Retinol is a vitamin A compound and one of the most effective ingredients in skincare. But with powerful results come potential side effects, especially during pregnancy. In this episode, we dive into the science behind retinoids, how they work, and why some forms may be risky if you are expecting. We break down the differences between oral and topical vitamin A compounds, review what the research and medical guidelines say, and explore how to weigh the benefits and risks for your skin and your baby. Plus, we cover safe and effective alternatives for both acne and anti-aging, and how to talk to your doctor or midwife about your skincare routine.

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Hi Vanessa,

I’ve been listening to your podcast since I found out I was pregnant, and it has helped me so much. I feel so much more confident navigating all the decisions that come with this new chapter.

I wanted to ask about retinol. I’ve used a retinol serum for a long time to keep my skin clear and smooth, and it has always worked really well for me. I recently read that it might not be safe during pregnancy, but I’m getting conflicting information. Do I really need to stop using it completely? And if so, what’s a good alternative?

I appreciate your help and all the great info you share every week.

-Amanda

Amanda, thank you so much for your message. I am happy to hear the podcast has been helpful for you. I completely understand how frustrating it can be to reconsider products you have used and loved for years, especially when they have worked well for your skin. Pregnancy often brings numerous changes and limitations, and it can be discouraging to think that you might have to overhaul your skincare routine on top of everything else. You are not alone in wondering what is safe and what is not, and I am happy to walk you through the evidence on retinol.

Why Skincare Ingredients Matter During Pregnancy

Your skin is your body’s largest organ, and it can absorb some of the ingredients in the products you apply. During pregnancy, certain substances have the potential to enter your bloodstream and cross the placenta to reach your baby. Because of this, it is essential to be mindful of the ingredients in your skincare. In addition, your skin can become more sensitive during pregnancy, which may make you more prone to irritation or reactions from products you previously tolerated well.

The Benefits of Retinoids in Skincare

Retinol is a vitamin A compound that belongs to a broader group of substances known as retinoids. Retinoids are used in skincare because they are some of the most effective ingredients for improving the health and appearance of skin. These work at a cellular level and are used to treat a variety of skin concerns.

Retinoids are used to treat acne by unclogging pores, reducing oil production, and preventing the buildup of dead skin cells. Retinoids stimulate collagen production, which helps reduce the appearance of fine lines and wrinkles. They also improve skin texture and tone, making skin appear smoother and more even. These ingredients speed up the rate at which your body sheds old skin cells and replaces them with new ones. This can brighten dull skin, fade dark spots or hyperpigmentation, and reverse signs of sun damage. If that is not enough, they also minimize the appearance of pores.

The Risks of Retinoids in Skincare

With powerful results come potential side effects, especially if you are pregnant. Not all vitamin A compounds carry the same level of risk. Factors like dosage, delivery method, and formulation make a difference.

The most concerning form is isotretinoin, an oral medication used to treat severe acne that does not respond to other treatments. This medication was previously known as Accutane and is now sold under brand names like Absorica, Amnesteem, Claravis, Myorisan, and Zenatane. Isotretinoin is strongly associated with severe birth defects, and in the United States, it is prescribed under strict regulations. Patients must have two negative pregnancy tests before starting treatment, use two forms of birth control, and continue monthly pregnancy testing throughout treatment. This medication should never be taken during pregnancy.

Other retinoids like tretinoin (Retin-A), retinaldehyde, retinol, retinol propionate, retinyl palmitate, and retinyl acetate are different. These are applied topically to the skin rather than taken orally. According to the American College of Obstetricians and Gynecologists, topical retinoids are a form of vitamin A and are in the same drug family as isotretinoin. Unlike isotretinoin, topical retinoids are applied to the skin, and the amount of medication absorbed by the body is low. But it is generally recommended that the use of these medications be avoided during pregnancy. Some retinoids are available by prescription. Other retinoids can be found in some OTC products. Read labels carefully.

The concentration of retinoids can vary widely depending on the product and formulation. Retinol is one of the most common forms used in skincare products. Retinol is typically found in varying concentrations, usually between 0.1% and 1%.

