Dr. Sparrow is a GMC-registered doctor qualified in medical aesthetic treatments, including medical-grade skincare, anti-wrinkle injections and soft tissue fillers. Her clinic runs from Bubba & Me, Tunbridge Wells, every Thursday.
To celebrate the recent partnership between Bubba & Me and Dr. Sparrow Aesthetics, we sat down with Dr. Sparrow for an enlightening Q&A session discussing skincare during pregnancy and the postpartum period.
1. Are there any specific skincare ingredients that pregnant women should avoid?
When determining if skincare ingredients are safe in pregnancy, three elements should be considered:
- Firstly, how much of the ingredient is absorbed through the skin into the bloodstream, and how likely is it that it will then cross the placenta to impact the fetus?
- If they are absorbed significantly, are there any known hazardous effects of the ingredient on a developing fetus?
- If there are no known hazardous effects, is there enough evidence to conclude that a product is safe?
A 2011 study which looked into absorption rates of common skincare ingredients concluded that retinoids, which are highly teratogenic when used orally, and hydroquinone, which is absorbed at a significant rate, are likely to be harmful in pregnancy (1).
Retinoids are used both orally and topically to combat signs of ageing, acne and skin brightness. Their rate of absorption through the skin is not well understood, but systemic retinoids have known hazardous effects in pregnancy and so therefore should be avoided (2). Retinoids are also commonly listed as vitamin A, retinol, retinoic acid, tretinoin, isotretinoin, retinaldehyde, adapalene, tazarotene or bexarotene, so you should check your skincare products for any of these ingredients.
(1) Bozzo P, Chua-Gocheco A, Einarson A. Safety of skin care products during pregnancy. Can Fam Physician. 2011 Jun;57(6):665-7. PMID: 21673209; PMCID: PMC3114665.
(2)Williams AL, Pace ND, DeSesso JM. Teratogen update: Topical use and third-generation retinoids. Birth Defects Res. 2020 Sep;112(15):1105-1114. doi: 10.1002/bdr2.1745. Epub 2020 Jul 9. PMID: 32643315.
Hydroquinone is absorbed rapidly and in high quantities through the skin, and its impacts on a developing fetus are unknown. Hydroquinone products should therefore be avoided in pregnancy (3). These are commonly found in treatments for hyperpigmentation, including melasma.
However, absorption of other ingredients varies significantly depending on where, why and for how long they are used. For this reason, there are several ingredients where caution is advised in pregnancy, such as salicylic acid and oxybenzone among others. Therefore, it is important to stick to products that are established as pregnancy-safe. I am bringing a range of skincare products to the clinic in mid-November which can be used safely in pregnancy and breastfeeding. If you are looking for a pregnancy-safe, high-quality skincare routine, please book an appointment and I would be happy to discuss this with you!
If you are uncertain about whether it is safe to continue using a skincare product during pregnancy, you should consult a healthcare professional.
(3)UK Teratology Information Service (2020), Exposure to Hydroquinone in Pregnancy, UK Health Security Agency, [accessed 11 Oct 2023], available at: https://uktis.org/monographs/exposure-to-hydroquinone-in-pregnancy/
2. What are some safe and effective skincare products for pregnant women?
There are many ways to treat common skincare problems in pregnancy, without the use of potentially harmful products. I recommend using products that are well-established as pregnancy safe, and you can look out for the ingredients below to help with specific skincare concerns -
Anti-ageing & fine lines: ascorbic acid (vitamin C), niacinamide (vitamin B3), hyaluronic acid, peptides and jojoba oil
Hyperpigmentation (melasma): daily sun protection (mineral sunscreen), niacinamide and vitamin C
Acne: low dose lactic or glycolic acid, or azelaic acid
Dry skin: hyaluronic acid, peptides
3. Can I continue using my current skincare routine during pregnancy, or should I make any changes?
Maintaining a good skincare routine in pregnancy is beneficial not just for the health of your skin, but for your mental health and general wellbeing too. It is a little bit of time at the start and end of every day that is just for you, to help you feel relaxed and refreshed. Pregnancy can be all-consuming at times, and having a routine to begin and end your day with can help you to check in with yourself and your state of mind. It can also help prevent common pregnancy skin concerns, particularly dryness and hyperpigmentation.
There are a few things to consider. Firstly, you should check that any products you wish to continue to use are pregnancy-safe. Take particular care to remove any products that contain retinoids or hydroquinone from your skin care routine.
Secondly, bear in mind that pregnancy is a time of significant physiological and hormonal change. Skin changes go hand in hand with that and your skin is likely to experience changes throughout your pregnancy, no matter what you do.
Good skin is all about maintaining a healthy skin cycle. Cell sloughing at the skin surface is an important part and helps regulate cell turnover in the deeper layers. Using a good cleanser and a gentle exfoliant helps with this. An appropriate toner for your skin type can help with oil regulation, to help minimise acne.
Lastly, sun protection is arguably the most important part of any skincare routine, for all people, in pregnancy and beyond. Adequate sun protection is essential to help prevent and treat one of the most common skin concerns in pregnancy - melasma (hyperpigmentation). You should use a broad-spectrum sunscreen that offers protection against UVA, UVB, Infrared-A (IR-A) and High Energy Visible Light (HEV). Your sunscreen should be SPF 30 or higher, and ideally be separate from cosmetic products. During pregnancy, you should avoid using chemical sunscreens that contain ingredients such as oxybenzone. Physical/mineral sunscreens that contain zinc oxide and titanium oxide are best.
