Hidden Skincare Myths During Pregnancy: Facts Every Expecting Mother Should Know

The journey of pregnancy includes many physical and emotional changes in addition to shifts in your hormone levels. Your skin is a common area where expectant mothers experience these changes most noticeably. Some of these normal changes to your skin include the well-discussed "pregnancy glow," and then there are those sudden breakouts, changes in pigmentation, and stretch marks, all showing how unpredictable a person's skin can be during pregnancy. In addition to these common changes, many myths circulate regarding skin care during pregnancy, causing some confusion about what to believe regarding skin care during this special time.

The purpose of this discussion is to help you understand what is true and what is a myth regarding pregnant women and their skin care. Additionally, we will explain the science behind skin care during pregnancy so that you can make informed choices for your own and your baby's skin.

Myth 1: Pregnancy Clears Acne 

Fact: Hormone Changes Can Often Cause More Acne 

Many women think that during 9 months of gestating a baby, they will finally have clear skin free from any acne problems. In truth, many women see an increase in acne severity from hormonal fluctuations, with hormonal levels such as elevated amounts of estrogen present throughout the pregnancy. 

The increase in hormones (especially estrogen, progesterone, and androgens) during pregnancy is known to stimulate the sebaceous (oil) glands, so when there is extra oil production, there will be extra clogged pores resulting in additional breakout areas. 

A large cross-sectional study of 1,284 postpartum women found that the onset or worsening of acne was reported in 35.7 % of pregnant women, showing that acne is a common pregnancy skin change influenced by hormonal and physiological shifts.

How to manage Acne safely during Pregnancy

• Non-comedogenic hydration

Not using a moisturizer can increase acne severity because it causes your skin to produce more oil. Non-comedogenic, lightweight moisturizers work to balance the production of oil from the skin's oil glands.

• Pregnancy-safe actives (used cautiously)

Both niacinamide and azelaic acid are considered safe to use while pregnant and may help decrease inflammation, redness, and blockages from pores. Avoid high doses; using lower concentrations and not combining them with other actives on top of one another is best for your safety.

• Cleaning Gently, Not Too Much

Use a very gentle, non-scented soap to wash your face and remove any excess oil. You should wash in the morning and at night. This will help your skin become healthier by not breaking down the skin barrier.

• Lifestyle Support

Your hormone balance and the health of your skin can be impacted by the way you nourish your body, stay hydrated, and manage stress.

Myth 2 - Cold milk baths prevent stretch marks.

Fact - No topical treatment can guarantee you will avoid stretch marks.

Stretch marks (striae gravidarum) are one of the most common skin concerns during pregnancy that are caused by rapid stretching of the skin and hormonal changes that affect collagen and elastin. The incidence of women having stretch marks during pregnancy can be as high as 50 to 90%. (American Pregnancy Association)

While the use of cold milk baths, oils, cocoa butter and other moisturizers are frequently promoted, there are no products currently available that have been proven through scientific research to entirely prevent the development of stretch marks. (Johns Hopkins University)

What is the basis for this myth?

Emollients and moisturizers may help keep the skin moist and more flexible, creating greater comfort when using the skin; they may also make stretch marks less visible. However, they do not address the underlying structural changes that lead to the development of stretch marks.

What Actually Helps:

• Staying hydrated and moisturizing your skin

• Gaining weight at a slow pace and within recommended amount

• Using a moisturizer to help relieve the itchiness associated with stretch marks and to make you more comfortable

Additionally keep in mind that genetics/your hereditary traits are the most significant factor influencing whether or not stretch marks will develop.

Myth 3: Anti-aging products must be stopped entirely

Fact - Some Anti-Aging Ingredients are unsafe, while others are safe

It is a fact that there are potent anti-aging ingredients and acne treatments that should be avoided while pregnant. However, this doesn’t mean you cannot use any type of skin care while pregnant- just use caution in selecting which ingredients you will use and not discontinue using skin care products altogether.