Pregnancy Warnings on Labels

Cosmetic and skincare products are not required to have FDA approval before they are marketed. The legal responsibility for the safety of products is on the companies that manufacture or sell these products. In an abundance of caution and to avoid litigation, it is common to see a warning or disclaimer on many products about pregnant or breastfeeding women. It usually reads, “Consult with a doctor if pregnant or breastfeeding” or “Do not use if pregnant or breastfeeding.” Amanda, if you look at the label of the retinol product you use, you will likely see some form of this warning.

Balancing Benefits and Risks of Skincare Ingredients

Many skincare products are designed to make your skin look better, support healing, or improve overall skin health. The active ingredients that make these products effective are also the ones that may carry risks, especially during pregnancy. When weighing the potential risks and benefits of any product, there are a few essential factors to consider.

Understanding Absorption and Exposure

Toxicity is generally dose-dependent. When you apply something to your skin, only a small amount, usually between 1% and 2%, is absorbed into your system. That amount can vary depending on whether the product is left on the skin or rinsed off. Leave-on products like moisturizers and serums tend to result in more absorption than rinse-off products like cleansers. The location on your body also plays a role. Products applied over larger areas of skin may result in greater absorption than those applied only to the face. Frequency of use is another factor. Using a product daily leads to more exposure than using it occasionally.

One way to minimize exposure is to reduce how often you use a product or limit how many products you use overall. Some people also choose to scale back their skincare routine during the first trimester, when fetal development is most critical.

If Your Current Routine Works, You May Not Need to Change It

If you are happy with your current skincare routine and the products you use do not contain ingredients that are explicitly cautioned against by organizations like ACOG, there may be no need to make any changes. Finding products that work for your skin can be challenging. If something is working for you, it is often best to stick with it. That said, pregnancy can increase skin sensitivity. If you begin reacting differently to a product, it might be time to cut back or explore new options.

Do You Need to Stop Using Retinol Completely?

Amanda, to answer your question of whether you need to stop using it completely, is ultimately a personal decision. It depends on your comfort level with the information we have discussed and should be made in consultation with your doctor, midwife, or dermatologist. They can help you weigh the potential risks and benefits for your unique situation.

Alternatives

You also asked what a good alternative is. If you use retinol for the benefits of improving acne, the American College of Obstetricians and Gynecologists also advises against other prescription acne medications during pregnancy. This includes hormonal therapy and tetracyclines, associated with the risk of congenital disabilities. ACOG states that over-the-counter products containing topical benzoyl peroxide, azelaic acid, topical salicylic acid, and glycolic acid may be used to treat acne during pregnancy.

If you use retinol primarily for the antiaging properties, there is a product I have tried and really liked that is a plant-based alternative to retinol that is pregnancy safe. The Phyto-Retinol Serum from 8 Sheep Organics contains 2.5% bakuchiol, which has been proven in clinical studies to be just as effective as retinol but much gentler on the skin. The Phyto-Retinol Serum results in firmer, smoother skin by helping to reduce fine lines and wrinkles, increasing new skin cell turnover, and reducing and tightening pores. All without any of the risks associated with traditional retinoids.

Like all 8 Sheep products, the Phyto-Retinol Serum comes with a 100% Happiness Guarantee. You can try it completely risk-free for 100 days. If you are not 100% happy with your purchase, simply email them, and they will get you a refund, no questions asked. You can check out the Phyto-Retinol Serum and get 10% off here.

Talk to Your Doctor, Midwife, or Dermatologist

If you are currently using or considering any products that contain retinoids or other vitamin A compounds, it is a good idea to check in with your dermatologist, doctor, or midwife. They can help you determine whether a product is safe to use during pregnancy and guide you toward the best options for your skin and your baby. If you are unsure about an ingredient, you can always bring the product to your next prenatal appointment and ask your provider any questions you may have.

Additional Resources:

• Pregnancy Safe Skincare

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Save 40% off the Zahler Prenatal +DHA on Amazon with the code PREPOD40. (Valid through July 31, 2025, code must be used with Apex Nutrition as the seller.) You can always see the current promo code for the Zahler prenatal vitamin here.

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