to weigh in on what to use when — for whatever reason — a retinoid isn’t on the program.
“Retinoid medicines — whether oral or topical — are derived from vitamin A, and we know retinoid pills, such as isotretinoin or acitretin , have the potential to cause birth defects. For that reason, it’s contraindicated to take those medications during pregnancy,” said Geraghty. Even though topical retinoid creams don’t absorb into the bloodstream the same way pills do, they come from the same family of medicines, so they’re not recommended during pregnancy or lactation, she said.
Although it’s true retinoid creams are typically applied in tiny amounts, and probably very little is absorbed into the bloodstream , why risk it? We have our whole lives to use retinoid creams and only relatively short amounts of time to be pregnant , Geraghty said. So she advises saving the retinoids until after pregnancy and breastfeeding.
Azelaic acid is one topical ingredient many dermatologists consider to be relatively safe during pregnancy, said Geraghty. Although medications and ingredients can’t be tested on pregnant women due to ethical reasons, this ingredient is considered to be on the more gentle and benign end of the spectrum.
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