One of the changes that occurs to your skin during pregnancy is that it becomes much more permeable (or, more porous) than it already is; therefore, some substances can pass through your skin into the bloodstream. Given that the unborn baby is particularly sensitive and susceptible to risks, any ingredient with a known or suspected potential effect on the fetus’ overall health will be avoided simply as a precautionary measure.

Here are some Ingredients to avoid Using while Pregnant :

• Retinoids (Retinol, Tretinoin, Adapalene, Isotretinoin)

Retinoids are derived from Vitamin A and are often referred to as anti-aging agents, as well as anti-acne agents. Although oral retinoids have a clear connection to fetal malformations, topical retinoids are absorbed in much smaller quantities than oral forms, yet, because of the potential risk to the growing fetus, most medical bodies recommend that you do not use these products at all while pregnant.

The possible negative effects of excessive Vitamin A on the fetus during development have been shown to impact the development of the brain, heart, and spinal cord. Therefore, since there is even a slight possibility of risk, medical professionals will recommend that females stop taking retinoids while they are pregnant.

• Hydroquinone

Hydroquinone is an effective and potent topical treatment known to lighten the skin. Typically, it’s used for the treatment of dark spots or skin discoloration from melasma, post-inflammatory hyperpigmentation. Owing to its reliability and potency, hydroquinone is a common ingredient found in prescription-strength topical creams and formulations designed specifically for skin depigmentation, or whitening.

Why Hydroquinone Is Avoided in Pregnancy:

Hydroquinone has a very high rate of absorption through the skin. Studies have shown that about 35-45% of the amount of hydroquinone applied can enter into the bloodstream, which is higher than most other cosmetic ingredients that have been studied. 

Due to the high systemic absorption of hydroquinone and because no studies have been conducted to address the safety of hydroquinone during pregnancy, physicians and dermatologists recommend that pregnant women not use hydroquinone and instead, opt for other safer alternatives until the delivery of their baby.

• Salicylic Acid - (Concentrated amounts)

Salicylic Acid, a beta hydroxy acid (BHA) is a common ingredient used in skin care products primarily due to its ability to unclog pores, clear the skin of acne, control excessive oil production and remove dead skin cells from the outer layer of skin. Salicylic Acid is most commonly used in acne product formulations (such as spot treatments), toners as well as professional chemical peels since it has the ability to penetrate deep into the pores.

Salicylic acid belongs to a similar chemical structure as acetylsalicylic acid or aspirin; therefore, use of low doses via rinsing off products (<2% salicylate) have a low risk whilst higher doses via leave-on products or chemical peels have potential of increased absorbency into the body. 

Since there have been reports in medical literature linking big dose exposure to salicylates with pregnancy complications, Dermatologists and Obstetricians typically recommend no use of high dose or professional chemical peel forms of salicylic acid when a woman is pregnant.

• Benzoyl Peroxide (High Strength)

The most widely used ingredient for the treatment of acne is benzoyl peroxide, which has excellent antibacterial properties that combat the bacteria responsible for acne (Cutibacterium acnes), reduce inflammation, and help to remove blockages from pores. Benzoyl peroxide is therefore found in many acne gels, treatments for specific areas, cleansers, and creams that are left on the skin.

Why is it not recommended to Pregnant Women 

Benzoyl peroxide in low concentrations (ex., 2.5 - 5% for products that are washed off) is typically regarded as low risk due to its rapid metabolism into benzoic acid, then excreted from the body. While low concentrations tend to have a low rate of problem occurrence during pregnancy, there is insufficient pregnancy-associated safety data on benzoyl peroxide in higher concentrations (typically > 5%) for leave-on preparation or for frequent application. For this reason, dermatologists recommend against the use of benzoyl peroxide during pregnancy- unless directed by your healthcare provider- by using the lowest effective concentration possible, or using gentler alternatives.

• Chemical Sunscreen

Chemical sunscreens contain UV filters that absorb sunlight to convert it to heat. Some of the filters will be absorbed through your skin; as such oxybenzone can be found as a detected chemical in your bloodstream after being absorbed into your bloodstream after application.

