Glow Baby Glow: Safe Skincare in Pregnancy

Pregnancy is a time when many parents-to-be become more conscious of what they put into and on their bodies. As an OB nurse, I frequently get questions about how to choose clean personal care products and if common treatments, like botox and retinol, are safe in pregnancy. So, should you make some changes to your normal skin and body care routine in pregnancy? Likely- Yes! Pregnancy is a perfect time to make the switch to cleaner skin and personal care products — and once you know why, you may never want to go back, even after baby arrives.

1. Is it safe to use Botox during pregnancy?

Let’s start with the big one- can I continue getting Botox in pregnancy? No, pregnancy is not the time to worry about those fine lines and wrinkles. Botox is classified by the FDA as a category C drug during pregnancy, meaning that while there is not conclusive evidence proving harm in pregnancy, there is also not enough research proving safety. Botox, in addition to other cosmetic treatments such as fillers, should be avoided in pregnancy. 

2. What about retinol? Is it safe to use during pregnancy?

Retinol and other retinoids (like tretinoin) are a form of vitamin A widely used in skincare for their anti-aging and acne-fighting properties. These medications are in the same drug family as isotretinoin, an oral drug that has been shown to cause severe birth defects. Unlike isotretinoin, topical retinoids are applied to the skin so the amount of medication absorbed by the body is low. But out of caution, is it best to avoid these products (both over-the-counter and prescription) while pregnant. 

3. I’ve heard a lot about endocrine-disrupting chemicals (EDCs). What are these and do I have to worry about them in pregnancy? 

Endocrine-disrupting chemicals (EDCs) are substances that interrupt your body’s normal hormonal activity by mimicking, blocking, or altering hormones- changing the way they function in the body and interfering with your endocrine system.  Since the endocrine system plays a crucial role in reproduction, these chemicals can negatively impact both male and female reproductive health. While more research is needed, EDCs have been linked to adverse reproductive outcomes such as infertility, low sperm and egg quality, miscarriage, low birth weight, and disruptions in fetal development. 

So, yes! Pregnancy is the perfect time to learn more about EDCs and begin minimizing your exposure to them. Unfortunately, EDCs are hiding throughout our environment. They are commonly found in food and beverage packages, household products such as detergents, pesticides, and plastics. But a huge source of exposure that is easier to address is personal care products. EDCs are commonly used in makeup, lotion, soap, shampoo, hair products, nail polish, and perfume because they enhance the texture, fragrance, and stability of these products. Unfortunately, EDCs are not always required to be listed on ingredient lists, but learning what to look for on personal care product packages can greatly enhance your ability to choose cleaner products.  

Phthalates are a group of chemicals used to make plastics more flexible and durable. They are commonly added to fragrances, nail polish, hair products, and moisturizers to help products retain their scent and increase the spreadability of lotions and creams. To avoid phthalates, opt for products that are labeled as phthalate-free or fragrance-free. Never use skin lightening or hair straightening products. Products labeled as fragrance-free are a better choice than those labeled unscented, as unscented products may still contain phthalates to mask smell.

Phenols, including Bisphenol A (BPA), are chemicals used in the production of plastics, resins, and other materials. BPA is often found in nail polish, shampoo, and lotion. Bisphenol S (BPS) and Bisphenol F (BPF) are often used as substitutes for BPA in products marketed as BPA-free, however, these compounds can still cause similar hormone disruptions. To reduce your exposure to phenols, avoid products that contain BPA, BPS, or BPF, and choose those labeled as BPA-free or phenol-free. Choosing alternatives to plastic such as glass or stainless steel can also reduce your exposure to phenols. 

Per- and polyfluoroalkyl substances (PFAS), often referred to as “forever chemicals,” are a large group of chemicals resistant to water, grease, and stains. PFAS are commonly found in cosmetics marketed for their water and oil resistant properties. Be mindful of products like waterproof mascaras, eyeliners, and other long-lasting cosmetics. Avoid products that list fluoro or perfluoro in their ingredients.

Triclosan is an antimicrobial chemical that was once widely used in antibacterial soaps and personal care products. Although banned from over-the-counter hand soaps by the FDA in 2016 due to safety concerns, it can still be found in products like toothpastes, deodorants and some cosmetics. To avoid triclosan, choose products labeled triclosan-free and check ingredient lists carefully. 

Choose mineral-based sunscreens. Many sunscreens contain oxybenzone, a known hormone disruptor. Choose a mineral-based sunscreen that contains zinc oxide or titanium dioxide.

4.That’s a lot to take in, where do I start? 

Avoiding EDCs can feel overwhelming, but choosing clean products does not mean you have to stop your skin care routine or have frizzy hair! Clean beauty is trending, and as consumers become more conscious about the ingredients they are putting on their bodies, many more brands are focusing on clean beauty and offering safe ingredient alternatives. 

Read the Label. Learning to read labels carefully will empower you to make informed choices. Choose products with less ingredients (even single ingredient!) and look for products with the following logos to help guide your choices.

There’s an app for that! You don’t have to memorize an endless list of clean products. The Environmental Working Group’s Skin Deep database is an amazing, free tool where you can search an extensive list of personal care products and learn of any hidden ingredients.

Educate yourself. There are many great resources available if you are interested in learning more about reducing your exposure to EDCs. We really enjoy the work of The Seed Program and The Silent Spring Institute including their Detox Me app. Also check out the super informative podcast: The Fertility Sisterhood: Cleaning Up Your Lifestyle For Future Generations

Take Away:

Your skin is your body’s largest organ, and pregnancy is the perfect time to become more mindful of the products you apply. Botox and retinol are out (temporarily!) but in addition, learning more about EDCs and choosing clean personal care products can support optimal health outcomes for you and your baby.