Except for the two prescription molecules, hydroquinone, which has a relatively high systemic absorption rate, and tretinoin, for which the evidence is controversial, skincare products act locally and produce minimal systemic levels. Consequently, in most cases, women can deal with these cosmetically unappealing skin conditions without compromising the safety of their unborn children.

No DermExcel™ product contains hydroquinone or tretinoin. These active ingredients are only available by prescription from a medical doctor.  DermExcel™ Retinol serum contains an active ingredient very similar to Tretinoin. We advise customers to discontinue the use of Retinol serum until after pregnancy.

The amount of drug absorbed from the skin when using this product is very low; however, there are four published case reports of birth defects in the literature associated with topical tretinoin use. The role of topical retinoids in these cases remains controversial, as two prospective studies that examined use during the first trimester of pregnancy with 96 and 106 women did not find an increased risk of major malformations or evidence of retinoid embryopathy. However, until data on larger cohorts are collected, women should not be encouraged to use topical retinoids during pregnancy.

Clindamycin and erythromycin are used alone or in combination with other agents as topical treatments for acne. A surveillance study examining the oral or topical use of clindamycin reported no increased risk of malformations among 647 women with use in the first trimester. Similarly, several studies evaluating the systemic use of clindamycin in the second or third trimester of pregnancy have documented no increased rates of adverse outcomes. Furthermore, the oral use of erythromycin in pregnancy has not been associated with teratogenicity in several thousand women.

When benzoyl peroxide is applied topically, only 5% is absorbed through the skin. Then, it is completely metabolized to benzoic acid within the skin and excreted unchanged in the urine. No studies on the use of this preparation in pregnant patients have been published; however, systemic effects on a pregnant woman and her child would not be expected, and therefore, the use of this product during pregnancy would not be of concern.

Topical salicylic acid is an ingredient in many cosmetic and acne products, and systemic absorption varies. Many extensive studies have been published in which researchers examined the outcomes of women who had taken low-dose acetylsalicylic acid during pregnancy. There was no increase in the baseline risk of adverse events, such as malformations, preterm birth, or low birth weight. Studies have been conducted on topical use in pregnancy; however, as such a relatively small proportion is absorbed through the skin, it is unlikely to pose any risk to a developing baby.

Glycolic acid is an alpha-hydroxy acid found in many cosmetics that treat acne. Several animal studies have demonstrated adverse reproductive effects when glycolic acid is administered in high doses, much larger than those used in topical cosmetic products in humans. Studies examining the use of glycolic acid in human pregnancy have not been conducted; however, using topical glycolic acid during pregnancy should not be of concern, as only a minimal amount is expected to be absorbed systemically.