Why you shouldn’t use chemical sunscreens while pregnant

Like with a lot of things currently being looked at as causing damage to the unborn fetus, we don’t know what definitive harmful amounts of oxybenzone there are in humans. However, it has been speculated that oxybenzone may have a harmful effect on the endocrine (hormones) system; therefore any potential effects will continue to warrant a precautionary approach, especially while you are pregnant. In addition to being naturally occurring, mineral sunscreens containing zinc oxide or titanium dioxide lay on top of your skin; they provide a reflective barrier for the sun's harmful rays and are the safest choice for any pregnant woman.

Myth 4: Baby’s Gender Can Cause Maternal Skin Problems

An old wives tale is that if a woman develops certain skin problems, such as having acne, this will predict whether she has a boy or girl.

Facts: There is no evidence that fetal gender affects maternal skin changes (i.e., acne, dryness, pigmentation). 

Skin changes during pregnancy are related to hormonal changes in the mother rather than to the sex of the fetus.

This myth is similar to the belief about heartburn during pregnancy (if you have heartburn, your baby will have lots of hair). A small study found an association between the amount of hair that a newborn has and the amount of heartburn that the mother experienced; however, the association between heartburn and a newborn's hair is not a direct or reliable relationship.

A baby's hair and gender are based on the mother and baby being genetically equal.

Myth 5: Natural Products Are Automatically Safe During Pregnancy.

Fact: Just because an ingredient is natural does not mean it's safe for your skin when pregnant.

Pregnant women are often deceived by such myths and use "natural" products. However, while many people believe that because something is natural it must be safe, many plant extracts and essential oils are biochemically active.

Your skin absorbs more during pregnancy, making your skin more sensitive to botanical and essential oil irritation and/or allergic reactions; therefore, there are numerous examples of biochemically active ingredients having negative systemic (whole body) effects.

Scientific studies consistently show that an ingredient's safety can be determined by three factors:

• Concentration

• Formulation

• Whether the skin can absorb that ingredient, and whether it be a synthetic or natural ingredient. 

You should always choose pregnancy-safe skincare products based on scientific fact, rather than on marketing labels.

Natural Ingredients that must be avoided during Pregnancy

In many cases, many plants contain powerful components that when absorbed can have adverse effects including causing skin irritation, disrupting hormone balance, and stimulating the circulation system. Those potential adverse effects are of greater concern during pregnancy.

Some examples of those types of plants include:

• Essential oils

Those like Clary Sage, Rosemary, Peppermint, Eucalyptus, Cinnamon and Thyme - These oils are very concentrated and depending on how they are used (inhalation or topical application) can cause skin irritation, headaches, nausea and/or uterine stimulation.

• Tea Tree Oil

In high concentrations, while it is usually labeled as “gentle” can actually cause contact dermatitis and increased sensitivity when used during pregnancy.

• Papaya enzyme and pineapple (bromelain) extracts

The extracts derived from papaya and pineapple enzymes (bromelain) that are found in exfoliating masks and peels may be overly enzymatic for pregnancy-sensitive skin.

• Camphor and menthol-heavy products

A lot of “cooling” balms and oils contain excess camphor and menthol, which could cause unwanted side effects if you absorb excessive amounts.

Safe Natural Ingredients During Pregnancy

The following natural ingredients are often used to formulate cosmetics for women who are pregnant because of their low potential for irritation as well as their ability to be absorbed into the body:

1) Aloe vera

Aloe vera is an oily extract obtained from the aloe plant. It is often used to hydrate and soothe irritated skin when applied topically at the appropriate concentration, and does not have any effect on hormone levels in the body.

2) Shea butter

Shea butter is an emollient (softening agent) made from the nuts of the shea tree. It is high in fat content and has a similar chemical structure to lipids found on the skin’s surface, helping to prevent dryness and itchiness associated with pregnancy. Because shea butter does not penetrate very deeply into the body when used topically, it has not been associated with any potential negative effects on fetal development.

