to use while pregnant?
Most experts agree that out of an abundance of caution, it’s best to skip salicylic acid during pregnancy, especially because there are plenty of other totally pregnancy-safe ingredients that help combat acne.
“Most medical societies state salicylic acid is not safe in pregnancy. It should not be taken orally or topically to treat acne or warts,” Skotnicki tells Romper. “The controversy comes with topical use as some medical societies say it is okay. I prefer not to confuse patients, it's easy to avoid [salicylic acid in pregnancy] because we have other choices for treatment,” she adds.
The reason salicylic acid is not pregnancy safe when taken orally is because, strangely enough, salicylic acid is a component of aspirin, and the painkiller is not safe to take while pregnant. Skotnicki says some studies show that aspirin can cause the baby to have intracranial bleeding in the third trimester (though it’s important to note that in some cases, doctors will be recommend a low dose baby aspirin to lower the risk of preeclampsia).
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What can you use instead of salicylic acid during pregnancy?
So what can you use instead? Fortunately there are many 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 they’re pregnancy-safe.
“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.”
You may hear that salicylic acid is okay in pregnancy if it’s used sporadically in formulas that contain less than 2% of the ingredient (and if you do accidentally use something that contains salicylic acid you really don’t need to panic). However, as Skotnicki advises, it probably makes the most sense just skip the ingredient while pregnant, especially since there are so many other pregnancy-safe and effective anti-acne ingredients available.
Hastie R, et al. (2021). Aspirin use during pregnancy and the risk of bleeding complications: a Swedish population-based cohort study. https://pubmed.ncbi.nlm.nih.gov/32687818/
Dr. Cybele Fishman, M.D., dermatologist with Advanced Dermatology PC
Dr. Sandy Skotnicki, M.D., dermatologist and author of Beyond Soap