Yes, breakouts during pregnancy are common. Acne affects up to 43% of pregnant women, and it can show up even if you’ve never had problem skin before. The cause is straightforward: your body ramps up production of certain hormones that trigger excess oil in your skin, and that extra oil clogs pores.
Why Pregnancy Causes Breakouts
During pregnancy, your body produces higher levels of hormones called androgens. These hormones signal your skin’s oil glands to produce more sebum, the waxy substance that normally keeps skin moisturized. When there’s too much of it, sebum mixes with dead skin cells and plugs your pores, creating the perfect setup for whiteheads, blackheads, and inflamed pimples.
This isn’t something you’re doing wrong with your skincare routine. It’s a direct result of the hormonal shifts your body needs to sustain a pregnancy. Some women notice only a few extra pimples on their chin or jawline, while others develop deeper, more painful breakouts that spread across the face, chest, and back.
When Breakouts Typically Start and Peak
Pregnancy acne can show up at any point, including the very first weeks. Some women notice it as one of their earliest pregnancy signs. But breakouts are most pronounced during the third trimester, when hormone levels are at their highest. So if your skin has been clear through the first and second trimesters, that doesn’t mean you’re in the clear.
The good news is that pregnancy acne typically resolves within a few weeks after delivery, once hormone levels begin to settle. That said, some women experience a second wave of breakouts postpartum. Pimples can appear right after giving birth or develop weeks to months later, especially around the time you stop breastfeeding or your period returns. These postpartum flare-ups are driven by the same thing: hormones shifting again.
What’s Safe to Use on Your Skin
This is where pregnancy acne gets tricky. Many of the most effective acne treatments are off-limits because they can be absorbed into your bloodstream and potentially affect the baby. The American College of Obstetricians and Gynecologists (ACOG) has identified four over-the-counter topical ingredients generally considered safe during pregnancy:
- Benzoyl peroxide: kills acne-causing bacteria on the skin’s surface
- Azelaic acid: reduces inflammation and helps unclog pores
- Salicylic acid: dissolves the buildup inside pores
- Glycolic acid: gently exfoliates dead skin cells
These products work locally on the skin and produce minimal levels in the bloodstream, which is why they’re considered low-risk. Stick to standard over-the-counter concentrations and use them as spot treatments or in a gentle daily wash rather than layering multiple products at once.
Ingredients to Avoid
Topical retinoids (often sold as tretinoin, adapalene, or under brand names like Retin-A) should not be used during pregnancy. While the amount absorbed through the skin is very low, there are published case reports of birth defects consistent with retinoid exposure. The evidence is debated, with two small studies finding no increased risk, but experts agree the safer move is to stop using these products entirely until after pregnancy and breastfeeding.
Hydroquinone, a skin-lightening ingredient sometimes used for dark spots, is another one to set aside. Roughly 35% to 45% of it gets absorbed into the body after topical application, which is substantially more than other skincare ingredients. Limited data hasn’t shown clear harm, but the high absorption rate makes it worth avoiding.
Oral acne medications like isotretinoin (Accutane) are absolutely contraindicated during pregnancy due to a well-established risk of severe birth defects. If you were taking it before becoming pregnant, it should have been discontinued before conception.
Daily Habits That Help
You can’t fully prevent hormonally driven breakouts with skincare alone, but a few habits can keep them from getting worse. Wash your face twice a day with a gentle, fragrance-free cleanser. Avoid scrubbing or using rough exfoliants, which irritate already-inflamed skin and can make breakouts spread. Use an oil-free moisturizer, since skipping moisture entirely causes your skin to compensate by producing even more oil.
Try not to pick at or squeeze pimples. Pregnancy increases blood flow to your skin, which makes inflammation more intense and scarring more likely. Change your pillowcase frequently, and if you’re breaking out along your jawline or hairline, check whether hair products or phone contact could be contributing. These small adjustments won’t eliminate pregnancy acne, but they can reduce the number and severity of flare-ups while you wait for your hormones to level out.
Severe Breakouts During Pregnancy
Most pregnancy acne is mild to moderate and manageable with the topical options listed above. But some women develop deep, painful nodular or cystic acne that doesn’t respond to over-the-counter products. If your breakouts are leaving dark marks, feel hard or lumpy under the skin, or are spreading across your chest and back, it’s worth bringing it up with your OB or a dermatologist. There are prescription-level options that can be used safely during pregnancy for more severe cases, and a provider can help you weigh the benefits against the risks based on your specific situation and trimester.