3) Oat extract (also called colloidal oatmeal)

Oat extract has been found to have both anti-inflammatory and barrier-repairing properties. There is strong clinical evidence supporting the use of oat extract in individuals who have sensitive and/or combination skin, and therefore, oat extract can be beneficial for pregnancy-associated dryness and itchiness.

4) Coconut oil

Coconut oil is an occlusive moisturizer (i.e., creates a barrier against moisture loss). Coconut oil is generally safe for use in cosmetics by pregnant women, but it may cause some individuals’ pores to become clogged if used in pure form, so only commercially manufactured products containing coconut oil should be used.

Myth 6: High Cost or “Recommended by Dermatologists” Meaning that Product is Safe for Use During Pregnancy

Fact: Just because something is priced high or has been recommended by an expert does not mean it will be safe to use during Pregnancy.

Luxury skin care and professional cosmetics can often be comforting to moms-to-be. You might think that, because the price is high or because the product is “recommended by a dermatologist”, that it has been thoroughly tested through all stages of life and will therefore be acceptable for use during Pregnancy. In many cases however, that assumption may be wrong.

What Really Matters

Pregnancy skincare should be carefully reviewed for other factors too, and not simply depend on branding and/or endorsements.

Intent of Ingredient

When selecting a pregnancy skincare product, you'll want to know what someone's intent was when creating their ingredient. Did the founder of the product develop their product with a thought towards skin comfort and barrier health, or was it developed as an aggressive means of getting rid of imperfections on the skin's surface?

Concentration and Frequency of Use

With any product, even typically safe, will become dangerous when used too often or at high concentrations.

Pregnancy-Specific

Very few skincare products are formulated specifically for pregnant women, as most are designed with postpartum bodies in mind rather than addressing the unique needs of a developing baby during pregnancy.

Response to the Skin

When a woman is pregnant, how her skin responds to a skincare product matters far more than how aggressively that product is marketed.

Bottom line: Safe pregnancy skincare should be chosen based on how safe and gentle a pregnancy skincare product is to use, NOT on whether you can find the most up to date or most expensive skincare product.

Myth 7: Strong Treatments Are Needed to “Fix” Pregnancy Pigmentation

Fact: The best way to handle pigmentation problems during pregnancy is to do so in a gentle manner as opposed to an aggressive manner.

What’s the Real Truth?

Due to hormones in the body pigmentation occurs during pregnancy (melasma, or dark areas of skin, etc). Increased amounts of estrogen, progesterone and the melanocyte stimulating hormone in the body make the skin more reactive to sunlight and to inflammation. If you use strong lightening agents, or if you treat your pigmentation intensively, You are more likely to compromise the skin barrier, leading to irritation and increased post-inflammatory pigmentation, than if the skin were treated gently. In fact, using strong treatments while pregnant can cause the skin that is stressed to create more pigment than less!

How Pigmentation Can Be Managed Gently

Sun Protection Is Crucial

Sun exposure is one of the biggest triggers for pregnancy-related pigmentation. A brief daily exposure can cause existing pigmentation patches to get darker than what was their previous color.

• Use a pregnancy safe sunscreen consistently.

• Wear physical barriers like hats, scarves and seek shade.

• Avoid the sun during peak hours if possible. 

In most cases sun protection can do more to prevent worsening of pigmentation than many active treatments.

Prioritize the Skin Barrier

Healthy skin barriers are important for controlling inflammation and pigmentation.

• Gentle cleansing; don’t exfoliate too much.

• Regular moisturizer used to reduce sensitivity.

• Have a consistent routine; don’t change your products often.

The calmer and more hydrated your skin is, the less likely pigmentation will develop bigger than it actually is over the long term.

Use Gentle/Supportive Brightening Methods

Gentle brighteners enhance the overall balance of your skin, which is a better option than using a spot corrector (harshly treated).

• Brightening ingredients that promote skin cell renewal without irritation.

• Low intervention treatments (takes longer to see the results).

• No high concentration of acid and aggressive peels.

• Providing comfort to the skin and allowing time for recovery.

