Magic (?) Retinoids and pregnancy

Kate Somerville RetinolREN RetinolDermologica RetinolDifferin

We’ll start with the basics and work our way to the skin guru fave, retinoids.

Retinoids are a form of Vitamin A.
Vitamin A is necessary for baby development. It is essential for vision, skin integrity, and bone development. Although most women in the US get adequate amounts from their diet, it is also usually found in prenatal vitamins.

Expert recommended supplementation dose is less than (or equal to) 5000 IUs daily.

But … vitamin A can cause harm to a developing fetus when exposed to high levels. Defects from the brain to face to heart to kidneys can be severe. If a little bit of something is good, it does NOT mean that a lot of it is better.

Vitamin A has significant antioxidant properties and is important for wound healing. This is where the beauty industry enters.  The form of vitamin A called retinoids has been touted as having magical skin care and anti-aging benefits. Women use it for prevention and treatment of wrinkles, blemishes, acne, discolorations … basically any skin care complaint one might have.

Retinoids can be divided into a few sub-groups. The most common are isotretinoin, tretinoin, acitretin, and adapalene.

Still with me?
Good. Let’s continue.

What about retinoids and pregnancy?

Isotretinoin is BAD for pregnancy. Accutane is isotretinoin in pill form. It is absorbed and gets into your blood stream and crosses the placenta. If you are using Accutane you need to use birth control! Taking it in early pregnancy can cause miscarriage or any of the birth defects I listed above (in up to half of all exposed pregnancies / babies).

Tretinoin, acitretin, and adapalene are all applied to the skin and are THEORETICALLY BAD for pregnancy. Because they are applied topically, only small amounts pass into the blood stream, and then even smaller amounts cross the placenta to reach the developing baby. Unfortunately there are some reports that using these medications have caused birth defects – the same birth defects that are attributed to Accutane. That’s enough to convince me to avoid retinoids in any shape, form, or function during pregnancy.

What to do?
Sorry, but stop using your Kate Somerville retinoid mask (or any other retinoid, for that matter) about 1 month before you try to get pregnant. If you accidentally get pregnant, stop as soon as you find out. Let your doctor know your exposure.

Treat your skin complaints with something that is safe for pregnancy. Your OB or dermatologist should be able to steer you in the right direction.

As far as postpartum / breastfeeding: although data is limited, it is probably safe to resume your topical retinoids after you have the baby. Or just let that new mommy glow brighten your skin for a while, then resume when you’re done breastfeeding.

Source: Duerbeck et al. Vitamin A: Too Much of a Good Thing? Obstetrical and Gynecological Survey. Vol 67, Number 2. 2012

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