Oral retinoids have a high risk of birth defects, which is why isotretinoin (also known as Accutane) is strictly contraindicated during pregnancy.

Though the data is limited regarding the safety of topical retinoids (such as tretinoin or tazorac) during pregnancy, most dermatologists advise against using them until after giving birth and/or breastfeeding. 

Very high doses of hydroquinone have been linked to increased risk of cancer development in mice, although no similar human studies have demonstrated the same effect.

To be safe, we recommend avoiding hydroquinone-containing products, and ingredients such as arbutin, which break down into hydroquinone.

Oral salicylic acid has been shown to cause birth defects and other pregnancy complications.

Practically speaking, you’d have to apply very high concentrations of salicylic acid to a large proportion of your body to have any significant systemic absorption. However, most experts advise avoiding these ingredients out of an abundance of caution.

Experts generally recommend avoiding benzoyl peroxide during pregnancy simply due to insufficient evidence to support its safety.

Bakuchiol is sometimes touted as a functional analogue of topical retinoids. It's a plant-derived antioxidant with anti-aging effects, although it is not a vitamin A derivative like retinoids.

However, there is little known about its safety in pregnancy, so many experts recommend avoiding it to be cautious.

One study has suggested that use of sunscreens containing oxybenzone during pregnancy may increase fetal risk of having a particular birth defect. Though the evidence is weak, it’s safest to opt for mineral sunscreens, with active ingredients of zinc oxide or titanium dioxide, which are FDA-designated “Generally Recognized as Safe and Effective.”

Versine Annotate: You can read more about sunscreen safety and its environmental impact on our Skincare 101 blog:

https://www.versineskincare.com/blogs/skin-health-101/the-lowdown-on-sunscreen-safety

Some reports have linked essential oils to increased risk of uterine contractions, and therefore, miscarriage or preterm labor. Though other studies dispute this, the potential risks likely outweigh the benefits.

Hormonal changes during pregnancy can result in a heightened or altered sense of smell, or hyperosmia. While some with hyperosmia may find relief in using fragrance-free products, other may find that certain scents, such as citrus aromas, can help control nausea. Do what works for you!

Extra Credit Q: Some doctors say to avoid glycolic acid during pregnancy because its molecule size is quite small and is absorbed into the body at a relatively high rate. What is your opinion?

A: Overall, glycolic acid is thought to be safe to use in pregnancy due to its minimal penetration into the dermis (the deeper layer of the skin beneath the epidermis).

However, as an extra precaution, it is generally recommended that patients stick with lower dose formulations (such as over-the-counter products, rather than higher concentration chemical peels performed in a dermatologist’s office).