Part 1. Safety Concern
Pregnancy is associated with hormonal changes that naturally result in changes to the skin, hair, nails etc. Some of the changes during this period come and go; other changes like stretch marks and acne scars can last a lifetime.
While there are measures every woman can and should take to prevent and treat such side effects; it is important for a woman to carefully think through these measures as they may have a major impact on the life developing inside of her.
However women face many challenges when trying to make informed decisions about safe skin- and body-care during pregnancy. This happens because quality information on what ingredients are safe or not safe to use during pregnancy is not easily available from doctors, or other resources. The mixed messages concerning the safety of topical ingredients are confusing. With the careful phrasing of “most probably safe”, “unlikely to significantly increase the risk” and “not enough data to prove unsafe”; we are left unsure of what to do. Even physicians sometimes get it wrong, as some women report having a particular ingredient recommended because it is topical, while others are warned to stay away.
In these series of articles we discuss the changes woman goes through during her pregnancy, provide some skin-care recommendations in pregnancy, name several ingredients and treatments that are either clearly prohibited or questionable and suggest some steps that every woman should consider when conducting her own research.
Why is it important to be careful about using so called ‘safe products’ during pregnancy?
Our skin serves as a barrier protecting us from the surrounding environment. During pregnancy the skin is responsible for protection of both the mother-to-be and the fetus. Nevertheless, some topical ingredients are able to pass through the skin into the blood stream. Some products may be absorbed in very small amounts by some women and high amounts in others as no two women are alike. The amount that gets through can depend on the amount of the chemical applied as well as on the condition of the skin. For example retinoids, commonly found in topical anti-aging and anti-acne skin care products, can be seriously dangerous to developing fetuses. A study measuring the amount of a topically applied retinoid showing up in the blood stream revealed a huge variation of between 5 to 31%; higher absorption being due to inflamed skin, dermatitis or skin rash, a common condition during pregnancy. The liver, our organ responsible for cleansing chemicals from our blood system, is also influenced by various factors: genetics and overall health can make a liver work faster or slower. Drugs or supplements taken during pregnancy can interact with liver function and dramatically change its ability to remove chemicals from the blood.
The next line of defense for the developing baby is the placenta - the main barrier protecting the fetus. The placenta mostly filters out large molecules such as bacteria. However some smaller molecules such as some chemicals found in skin care products are able to get through to the baby. Studies show that some chemicals applied topically can appear in mother’s blood system, pass through the placenta and thus reach the fetus.
Before using any topical skin-care product double check with your doctor (obstetrician, dermatologist) and then double-check ON your doctor:
Because some molecules can permeate the skin and placenta it is highly important to consult a doctor before using topical skin treatments or skin-care products. Using the wrong product may potentially cause harm to the baby. Though in our lives we get used to relying on “experts’ opinion” when making health related decisions, the truth is that there are cases when due to the lack of scientific evidence and proper trials even the experts have conflicting opinions. For example, pregnant women have reported having products containing salicylic acid recommended to them by their doctors for acne. However salicylic acid belongs to the aspirin family which, in oral form has been shown to cause birth defects in babies. If topically applied in sufficient quantities, the amount of salicylic acid absorbed can equal taking an aspirin tablet orally. Experts disagree over whether the amounts absorbed are sufficiently high to do damage to the fetus, but it is difficult to do studies which will clearly answer this question. Further, absorption rates and blood levels will clearly be higher in some women than in others. Like aspirin, topical salicylic acid is best avoided during pregnancy.
What about skin care product manufacturers; can they be trusted sources of information about their products?
When we contacted a well known brand and asked if their products are pregnancy safe the immediate response we got was: “Yes, all the products are safe”. However, when we specifically asked about the salicylic acid in one of the products, we were told “Consult your doctor”. The Bottom Line: Don’t base your decisions about skin-care during pregnancy on just one source of information. It is always better to double-check with your doctor and then double-check ON your doctor. An FDA web-resource www.safefetus.com gives information about the safety of certain products or ingredients for pregnant women. Remember however, if you do not find the ingredient you are considering to use on the website it does not necessarily mean it is safe.
Responding to Skin Changes during Pregnancy
Acne-Treatment during Pregnancy: Ingredients to Avoid
Body Care during Pregnancy
SPA and Beauty Salon Treatments during Pregnancy