Acne is a common symptom of pregnancy, affecting roughly half of all pregnant women. In one epidemiological study, the overall prevalence was 48.53%, and more than half of those women already had a history of acne before becoming pregnant. Hormonal shifts during pregnancy increase oil production in the skin, which can trigger new breakouts or make existing acne worse.
Why Pregnancy Causes Acne
During pregnancy, your body produces significantly higher levels of hormones that stimulate the oil glands in your skin. These glands, called sebaceous glands, ramp up oil (sebum) production, which can clog pores and lead to breakouts. If you were acne-prone before pregnancy, you’re more likely to experience flare-ups, but even women who’ve never had significant acne can develop it for the first time.
Increased blood volume, stress, and changes in immune function during pregnancy can also contribute. Your skin is responding to a completely different hormonal environment than it’s used to, and acne is one of the most visible results.
When Breakouts Typically Start and Peak
Breakouts can begin as early as the first trimester, sometimes even before you realize you’re pregnant. However, pregnancy acne is often most pronounced during the third trimester, when sebaceous gland activity reaches its highest level. Some women notice a steady worsening as pregnancy progresses, while others experience intermittent flare-ups that come and go throughout all three trimesters.
There’s no single pattern. The timing depends on your individual hormonal response, your skin type, and whether you had acne before conceiving.
Where Pregnancy Acne Appears
Pregnancy acne shows up in the same places as regular acne: the face (especially the jawline, chin, and forehead), chest, and back. Jawline and chin breakouts are particularly common because these areas are more sensitive to hormonal fluctuations. The breakouts can range from small whiteheads and blackheads to deeper, more painful cystic spots.
Safe Ways to Manage It
The simplest starting point is washing your face twice a day with a mild cleanser and lukewarm water. Avoid scrubbing aggressively, which can irritate skin and worsen breakouts. Oil-free moisturizers and non-comedogenic makeup (products that won’t clog pores) help keep your routine from adding to the problem.
For active treatment, benzoyl peroxide and salicylic acid are both considered safe to use during pregnancy. These are found in many over-the-counter acne washes, spot treatments, and creams. Glycolic acid, a gentle exfoliant, is also generally considered safe. Keep in mind that salicylic acid shows up in some pain-relief creams and wart treatments too, and absorption can be higher from those products, so stick to face-specific formulations at standard concentrations.
Acne Treatments to Avoid During Pregnancy
Several acne medications carry serious risks during pregnancy and should be stopped immediately if you become pregnant:
- Isotretinoin (sold as Absorica, Claravis, and other brands) can cause severe birth defects, including intellectual disabilities, life-threatening heart and brain defects, and physical deformities. This is the most dangerous acne medication to take while pregnant.
- Tazarotene (sold as Tazorac and other brands) is a topical retinoid that can also cause serious birth defects.
- Spironolactone (Aldactone), a hormonal medication sometimes prescribed for adult acne, is unsafe during pregnancy.
- Topical retinoids like tretinoin (Retin-A) and adapalene (Differin) are in the same drug family as isotretinoin. Although they’re applied to the skin and less is absorbed, most experts recommend stopping them during pregnancy.
- Oral tetracyclines, a class of antibiotics sometimes used for acne, can discolor the developing baby’s teeth if taken after the fourth month and may affect bone growth.
Other Skin Changes That Look Like Acne
Not every bump or rash during pregnancy is acne. Pregnancy triggers a range of skin changes, and it’s worth knowing what else could be happening. Melasma causes dark patches on the face, particularly the cheeks and forehead, and worsens with sun exposure. Stretch marks, though obviously different in appearance, can sometimes be accompanied by itchy, raised skin that gets mistaken for a breakout.
More rarely, conditions like PUPPP (a very itchy rash that starts in stretch marks, usually in the third trimester) or prurigo of pregnancy (small, itchy bumps on the arms, legs, or torso) can appear. These are distinct from acne because they’re intensely itchy, while acne typically isn’t. If your breakouts are unusually itchy, widespread beyond typical acne zones, or don’t look like typical pimples, it’s worth having them evaluated.
Does It Go Away After Delivery?
For most women, pregnancy-related acne is temporary. It usually improves as hormone levels stabilize after delivery, though this process takes several weeks. Your skin won’t clear up overnight once the baby arrives.
Some women find that acne actually develops or worsens after giving birth, particularly when they stop breastfeeding or when their menstrual cycle returns. Both of these events trigger another hormonal shift that can kick off a new round of breakouts. If you’re breastfeeding, benzoyl peroxide and salicylic acid remain safe options, but retinoids are still off-limits. Be careful applying any acne-fighting creams or gels to your chest area, since your baby could come into contact with them during nursing.