Salicylic acid is a common skincare ingredient, often used for acne. It functions as a beta hydroxy acid (BHA), helping to exfoliate the skin and clear pores. For breastfeeding parents, a common question arises regarding the safety of continuing such skincare routines.
How Salicylic Acid Enters the Body
When salicylic acid is applied to the skin, it can be absorbed into the bloodstream. The extent of this absorption depends on factors such as the concentration of the product, the area of skin covered, and the duration of contact. Once in the bloodstream, any absorbed compound can potentially transfer into breast milk. Although topical application generally results in lower systemic levels compared to oral ingestion, the possibility of some transfer exists.
Possible Effects on the Breastfed Infant
Topical salicylic acid is minimally absorbed into the bloodstream, making it unlikely to affect a breastfed infant. However, the infant’s developing liver has a reduced capacity to metabolize certain compounds compared to adults. High doses of oral salicylic acid, such as aspirin, have been linked to metabolic acidosis in breastfed infants. Reye’s syndrome, a serious condition affecting the brain and liver, is associated with aspirin administration to infants with viral infections. While the risk of Reye’s syndrome from salicylate in breast milk is unknown, it is considered very unlikely with isolated or small doses used topically. Infants, especially newborns and preterm babies, are more susceptible to the effects of salicylates because their organs are still developing.
Expert Guidelines for Use
Topical salicylic acid is generally considered safe for use during breastfeeding when applied in small amounts. Low concentrations, typically 2% or less, pose minimal risk. It is important to avoid applying salicylic acid to large areas of skin, broken skin, or areas with a rash to minimize systemic absorption.
Avoid applying salicylic acid to areas where the infant might come into direct contact or ingest it, particularly around the nipples or chest. If application to the chest is necessary, it should be thoroughly washed off before feeding. Consider starting with a limited frequency, such as once or twice a week, and gradually increasing if needed, while monitoring skin response. Always consult a healthcare provider for personalized advice before starting any new skincare products while breastfeeding.
Alternative Skincare Options
Several other skincare ingredients are generally considered safe alternatives for managing skin concerns during breastfeeding. Benzoyl peroxide, a common acne treatment, is typically safe for topical use, with only about 5% absorbed systemically. Azelaic acid is another widely recommended option, with minimal absorption (around 4%) after topical application, and it is naturally present in human milk.
Glycolic acid, an alpha hydroxy acid, is also generally safe in the small amounts. Beyond specific ingredients, maintaining a consistent skincare routine with gentle, non-comedogenic products and focusing on lifestyle adjustments like stress management and hydration can also support skin health. Retinoids, both topical and oral, are generally not recommended during breastfeeding due to potential risks.