I am often asked about safe skincare in pregnancy, as well as a variety of beauty treatments. Most women have an established skincare routine they’d like to continue. Other women are experiencing some of the less joyful side effects of pregnancy. Adult acne outbreaks are a particularly common problem!
You’ll be happy to know that there are plenty of options for safe skincare in pregnancy. Many common hair and beauty treatments can also be continued. However, some treatments are harmful so always double-check your own regime.
Unfortunately, good scientific studies of beauty products are often lacking. Instead, we rely on information from pregnant women who have used the treatment in the past. If lots of pregnant women have used a treatment and no apparent harm has been done, we can be reasonably confident the treatment is safe. If very few pregnant women have used a treatment, then we don’t know if it is safe.
At the end of the day, beauty treatments are nice but usually not medically necessary. If the safety of a treatment is unknown, err on the side of caution and avoid it during pregnancy. The following advice is also general and does not replace advice from your own doctor. Always discuss your own circumstances with your obstetrician or GP, especially if you have a high-risk pregnancy.
Massage is generally considered safe in pregnancy. You will need to adjust your position on the massage table. As your belly grows, it’s important not to lie flat on your back for long periods. Lying flat causes the pregnant uterus to compress the large vein in the abdomen. This can make you feel sick or pass out. A professional massage therapist with pregnancy experience will be aware of this and use alternative positions.
Hot tubs & saunas
Traditionally we have advised pregnant women to avoid hot tubs, spa baths and saunas. We were concerned that these treatments could significantly raise the core temperature of the body. A few small studies suggested that high body temperatures might be associated with miscarriage or certain congenital abnormalities.
A more recent study suggested that core temperature remained reasonable if hot tub use was limited to 20 minutes at a water temperature of 40 degrees Celsius. However, this study was small and looked at body temperature, not pregnancy outcomes. So it doesn’t prove that hot tubs and saunas are safe for the baby.
Finally, overheating can lead to dehydration and fainting. This is more likely when you are pregnant. Overall, it’s probably best to avoid hot tubs and saunas during pregnancy.
Good news – you can continue to colour your hair throughout pregnancy. The dye is mostly applied to the lengths of your hair, which are made up of dead cells. A small amount of colour will be applied to your scalp; however, very little is absorbed this way when compared to treatments you swallow.
There’s also safety in numbers! Thousands of women have coloured their hair during pregnancy. We have never noted any harmful effect on their babies.
Skincare and Makeup
It’s not hard to find safe skincare in pregnancy. Most over-the-counter products are ok to use provided you check the ingredient list. It is important to use products from reputable brands – this applies especially to products ordered online. Less reputable companies may substitute ingredients or not list them at all.
There are a few key ingredients you should avoid:
- Minoxidil is widely available to promote hair growth. Women have used it to grow their eyebrows and eyelashes. There is very little information about using it in pregnancy. There is at least one report of a baby born with serious abnormalities after the mother used minoxidil. Do not use it in pregnancy.
- Hydroquinone fades dark spots and is used in skin-lightening creams. There is very little scientific information about its use in pregnancy. Large amounts get absorbed through the skin. This means the risk of baby being exposed is high. Do not use hydroquinone in pregnancy.
- Retinoids are derivatives of Vitamin A. Retinoids are taken orally (as a tablet you swallow) or applied topically (rubbed into the skin).
- Oral retinoids are used to treat severe acne. Common brand names include Roaccutane or Oratane. Pregnant women must never use oral retinoids. They cause severe birth defects affecting the face, skull, heart and nervous system. Women taking oral retinoids outside of pregnancy must use effective contraception at all times.
- Topical retinoids are often found in anti-acne and anti-ageing skin creams. The amount of retinoid absorbed through the skin is very low. There is conflicting evidence about the risk of birth defects from topical use. Birth defects were described in a handful of cases after patients used a topical retinoid called tretinoin. However, other studies did not show an increased risk to the baby after using retinoid creams. Although there is uncertainty, the potential for serious harm means patients should avoid topical retinoids in pregnancy.
In the words of the song, wear sunscreen! It’s an essential part of safe skincare in pregnancy. Sunscreens have been widely used in pregnancy with no evidence of harm to the baby. The benefits – preventing skin cancer – are clear. Buy a good quality SPF50+ tested for the Australian sunshine. We usually recommend the Australian Cancer Council brand.
Botox is actually a toxin that causes paralysis when it’s injected into muscles. It has only been in widespread use for a relatively short time. Botox has been used during pregnancy in a handful of cases, mostly before women realized they were pregnant. In two of these cases the woman had a miscarriage. However, miscarriage is very common so it is impossible to say if Botox was the cause. There is simply not enough information available to justify using Botox for cosmetic reasons during pregnancy.
Laser hair removal
The respected Australian pregnancy organization Mothersafe concluded that laser hair removal is probably safe in pregnancy. They reached this conclusion because the laser heats the outer skin but does not penetrate further than the skin. Therefore it’s unlikely to cause problems for the unborn baby. We can’t say it has been proven to be safe though, because no clinical trials have been performed. A common sense approach is to avoid the abdomen/bikini area just in case. Or use an alternative we know is safe, like shaving!
Another point to consider is that laser hair removal is often less effective during pregnancy. Pregnancy hormones affect the pigmentation in your skin as well as the growth of hair follicles. Both of these factors can reduce the effectiveness of laser treatment. Your skin may also be more sensitive, making treatments more painful and more likely to result in unwanted reactions.
You’ll find that many laser providers refuse to treat pregnant women because of the lack of clinical trials and because of the reduced effectiveness.
You can safely use tanning creams but you should probably avoid spray tans. Fake tans use an ingredient called DHA to darken the outermost layer of skin cells. Very little DHA is absorbed into your system from tanning creams. In contrast, spray tans are applied as a fine mist that can be breathed in. We don’t know the effects of inhaling DHA during pregnancy, so we can’t say that it is safe. At minimum, you should use a mask or nose plugs to prevent inhaling the spray. Even better, switch to a tanning cream.
Most countries have banned tanning tablets. Tanning tablets often use high doses of potentially toxic substances and should never be taken, whether you are pregnant or not!
As always, this information is intended for general educational purposes only. It is not medical advice. Please discuss any medical issues with your own doctor. Read our full medical disclaimer here.