Adult acne during pregnancy and breastfeeding is a common problem. Under these circumstances, the adrenal glands secrete higher levels of androgen hormones that cause the sebaceous glands in the skin to increase in size and production. The extra oil clogs the enlarged pores and promotes the growth of bacteria, especially Propionibacterium acnes. Pregnant or breastfeeding women must be more cautious about acne therapies because many of the most effective prescription treatments for stubborn acne are contraindicated during pregnancy and lactation.
In addition to a variety of over the counter and prescription medications, effective acne treatment always begins with proper skin hygiene. Here are a few guidelines that are supported by medical evidence:
- Patients should wash their skin by applying a synthetic detergent cleanser with their fingers and then rinsing with warm water twice daily.1 Synthetic cleansers, like Cetaphil, minimize skin irritation and dryness by having a pH much closer to that of skin than soap.2-4
- Patients should cleanse their skin gently and avoid aggressive scrubbing. Repetitive irritation can aggravate acne and promote the development of new lesions.1
- Similarly, acne comedones should not be picked or squeezed as this can exacerbate scarring.
- Water-based lotions and cosmetics are less likely to clog pores than oil-based products. Patients should be encouraged to seek out “non-comedogenic” skin care and cosmetic products.
James Abbey, MD
1. Gollnick H, Cunliffe W, Berson D, et al. Management of acne: a report from a Global Alliance to Improve Outcomes in Acne. Journal of the American Academy of Dermatology. Jul 2003;49(1 Suppl):S1-37.
2. Draelos Z. Cosmetic therapy. In: SE W, ed. Dermatology. 2nd ed: Elsevier; 2007.
3. Draelos Z. Cosmetics and cosmeceuticals. In: Bolognia JL JJ, Rapini RP, ed. Dermatology. 2nd ed: Elsevier; 2008:2301.
4. Subramanyan. Role of mild cleansing in the management of sensitive skin. Poster presented at the American Academy of Dermatology 61st Annual Meeting. San Francisco, CA; 2004.