Pregnancy-Safe Skincare Routine: What to Use and Avoid, Trimester by Trimester

A pregnancy-safe skincare routine keeps the basics and swaps out a few actives: a gentle cleanser, moisturizer and broad-spectrum SPF 30+ every day, with azelaic acid, benzoyl peroxide up to 5%, glycolic acid or small-area salicylic acid for acne and dark spots. Stop retinoids (retinol, tretinoin, adapalene, tazarotene) and prescription isotretinoin, and confirm every active with your OB.

Below is the evidence behind each yes and no, a morning and evening routine you can copy, what changes from the first trimester to the third, and how to handle the two problems that bring most people to this page: pregnancy acne and melasma. None of this replaces your obstetrician or dermatologist, who knows your history and your pregnancy.

What skincare should you avoid during pregnancy?

The clearest "avoid" list covers retinoids and a handful of prescription acne drugs. The American Academy of Dermatology (AAD) says isotretinoin, tazarotene and spironolactone can cause serious birth defects, and that most experts recommend stopping adapalene and tretinoin during pregnancy. The same page says oral doxycycline, minocycline and tetracycline should be stopped by the 15th week of pregnancy.

Over-the-counter retinol sits in the same family. A 2023 narrative review in Dermatology and Therapy notes the data on topical retinoids are conflicting, but that most experts recommend avoiding all topical retinoids during pregnancy. An earlier review in Canadian Family Physician found that very little topical retinoid is absorbed through the skin, yet still concluded that pregnant women should not be encouraged to use topical retinoids until better data exist.

Two more ingredients deserve caution. Hydroquinone, the classic dark-spot fader, is unusually well absorbed: the Canadian Family Physician review lists 35% to 45.3% systemic absorption through the skin and recommends keeping exposure low. And salicylic acid is fine in a face wash but not something to spread over large areas for weeks; the 2023 review says pregnant patients should avoid applying topical salicylic acid over large areas for prolonged periods.

Which skincare ingredients are considered safe during pregnancy?

Most everyday products are low risk, and several acne and brightening actives have reasonable support. Here is how the main ones line up, based on the AAD and the two reviews above. "Generally considered OK" still means: show the product to your OB.

The figures in the table come from the AAD's acne treatment in pregnancy page, the 2023 review (azelaic acid up to 20%, benzoyl peroxide up to 5%, glycolic and lactic peels) and the 2011 review (absorption of benzoyl peroxide, glycolic acid, hydroquinone and sunscreen filters). For azelaic acid specifically, our guide to azelaic acid benefits covers strengths and how to start it.

Hydrators and barrier ingredients such as glycerin, ceramides, hyaluronic acid and petrolatum don't have pregnancy studies of their own, but they aren't drugs and nothing in these sources flags them. Vitamin C is a common pick for dullness and dark spots, and the AAD lists it among melasma treatment options; there are no pregnancy studies on it in the sources we checked, so add it to the list you run past your OB.

What does a pregnancy-safe AM and PM routine look like?

A pregnancy routine can be four steps in the morning and three at night. Introduce one active at a time and give it several weeks.

Morning

1. Gentle cleanser, or just water if your skin is dry. If you're breaking out, a salicylic acid face wash used on the face only is fine for most people.
2. Vitamin C serum (optional, after your OB's okay) for brightness and as an antioxidant under sunscreen.
3. Moisturizer in the texture your skin likes: gel for oily, cream for dry.
4. Broad-spectrum sunscreen, SPF 30 or higher. The AAD recommends SPF 30 or higher, and the FDA advises reapplying at least every two hours, more often if you sweat. If you're prone to melasma, pick a tinted mineral formula (see below).

Evening

1. Cleanser to remove sunscreen and makeup.
2. One treatment step: azelaic acid most nights, or a glycolic or lactic acid product two or three nights a week. Don't use both on the same night while you're testing tolerance. Our glycolic acid guide explains how to build up slowly.
3. Moisturizer, richer than your morning one if your skin feels tight.

If you were using retinol at night, azelaic acid is the most common swap: it works on breakouts, redness and dark marks, and among the over-the-counter options it's the one the AAD describes as thought to be safe, with no "limited amounts" qualifier.

