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Is It Safe to Use Azelaic Acid During Pregnancy?

by Ella Goodman 04 Nov 2023

Hey, Glow-Getters!

You’ve got a bun in the oven, and your skin is throwing a party of its own - hello, hormonal acne!

But before you RSVP ‘yes’ to every skincare invite, let’s chat about what’s safe for your baby-on-board glow up.

Today’s VIP guest: Azelaic Acid.

Is it the plus-one your pregnancy skin actually needs?

Is Azelaic Acid Safe When You're Pregnant?

Alright, mama-to-be, let’s spill the tea on azelaic acid.

Azelaic acid isn't just a run-of-the-mill ingredient; it's a dermatological darling for those dealing with the trifecta of skin annoyances: acne, rosacea, and those pesky marks that linger after a breakout (the notorious hyperpigmentation).

It waves its magic wand and, presto, your skin is clear, calm, and even-toned.

But pregnancy has turned your body into a lush ecosystem, growing a whole new person. You're the world's most exclusive club, and not every ingredient makes it onto the guest list.

So, does azelaic acid get the bouncer's nod?

Short version: Yes, it usually does.

Azelaic acid is a naturally occurring acid—found in grains like barley, wheat, and rye. It's got anti-inflammatory and antibacterial properties, which means it's not just randomly battling spots and redness; it's going about it like a skilled diplomat, soothing skirmishes on your skin's surface and keeping the peace in the deeper layers.

And here’s the kicker: Azelaic acid doesn't just do drive-by treatments; it's all about that sustainable, long-term relationship with your skin.

The reason it's got the pregnancy pass is its lack of systemic absorption—fancy talk for saying it doesn’t really get past your skin’s bouncers and into the bloodstream, where it could potentially rendezvous with your baby. This makes azelaic acid a rarity in the realm of effective skincare that's also pregnancy-friendly.

However, let's get real for a second.

The skin is your largest organ and it's on high alert while you're pregnant, protecting both you and your VIP (Very Important Pregnancy).

What you put on it should be given as much thought as what you put in it. That's why your OB-GYN should be your go-to, your skincare sommelier if you will. They know your body's unique tune and can recommend whether azelaic acid can harmonize with it during pregnancy.

The research on azelaic acid during pregnancy, while limited, is reassuring.

But let's break it down: Not all formulations are created equal. We're talking creams, gels, foams... the works. Your healthcare provider will likely steer you toward formulations with just the right rhythm and blues—effective enough to keep your skin in the groove, gentle enough not to cause a scene.

So, when it comes down to it, the answer is a cautiously optimistic 'yes'—azelaic acid can be the skin savior for your pregnancy journey, with your doctor's backstage pass.

It’s all about striking that perfect chord between efficacy and safety, keeping you and your little one grooving safely to the skin health beat.

What Percentage of Azelaic Acid Is Safe During Pregnancy?

So, we’ve established azelaic acid isn’t on the pregnancy blacklist, but how much can you actually use?

Dermatologists often light up the 'safe' sign for azelaic acid products that contain 15-20% of the active ingredient.

Why this specific range, you ask?

It’s not a number plucked from thin air, nor is it a one-size-fits-all. It's the sweet spot backed by research and experience, the concentration that's been shown to be effective without causing undue irritation or absorption concerns.

Here's the science bit. Azelaic acid works its wonders topically, meaning it gets down to business on the surface of your skin, acting locally rather than systemically.

This is a fancy way of saying that, unlike some ingredients that are absorbed into the bloodstream, azelaic acid prefers to hang out where it's applied.

In layperson’s terms, it doesn’t crash the party; it’s the responsible guest that knows its limits.

When you're not expecting, you might play fast and loose with concentrations, layering products like a skincare mixologist. But with a baby on board, you're aiming to nail that Goldilocks ratio—just right.

And "just right" when it comes to azelaic acid means high enough to effectively discourage uninvited acne and pigmentation from lingering, yet low enough not to overwhelm your increasingly sensitive pregnancy skin or potentially affect your little one.

That said, the skin can be a bit of a drama queen during pregnancy, more reactive than a YouTube influencer reading mean comments.

This is why sticking to the 15-20% bracket makes sense—it’s strong enough to be effective but unlikely to cause irritation or other issues. Think of it like your favorite reality TV episode; it’s got just enough drama to be compelling without making you switch the channel.

Remember, azelaic acid is not going rogue; it's not absorbing deeply into the skin and gate-crashing your bloodstream to reach your growing baby. But you still need to apply the principle of 'less is more'. This is where the advice of a trusted dermatologist becomes invaluable—they're the equivalent of a top-notch talent scout, able to spot what will work for you in a sea of options.

What Skincare Products to Avoid When Pregnant?

