Acne products

Many women have breakouts in the first trimester because of changing estrogen levels, even if they've always had clear skin. If you'e dealing with pregnancy-induced acne, a dermatologist can likely give you a safe topical antibiotic. You can find a dermatologist in your area through your health insurance company or at the American Academy of Dermatology Web site.

But if you prefer to avoid yet another doctor appointment, using a facial wash that contains no more than 2 percent salicylic acid (look for the percentage on the product label). This small amount is considered safe.

If you want to be doubly sure, ask your obstetrician or midwife before use. As for what to avoid when it comes to treating acne, stay away from leave-on acne lotions, gels, and creams, as well as at-home peels, which can contain salicylic acid or retinoids. And, of course, steer clear of the oral form of the retinoid Accutane.

On the label:
Beta hydroxy acid
BHA
Differin (adapelene)
Retin-A, Renova (tretinoin)
Retinoic acid
Retinol
Retinyl linoleate
Retinyl palmitate
Salicylic acid
Tazorac and avage (Tazarotene)
Tretinoin

Note: Glycolic acid is an AHA, and safe to use.

Bottom line:
Consult your dermatologist, or use mild over-the-counter cleansers only.

Retinoids

These powerful substances, found in some antiaging moisturizers, are lauded for helping reduce wrinkles and improve skin tone. Retinoids are a type of vitamin A that speeds up cell division (quickening your skin's renewal) and prevent skin collagen from breaking down.

But retinoids are one of the skin-care ingredients that experts recomend that expectant moms stay away from. Some studies have shown that high doses of vitamin A during pregnancy can be harmful to an unborn child. And oral retinoids, such as isotretinoin (Accutane, an acne treatment), are known to cause birth defects.

If you've been using a skin cream that contains a retinoid, don't panic. Retinoids have not been shown to cause problems in their topical form in pregnant women.

"There is no data to show these retinoids ingredients are harmful when used on the skin - doctors are just being extra cautious.

On the label:
Differin (adapelene)
Retin-A, Renova (tretinoin)
Retinoic acid
Retinol
Retinyl linoleate
Retinyl palmitate
Tazorac and avage (Tazarotene)

Bottom line:
Best to avoid

Salicylic acid

This mild acid is used to treat certain skin disorders, including acne, and you can find it in a number of skin products, such as cleansers and toners. It can penetrate facial oils to get deep into pores and clean out dead skin cells. Salicylic acid is in the aspirin family, so it can also help reduce inflammation or redness. BHA, or beta hydroxy acid, is a form of salicylic acid and is used in some topical exfoliants to reverse signs of aging.

But salicylic acid is another no-no for pregnant women. High doses of the acid in its oral form have been shown in studies to cause birth defects and various pregnancy complications.

Again, doctors are being cautious by recommending that pregnant women avoid the topical use of salicylic acid. Small amounts applied to the skin - such as a salicylic acid-containing toner used once or twice a day - are considered safe.

But the concern is stronger about face and body peels containing salicylic acid. This kind of "soaking" in the ingredient is similar to taking one or more aspirin when pregnant.

More product used equals more absorption into the bloodstream. Always check with your doctor before having a peel treatment. Better yet, if you must have a peel, have it done professionally at your dermatologist's office. A dermatologist will know how to do it safely during pregnancy.

On the label:
Salicylic acid
Beta hydroxy acid
BHA

Note: Alpha hydroxy acids, sometimes listed as AHAs, glycolic acid, or lactic acid, are safe.

Bottom line:
Best to avoid

Hair removers & minimizers

Lotions that remove your hair chemically (depilatories) or that minimize hair between shaves sound like a dream come true when you can barely reach - not to mention see - your legs. The good news is that these products are considered risk-free.

There are no specific ingredients to avoid when it comes to these types of products. The only risk is an allergy.

Catherine Lynch, director of the division of general obstetrics and gynecology at the University of South Florida, says, "As long as you use [chemical hair removers] as directed, they shouldn't be a problem. It's a topical solution that isn't absorbed into your bloodstream, so it can't have any effect on the baby."

If you've had an allergic skin reaction to hair minimizers or removal creams in the past, then you should avoid these products during pregnancy as well.

Also, some women's skin gets extra sensitive during pregnancy, so you may have a reaction to these ingredients even if you haven't before. Before slathering your whole leg, do a patch test on a small piece of skin behind your knee and wait 24 hours to see if you react.

On the label:
Potassium Thioglycolate (depilatory)
Calcium Thioglycolate (depilatory)
Sodium Hydroxide (minimizer)
Sanguisorba Officinalis Root Extract (minimizer)
Hydrolyzed Soy Protein (minimizer)

Bottom line:
Safe to use

Sunscreens

Just because you're pregnant doesn't mean you can't hit the beach. In fact, feeling the sand between your toes and that warm breeze in your hair may provide that perfect "relaxation point" your Lamaze instructor has been talking about. And as your mom always told you: Don't forget the sunscreen.

Sunscreens, including those with ingredients that penetrate the skin, are perfectly safe when you've got your own bun in the oven.

"Ingredients that do go deep into the skin do so in such small concentrations" that they're not worth worrying about, says Johnson. "I personally prefer titanium dioxide and zinc oxide - they are powerful physical sunscreens and do not penetrate the skin."

She adds, "In addition to sunscreen, we advise sun-smart behaviors - avoiding the sun between 10 a.m. and 4 p.m.; using a sun hat, sunglasses and sun-protective clothing; & reapplying your sunscreen every two hours."

And if you have melasma, you can try a UV protector with a skin lightener.

On the label:
Titanium dioxide
Zinc oxide
Avobenzone (Parsol 1789)
Oxybenzone
Dioxybenzone
Benzophenone
Octyl methoxycinnamate (OMC)
Para-aminobenzoic acid (PABA)
Octocrylene

Bottom line:
Safe to use

Makeup

You may not give a second thought to the kind of makeup you use, but even cosmetics are something to consider when pregnant, says dermatologist Johnson.

Many makeup products are marked "noncomedogenic" or "nonacnegenic" - meaning they're oil-free and don't clog pores. These are safe and will not affect the health of your baby.

Avoid cosmetics that contain retinol or salicylic acid (found in some makeup for acne-prone skin).

If you want to be super careful during pregnancy, try some of the minerals-only makeup lines. These products use ingredients that primarily sit on top of the skin and don't cause irritation for most people.

On the label:
Differin (adapelene)
Retin-A, Renova (tretinoin)
Retinoic acid
Retinol
Retinyl linoleate
Retinyl palmitate
Tazorac and avage (Tazarotene)
Tretinoin

Bottom line:
Avoid cosmetics that contain retinoids or salicylic acids. Otherwise, safe to use.

The final word

When you're pregnant, it's important to discuss any product you use on your skin with your healthcare provider.

But if you realize you have used a product that contains one of the potentially harmful ingredients noted above, don't panic. Simply stop using the product now and pick one with known-to-be-safe ingredients.

"Most over-the-counter products by reputable brands are safe," she says. "And if you are applying these products to less than 10 percent of your total skin surface, the risks of systemic effects are very low."

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