How does skincare change trimester by trimester?

The ingredient rules stay the same all nine months, but what your skin needs tends to shift. Hormone changes show up differently for everyone, so treat this as a rough map.

First trimester (weeks 1 to 13)

This is the time to audit your shelf. Pull anything with retinol, retinal, retinyl esters, tretinoin, adapalene or tazarotene, and set aside hydroquinone. If you take an oral antibiotic for acne, talk to your prescriber now, since the AAD says doxycycline, minocycline and tetracycline should stop by the 15th week. If you break out, start with a gentle cleanser, benzoyl peroxide or azelaic acid instead of reaching for leftover prescriptions.

Second trimester (weeks 14 to 27)

This is when many people notice dark patches. The AAD notes that melasma often begins during pregnancy, because rising estrogen and progesterone are thought to trigger it. Make daily sunscreen and a hat non-negotiable, and keep your treatment step steady instead of adding more actives.

Third trimester (weeks 28 to 40)

Comfort usually matters most now. If your skin feels drier or itchier, move to a cream moisturizer and cut acid nights back. Tell your OB about any new rash or itching that doesn't settle with moisturizer instead of assuming it's dry skin. Plan ahead for postpartum: if you hope to bring retinoids back, read our guide to skincare while breastfeeding before you restart anything.

How do you treat pregnancy acne?

Pregnancy acne usually responds to the same over-the-counter basics as other acne, minus retinoids. A routine that works for many people:

• A gentle cleanser twice a day, or a salicylic acid wash once a day on the face.
• Benzoyl peroxide up to 5% as a wash or leave-on, which the 2023 review describes as widely considered acceptable during all phases of pregnancy. Start every other day; it can dry and bleach fabric.
• Azelaic acid at night for breakouts and the dark marks they leave.
• A non-comedogenic moisturizer and sunscreen.

If you have painful, deep or scarring acne, see a dermatologist and tell them you're pregnant. Prescription options such as topical clindamycin are thought to be safe, and the AAD notes that some oral antibiotics are used in pregnancy under a doctor's care.

What helps melasma during pregnancy?

Sun protection does most of the work, and active fading treatments are often better saved for after delivery. The AAD's melasma page says dermatologists often recommend a sunscreen with zinc oxide, titanium dioxide or iron oxide, SPF 30 or higher, with a wide-brimmed hat and shade, and suggests a tinted sunscreen if mineral filters leave a white cast.

The same page says melasma can fade after you deliver your baby, though it can also last for years. That's one reason to avoid aggressive treatment now. Azelaic acid and vitamin C are gentle options to discuss with your OB, while hydroquinone (now prescription-only in the US, per the AAD) and tretinoin-based creams are worth postponing. For a deeper look at why it comes back, see melasma causes and triggers.

Is salicylic acid safe during pregnancy?

In a face wash or as a spot treatment, yes, for most people. The AAD says salicylic acid is generally considered safe for a limited time and advises talking to your obstetrician or dermatologist before use. The Canadian Family Physician review found absorption from normal skin was undetectable at concentrations up to 25%, while noting it could be higher on damaged skin. The caution is about how much skin you cover and for how long: daily leave-on salicylic acid all over the body, or high-strength salicylic peels, are the uses to skip unless your doctor says otherwise.

How can a skin scan or ingredient scanner help?

Pregnancy changes skin slowly, and it's hard to tell from the mirror whether dark patches are spreading or whether a new moisturizer is helping. A selfie taken under the same light each week gives you a record. Pori returns an overall skin score with a breakdown that includes Pigmentation & Tone and Hydration & Moisture, so you can watch melasma or dryness over the trimesters instead of guessing.

Pori's ingredient scanner (a Pro feature) reads a barcode or a photo of the label and flags each ingredient as beneficial, use with caution or avoid for your skin type. It judges ingredients against your skin type, not against pregnancy, so still check the list yourself for retinol, retinal, retinyl palmitate, adapalene and hydroquinone, and bring anything you're unsure about to your OB. Our guide to reading ingredient labels shows where those names hide.

An app is not a diagnosis and can't tell you whether a product is safe for your pregnancy. Your OB and dermatologist make that call.