Preventing Inflammation

Heat, friction, and irritation can all deepen pigmentation.

• Stay away from using scrubs; use soft towels only; do not excessively rub your face.

• Be careful not to wax or thread pigmented skin.

• Limit the friction to pigmented skin caused by wearing tight masks/clothing on it.

Myth 8: Minimalist skincare is no skincare.

Fact: Minimalist skincare is intentional skincare.

What's actually true?

A lot of women respond to their worry about skincare product ingredients by not using any type of skincare product at all during pregnancy. Although this is an effort to keep you and your baby safe, the lack of any skincare could create even more problems for your skin. Due to the hormonal changes throughout the nine-month process, our skin becomes more prone to dryness, itching, tightness, and overall reactivity. Therefore, if you don't have any type of basic skincare routine (cleansing, moisturizing, protect), then you will continue to weaken the barrier of your skin. Weakening the barrier will lead to more sensitivity and discomfort.

How to Have a Minimal & Intentional Skin Care Routine

1. Keeping a Simple, Supportive Core Routine

Rather than requiring multiple steps, a few basic essentials satisfy most pregnancy-related skin concerns:

• A gentle (non-stripping) cleanser

• A moisturizer that helps support the skin's barrier function.

• Sun protection for daytime use.

The fewer products applied to your skin, the less it will become agitated; therefore, a more balanced complexion is achieved with this small core routine.

2. Choosing Products That Do More Than One Job

By using a multi-functional product it reduces the amount of product needed to layer up.

• A moisturizer that soothes irritated/sensitive skin.

• A sunscreen with added moisture

• A pH-balancing cleanser

The fewer products that come in contact with your skin will therefore limit the potential for irritation to occur.

3. Supporting the Skin’s Natural Resilience

Pregnancy skin often needs support, not correction.

• Avoiding frequent product switching

• Letting the skin adapt slowly

• Prioritizing comfort over cosmetic results

When the barrier is intact, the skin can regulate itself more effectively- even amid hormonal changes.

Myth 9: Swelling is just “Part of Pregnancy” and Can’t Be Managed

Fact: Swelling reflects circulation and fluid balance- and can often be eased with supportive care.

While most women have mild edema (swelling) in their feet, ankles, and hands, as well as sometimes in their face, the amount of swelling will vary based on many factors including the increase in blood volume, hormonal changes, and the pressure of the growing uterus on the blood vessels. However, not everyone is going to have retention; it will vary from person to person. Although retention may be prevented or reduced through various lifestyle factors such as prolonged sitting/standing, dehydration, exposure to heat, or reduced blood flow to extremities, the degree of retention will be limited by what we can control responsibly

Swelling in the body should not be viewed as a problem that needs to be resolved but rather how best to manage the swelling through proper circulation support and fluid movement.

Gentle Movement- Short walks, ankle rotations, and light stretching will help promote blood and lymphatic flow.

Elevate Legs- By raising the legs above the level of the heart when lying down, blood and lymph will flow back into the cardiovascular system more easily.

Drink plenty of water- Making sure you are hydrated will help the body get rid of any extra fluid rather than holding onto it.

Wear Comfortable Clothing- Tight clothing (waistbands, socks, or shoes) restrict circulation and can increase swelling.

Sleep on Left Side- Sleeping in this position takes pressure off of large arteries and allows for better circulation to the lower body.

Keep Your Body Cool and Wear Breathable Fabrics- If you are in a hot environment and not wearing breathable clothing, your body will retain fluid.

Your baby and you are constantly changing and adapting to one another throughout pregnancy. When you experience swelling during this time, it is your body’s way of telling you to slow down, increase your circulation. If you manage swelling gently, it will be more comfortable for you and will happen in a routine manner rather than in an overwhelming way.

Myth 10: Digestive Problems are Separate from Body and Skin Changes.

Fact: Digestion has an effect on everything including our skin clarity, energy levels, moods, and our immune system.

