Safety of dermatologic medications in pregnancy and lactation: Part I. Pregnancy

J Am Acad Dermatol. 2014 Mar;70(3):401.e1-14; quiz 415. doi: 10.1016/j.jaad.2013.09.010.


Dermatologists are frequently faced with questions about the safety of commonly prescribed topical and systemic medications during pregnancy and lactation from women of childbearing age who are pregnant, considering pregnancy, or breastfeeding. Safety data, particularly regarding medications that are unique to dermatology, can be difficult to locate and are not consolidated in a single reference guide for clinicians. Parts I and II of this continuing medical education article provide a capsule summary of key points for the most commonly prescribed dermatologic medications to facilitate patient medication risk counseling in pregnancy. A summary table details safety classification data for 3 primary international classification systems: the US Food and Drug Administration, the Swedish Catalogue of Approved Drugs, and the Australian Drug Evaluation Committee. In addition, this table includes an alternative pregnancy classification system developed by a consortium of active members of teratology societies in the US and Europe detailed in Drugs during Pregnancy and Lactation: Treatment Options and Risk Assessment and a safety classification system developed for breastfeeding mothers detailed in Medications and Mother's Milk.

Keywords: acne; antibiotic; antifungal; antihistamines; antiviral; atopic dermatitis; biologics; breast milk; breastfeeding; corticosteroid; cosmetics; fetus; gestation; lactation; medication safety; nursing; phototherapy; pregnancy; psoriasis; surgery; trimester.

Publication types

  • Review

MeSH terms

  • Abnormalities, Drug-Induced / prevention & control*
  • Administration, Oral
  • Administration, Topical
  • Adult
  • Australia
  • Breast Feeding
  • Dermatologic Agents / adverse effects*
  • Dermatologic Agents / therapeutic use
  • Drug-Related Side Effects and Adverse Reactions / prevention & control*
  • Education, Medical, Continuing
  • Europe
  • Female
  • Gestational Age
  • Humans
  • Lactation / drug effects*
  • Patient Safety*
  • Pharmaceutical Preparations
  • Pregnancy
  • Prenatal Care / methods
  • Risk Assessment
  • Skin Diseases / diagnosis
  • Skin Diseases / drug therapy
  • United States
  • United States Food and Drug Administration
  • Young Adult


  • Dermatologic Agents
  • Pharmaceutical Preparations