4. Are there any treatments or procedures that are safe during pregnancy to address common skin issues?
Unfortunately, there is insufficient evidence to suggest that invasive aesthetic treatments, like botulinum toxin injections and soft tissue fillers, are safe. These are therefore contraindicated in pregnancy.
Many brands of medical-grade skincare, including ZO® Skin Health, are also not suitable during pregnancy and while breastfeeding.
I will be bringing in a range of high-quality skincare products in mid-November which are suitable for use during pregnancy and breastfeeding.
It may be worth considering a pregnancy-safe facial, although bear in mind that due to the hormonal changes you experience during pregnancy, your skin may not respond in the same way it has in the past.
6. What steps can I take to maintain healthy skin during pregnancy?
Hydration is key! Make sure you are drinking enough water during the day.
Good skin is about maintaining a healthy skin cycle. A good cleansing, exfoliating and toning regime is essential to keep the skin clean, manage excessive oil (which is to blame for lots of common skin concerns, such as acne) and allow adequate penetration of restorative ingredients, such as vitamin C, to the deeper layers of the skin.
Finally, sun protection is extremely important. Certain skin conditions are more common in pregnancy, such as melasma, which is contributed to by sun exposure. UV damage is the largest external factor that contributes to the ageing process, so even outside of pregnancy, it is important to use sun protection year round. UVA radiation can penetrate cloud, glass and clothing so a daily SPF is an essential year-round. Certain skin conditions which are more common in pregnancy, can be both prevented and treated by using adequate sun protection. Choose a broad-spectrum sunscreen which offers protection against UVA, UVB, infrared-A and high energy visible light. Your sun screen should be SPF 30 or higher, and ideally separate to any cosmetic product you’re using to ensure complete coverage. During pregnancy, it is important to use ‘physical’ sunscreens containing titanium oxide and zinc oxide and avoid ‘chemical’ sunscreens that may contain hazardous ingredients.
7. Are there any particular skincare products or ingredients that can help with postnatal recovery and skincare?
During the postpartum period, you may find your skin texture, type and complexion continues to change, particularly in the first six weeks after giving birth. I recommend not making any major changes to your skincare routine during this time, while your body is recovering and adjusting.
That being said, dryness and stretch marks are commonly experienced and can be helped by maintaining good hydration (also extremely important if you are breastfeeding!), use of gentle emollients and topical vitamin E to reduce transepidermal water loss (4).
(4) Putra IB, Jusuf NK, Dewi NK. Skin Changes and Safety Profile of Topical Products During Pregnancy. J Clin Aesthet Dermatol. 2022 Feb;15(2):49-57. PMID: 35309882; PMCID: PMC8884185.
8. How long should I wait after giving birth to start using certain skincare products or treatments?
If you choose to breastfeed (either directly or pumping), it is important to continue using products that are safe in pregnancy and breastfeeding.
If you choose not to breastfeed, you can resume use of products you excluded during pregnancy. However, your hormones and physiology will continue to change in the postpartum period, especially for the first six weeks but continuing for many months. I would recommend caution when introducing strong skincare ingredients during this time, as your skin is likely to remain sensitive and fluctuate.
9. Are there any skincare practices that can help prevent or minimize postpartum skin conditions?
We have already discussed many of the skincare practices that are helpful during pregnancy and postpartum, but the most important in my opinion is maintaining good hydration by drinking plenty of water, and using daily mineral sunscreen to protect your skin.
Gentle emollients can be used throughout pregnancy to help minimise stretch marks. Unfortunately, stretch marks are difficulty to prevent and treat, and there is a lack of robust evidence supporting any particular method of prevention(5),(6).
Topical tretinoin may be beneficial in treating new stretch marks during the postpartum period, although this is not a safe treatment during breastfeeding (6).
(5) Emily Forbat & Firas Al-Niaimi (2019) Treatment of striae distensae: An evidence-based approach, Journal of Cosmetic and Laser Therapy, 21:1, 49-57, DOI: 10.1080/14764172.2017.1418515
(6)K. Korgavkar, F. Wang, Stretch marks during pregnancy: a review of topical prevention, British Journal of Dermatology, Volume 172, Issue 3, 1 March 2015, Pages 606–615, https://doi.org/10.1111/bjd.13426
10.Can you recommend any specific postnatal skincare routines or tips for new mums?
It is very difficulty to fit in a thorough skincare routine around a newborn, and exponentially harder if you have older children too. Go easy on yourself and know that there will be time to re-establish a good skincare routine later. In the postpartum period, your skin is still subject to significant hormonal and physiological changes so expect ongoing fluctuation, particularly in texture and complexion.
Keep well hydrated, always apply your daily sunscreen and if you can manage to squeeze in using a good cleanser, exfoliant and toner then your skin will be better prepared to absorb restorative ingredients when you are ready to re-introduce them.
11. Is Melasma in pregnancy normal and will it disappear after birth?
Melasma, or patches of hyperpigmentation, is very common in pregnancy. 15 - 50% of pregnant people experience melasma (7). It is not fully understood what causes melasma - the rise in oestrogen, progesterone and melanocyte-stimulating hormone in pregnancy combined with UVA, UVB, IRA and HEV exposure are likely to contribute.
Melasma typically does improve in a few months after pregnancy, with avoidance of sun exposure (helped by use of broad-spectrum, high-SPF sunscreens)5. It can also be treated with topical agents - most effectively with hydroquinone (although please note, this is not suitable while breastfeeding).
(7)Basit H, Godse KV, Al Aboud AM. Melasma. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459271/