Treatment of acne vulgaris in pregnant patients

Dermatol Ther. Jul-Aug 2013;26(4):302-11. doi: 10.1111/dth.12077.

Abstract

The management of acne vulgaris in the setting of pregnancy raises important clinical considerations regarding the efficacy and safety of acne treatments in this special patient population. Particular challenges include the absence of safety data, discrepancy in safety data between different safety rating systems, and lack of evidence-based recommendations for the treatment of acne during pregnancy. Nonetheless, many therapeutic options exist, and the treatment of acne in pregnant women can be safely and often effectively accomplished. For mild or moderate disease, patients can be treated with topical antimicrobial agents, anti-inflammatory agents, as well as glycolic and salicylic acid. Several topical agents, notably benzoyl peroxide, previously viewed as potentially dangerous are cited by many sources as being considered safe. When necessary, systemic therapies that can be safely added include penicillins, amoxicillin, cephalosporins, erythromycin, clindamycin, and tetracyclines or sulfonamides, depending on the stage of fetal development. Adjunct therapy may include phototherapy or laser treatments. Physicians should work with this often highly motivated, safety-conscious patient population to tailor an individualized treatment regimen. This treatment regimen will likely shift throughout the different stages of fetal development, as distinct safety considerations are raised prior to conception as well as during each of the trimesters of pregnancy. Important considerations regarding acne management in breast-feeding mothers is also discussed.

Keywords: acne vulgaris; lactation; pregnancy; safety; treatment.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris / etiology
  • Acne Vulgaris / therapy*
  • Anti-Bacterial Agents / therapeutic use
  • Female
  • Humans
  • Lactation
  • Laser Therapy
  • Phototherapy
  • Pregnancy
  • Pregnancy Complications / etiology
  • Pregnancy Complications / therapy*
  • Retinoids / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Retinoids