Now, not all skincare ingredients are as baby-friendly as azelaic acid.

Some are like that one aunt who means well but ends up causing a ruckus. When you’re preggers, you need to RSVP ‘no’ to a few skincare shindigs.

First, let's talk about retinoids.

These vitamin A derivatives are like the high-flying, jet-setting types in the skincare world. They’re known for turning back the clock on wrinkles and keeping your skin in its prime.

But when you’re pregnant, retinoids are persona non grata.


They’ve been linked to birth defects and, as such, they're seated firmly on the bench during pregnancy. There are no "if's," "and's," or "but's" about it—retinoids are out.

Next, salicylic acid.

At low over-the-counter concentrations for occasional use, salicylic acid can sometimes still get the OB's okay.

But the high-dose stuff, like peels and intense treatments? Give them the red card.

High doses of salicylic acid can be absorbed into the bloodstream, and that’s not a ride we want for the little nugget in the womb.

Now, let’s chat about hydroquinone.

This ingredient is like that charming friend who always tells captivating stories but has a reputation for stirring up trouble.

Hydroquinone is a skin-lightening agent, and while it can be a beacon of hope for dark spots, it's a no-fly zone in Pregnancyville.

The reason? Because a significant amount can get absorbed systemically. And with not enough research to green-light its safety during pregnancy, it's better to leave it off your guest list.

You might be thinking, “But my skin needs help during pregnancy!”

And you’re right; your skin does need TLC during this time, but with safe, gentle products.

Think of this as an opportunity to embrace the natural glow of pregnancy and focus on ingredients that are more like the reliable bestie who brings you chicken soup when you’re sick—think hyaluronic acid for hydration, vitamin C for brightening, and zinc oxide for sun protection.

These ingredients are like the pals who hold your hair back without judging and stay put through every tearjerker chick flick—they're good for your skin and won't rattle your little one.

Let's put it this way: your pregnancy skincare routine should be as straightforward and nurturing as a lullaby. This isn't the time for complex remixes or experimental beats.

Keep it simple, keep it safe, and when in doubt, keep it off your skin until your bundle of joy arrives.

And, of course, your OB-GYN should always have the final say—consider them your personal skincare bouncer, deciding who gets behind the velvet rope.

Why Is Salicylic Acid Bad for Pregnancy?

Cue the dramatic music—let's talk about salicylic acid and pregnancy.

It's the skincare equivalent of a bouncer, showing pimples and blackheads the door with a firm but gentle hand. But when you're toting a tiny human inside of you, the rules change, and our bouncer buddy gets a little less friendly.

Here’s the deep dive: salicylic acid is part of the aspirin family, known scientifically as salicylates. These bad boys can work wonders on your skin, penetrating oil-laden pores and exfoliating dead cells like a pro.

But during pregnancy, the plot thickens. High doses of salicylic acid have the potential to cross the placenta, and that’s where we hit the pause button.

Why hit pause, you ask?

Well, because in larger doses or through more absorbent methods (like oral intake or professional peels), salicylic acid can enter your bloodstream and, by extension, your baby's tiny, developing body. And while your grown-up body can handle it like a champ, your baby’s body is more like an open mic night—new, untested, and vulnerable.

You see, high levels of salicylic acid can lead to complications—think of it as crashing the baby’s serene nursery with a heavy metal concert.

In animal studies, high doses have been associated with birth defects and complications. And while we’re not furry critters, these findings make doctors err on the side of caution.

For your little bun in the oven, it's better to avoid any potential risks, however small they might be.

Let's bring this home: If salicylic acid is a potent cocktail, pregnancy is the time you’re volunteering as the designated driver.

A light, topical application, such as a cleanser or spot treatment with a low dose, could be in the clear—but this isn’t a decision to make solo.

Always, and I mean always, bring your dermatologist or OB-GYN into the loop. They're the mixologists who know what's safe for your unique pregnancy cocktail.

They might tell you a swipe here and there is fine—akin to sniffing the cork of a fine wine rather than taking a gulp. But they might also direct you to other ingredients that can gently care for your skin without the risk, like azelaic acid, which we've crowned the pregnancy-safe hero earlier on.

Wrapping Up with a Bow

Alright, time to tie this all together with a pretty bow.

Whether you’re dealing with pregnancy glow or pregnancy ‘oh no,’ azelaic acid can be your skin savior - if you use it right.

Stick to safe percentages, consult your doc, and remember, less is more.

Keep your skincare routine as clean as your newborn’s nursery, and you’ll not only keep your baby safe but also rock that mom-to-be radiance.

And when in doubt, remember: your body is doing the incredible job of growing a tiny human. That, my friend, is the most beautiful glow of all.

Now, go on and shine bright, you gorgeous mama, with your baby-safe, azelaic acid-infused glow!

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