Due to proper hormonal levels, digestion slows down due to progesterone in your body. This makes food less digestible and causes the symptoms known as bloating, gas, heartburn, constipation, nausea, and fullness after eating. When your digestion is slow or irritated your body has to redistribute energy from repairing to manage the issues associated with poor digestion.

This internal imbalance can show up externally as:

• Dull or uneven skin tone

• Increased sensitivity of skin or sudden breakouts.

• Puffiness or water retention

• Fatigue and irritability

In pregnancy, the gut and skin are closely linked- what’s unsettled inside often reflects outside.

Gentle Methods to avoid Digestive Discomfort:

Prevention during pregnancy is less about strict rules and more about rhythm and awareness:

• Smaller, frequent meals: Heavier meals cause difficulty in digestion, but smaller portions are more easily digested by the body.
  
  
• Warm and simple foods: Warm, cooked foods such as soup, stew, and warm grains are much easier for the digestive system to digest than raw, cold or fried foods.
  
  
• Mindful eating: Eating slowly, without screens, chewing and tasting food thoroughly before swallowing can help to reduce bloating and acidity.
  
  

• Hydration: Sipping water throughout the day, will help to keep your stool hydrated and soft when increasing your fiber intake, which helps prevent constipation.
  
  
• Gentle, slow movement: Gentle movement such as walking after meals can promote better digestion of food

Caring for Skin While Supporting Digestion

Instead of treating skin concerns in isolation, pregnancy care works best when internal and external support align:

• Skincare that supports barriers: A properly hydrated body will be protective of the skin during periods of digestive strain.
  
  
• Don't exfoliate too much: A body that has a poor digestive system may cause the skin to become reactive and using an exfoliation routine that uses minimal exfoliation may help to minimize reactive skin responses.
  
  
• Nourishment over correction: Instead of using aggressive methods of trying to correct the surface of your skin, choose products that promote calmness and strength.

What is Important

Healthy digestion in pregnancy does not mean control; it means comfort, consistency and care.  When your digestive system is healthy, energy increases, inflammation decreases, and because of this, many times you will have clear healthy skin as well.

Conclusion 

Pregnancy is about discovering your body, not fighting with it. Most of the pregnancy care comes from seeing symptoms, such as skin changes, swelling, digestion, and hair issues, as individual experiences rather than as an entire experience. In fact, the whole experience of being pregnant is interconnected; thus, changes inside the body will have an impact on things outside the body.

The most helpful thing is not to intervene excessively, avoid doing things out of fear, or be overly aggressive in trying to "fix" yourself, but to have gentle, informed care that is based on awareness. Once we move away from the myths surrounding pregnancy and towards evidence backed up by empathy, we'll start to treat pregnant women intentionally rather than reactively.

Recommended Products by Blue Nectar:

Saffron & Almond Body Stretch Mark Oil for Pregnancy (12 herbs)

Triphaladi Ayurvedic Fat Burning & Slimming Oil (11 herbs)

Niraa Cocoa Butter Stretch Mark Removal Cream Body Lotion for Skin Firming and Moisturization ( 12 herbs, 200ml)

Related Articles:

Nalpamaradi Thailam Uses for Moms and Little Ones: A Complete Guide to Safe Usage During Pregnancy and Childhood

Say goodbye to pregnancy stretch marks with stretch mark lotion

References:

https://www.aad.org/public/everyday-care/skin-care-secrets/routine/pregnancy-skin-care

https://pmc.ncbi.nlm.nih.gov/articles/PMC9823189/

https://pubmed.ncbi.nlm.nih.gov/32509349/

https://pmc.ncbi.nlm.nih.gov/articles/PMC5440454/

https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/skin-changes/

https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-really-helps-you-bounce-back-after-pregnancy

https://share.upmc.com/2023/03/is-retinol-safe-during-pregnancy/

https://www.yashodahospitals.com/medicine-faqs/hydroquinone/

https://www.sciencedirect.com/topics/neuroscience/benzoyl-peroxide

https://pmc.ncbi.nlm.nih.gov/articles/PMC8802657/