If some future mothers have a radiant complexion and beautiful skin, others on the other hand see their pregnancy marked by breakouts. Focus on the causes and treatment of pregnancy acne.

Like most pregnancy ailments, hormonal impregnation is the root cause of pregnancy acne. The strong secretion of progesterone and estrogen causes overactivity of the sebaceous glands which produce more sebum. This excess sebum tends to clog the pores of the skin, promoting the appearance of inflammatory pimples and / or blackheads on the face and back. Pregnancy acne can appear at any term, last throughout pregnancy, or be transient. It has, of course, no effect on the baby.

The first rule is to avoid self-medication – a basic rule during pregnancy – and take advice from a dermatologist before starting any treatment. Certain molecules usually used against acne are indeed contraindicated during pregnancy because of their teratogenic nature, that is to say likely to cause malformations in the fetus. This is the case with derivatives of vitamin A (isotretinoin, tretinoin) and antibiotics of the cyclin family.Dermal route, it is preferable to avoid using isotretinoin during pregnancy, indicates the CRAT ( Reference Center for Teratogenic Agents) (1).

If the treatment of acne cannot be postponed after childbirth, the use of the following molecules is possible during pregnancy, indicates the CRAT:

• benzoyl peroxide, regardless of the term of pregnancy. In local application, it has an anti-bactericidal action and regulates the secretion of sebum while slowing down its retention in the sebaceous gland;
• local antibacterials regardless of the term of pregnancy;
• zinc from the 2nd trimester, taking into account any other zinc intake (“multivitamin and trace element” supplements in particular). Anti-inflammatory and antibacterial, zinc gluconate helps to curb hyperseborrhea as well as the proliferation of the bacteria acnes involved in acne;
• possibly oral azithromycin or erythromycin if a systemic antibacterial is really needed (2).

In terms of daily hygiene, it is important to wash your face thoroughly in the evening with special purifying products. As a care cream, we can also turn to dermato-cosmetics dedicated to acne, offered by many laboratories. Ask your pharmacist for advice.

As for natural care, it is possible to take a steam bath and then apply to the buttons manuka honey, thyme or rosemary for their antiseptic and healing action, or mini-poultices of pink or green clay (3).

In aromatherapy, application after makeup removal from hydrosols of Damascus rose, cistus, sandalwood, cypress, globular eucalyptus, red myrtle, linalool thyme (alone or mixed) can help to cleanse the skin (4). However, be careful with the use of essential oils, some of which are contraindicated in early pregnancy and throughout pregnancy for some.

Women with a history of acne during puberty, adulthood, or a previous pregnancy are more likely to be affected by pregnancy acne. However, in women with oily or acne skin, the course of pregnancy is unpredictable: acne can improve or, on the contrary, worsen.

Food is not the direct cause of this pregnancy acne but it can maintain the phenomenon. Insulin peaks, due to the ingestion of foods with a high glycemic index, can indeed amplify hormonal secretion and therefore the secretion of sebum.

The sun is a false friend of acne: it can improve it temporarily, but then has a rebound effect.

Acne is a hormonal phenomenon that is difficult to control. However, it is possible to limit it with certain precautions:

• use appropriate care (purifying and non-comedogenic);
• avoid touching the buttons. This accentuates the inflammatory process and promotes the proliferation of bacteria;
• limit foods with a high glycemic index and favor those with a low or medium glycemic index. Foods rich in zinc (oyster, cocoa, wheat germ, veal, egg, etc.) help to regulate sebum secretion.

Pregnancy acne is manifested by pimples, while the pregnancy mask is characterized by the appearance of brown spots on the face and neck which, if there are many, can form a kind of “mask”. These spots are due to hyperpigmentation of the skin caused by pregnancy hormones. The pregnancy mask affects 50 to 70% of pregnant women. It improves in 6 to 18 months after childbirth and disappears completely in 70% of cases. (5)