Acne and Pregnancy: A Clinical Review and Practice Pearls

Acne vulgaris is a common condition that routinely affects females of childbearing age.Taking into consideration the reproductive journey of women when treating acne is of paramount importance given the safety concerns to both the mother and the fetus associated with certain medications.Therefore, careful consideration of therapeutic choices during pregnancy is crucial.Herein, we summarize the safety of acne treatments during pregnancy and offer practical clinical pearls for routine dermatology practice.Cutis.2024;113:E26-E32.A cne vulgaris, or acne, is a highly common inflammatory skin disorder affecting up to 85% of the population, and it constitutes the most commonly presenting chief concern in routine dermatology practice. 1Older teenagers and young adults are most often affected by acne. 2 Although acne generally is more common in males, adult-onset acne occurs more frequently in women. 2,3Black and Hispanic women are at higher risk for acne compared to those of Asian, White, or Continental Indian descent. 4As such, acne is a common concern in all women of childbearing age.Concerns for maternal and fetal safety are important therapeutic considerations, especially because hormonal and physiologic changes in pregnancy can lead to onset of inflammatory acne lesions, particularly during the second and third trimesters. 56][7] In fact, acne affects up to 43% of pregnant women, and lesions typically extend beyond the face to involve the trunk. 6,8-10Importantly, one-third of women with a history of acne experience symptom relapse after disease-free periods, while twothirds of those with ongoing disease experience symptom deterioration during pregnancy. 10Although acne is not a life-threatening condition, it has a well-documented, detrimental impact on social, emotional, and psychological well-being, namely self-perception, social interactions, quality-of-life scores, depression, and anxiety. 11herefore, safe and effective treatment of pregnant women is of paramount importance.Because pregnant women are not included in clinical trials, there is a paucity