Yes, No, Jury’s Out: Lotions and Cosmetics During Pregnancy

Wouldn’t it be great to buy a product and know FOR SURE that it is or is not safe for you and your pregnancy? Why does this seem so hard for manufacturers to produce?

Here are the problems:

There are cosmetics – products that you apply to your body to clean it, make it more attractive or change the way it looks. And there are cosmeceuticals -a cosmetic combined with a drug. An example of a cosmeceutical is makeup with sun -block or fluoride toothpaste. If your cosmetic has an “active” ingredient, then it contains a drug and is a cosmeceutical.

Drugs are easier to determine if they cause harm when taken in pregnancy, but if there is no active ingredient, then it is strictly a cosmetic and there is little if any, information on the safety in pregnancy. The FDA does not regulate the cosmetic industry or it’s health and beauty claims.

Other problems:

. The safety of medications is dependent on the way the medication was taken: applied to the skin, inhaled, or swallowed.

. When during pregnancy the medication was used: first trimester or later.

. The amount of the drug used: higher dose, higher risk.

. The health and wellness of the women.

What should you do when you are pregnant? Do you never put on make-up, skin cleanser, or dye your hair?

The basics start with LOOKING AT LABELS!!

There are nine products that are banned for use in the US for cosmetics. They include:

Bithionol

Mercury compounds

Vinyl chloride

Halogenated salicyanilides

Zirconium complexes in aerosol sprays

Choloform

Methylene chloride

Chlrofluorocarbon propellants

Hexachlorophene

These are cancer causing substances and have not been studied in pregnancy but you can assume if they are bad not pregnant, they are not good pregnant.

Please check with your doctor on what he or she recommends for you during your pregnancy. But, here is what I tell my patients:

Cosmetics: You’re really on your own. There is no consistent evidence that the makeup you use or cleanser to clean your face is harmful in pregnancy. Check the label, if there are no “active” ingredients, you can continue to use it throughout pregnancy.

Commonly Used Active Ingredients in Cosmeceuticals

Benzoyl peroxide: There is no evidence that benzoyl peroxide is a concern in pregnancy. There is no data to support it’s safety but it is commonly used and there are no case reports of birth defects.

Salicylic acid: taken by mouth is aspirin. When put on your skin, only 5-10% of the medication is absorbed and is called salicylic acid. Aspirin in low doses (less than 81mg) is safe throughout pregnancy, so topical application with its lower absorption rate is unlikely to be a concern.

Topical hydrocortisone: Oral consumption of cortisone has been linked to increased risk of cleft palates though topical exposure has not. Applying hydroxycortisone to your skin is unlikely to cause a concern if given after the first trimester.

Alpha-hydroxy acids: There is little evidence on the oral form malic acid and whether it is a concern in pregnancy, but the topical form of doses less than 10% appear to be safe in pregnancy.

Vitamin A or its derivatives: Retin-A, retinals, Isotretinion, or tretinion. Vitamin A taken orally in large doses (20,000 IU) has been shown to cause birth defects. Even topical use of tretinion, at significantly lower doses showed similar birth defects as the higher oral dose, though at a much lower incidence. Clearly there is risk with this medication and there are safer alternatives. Avoid this one with pregnancy.

Hair Dye: if it doesn’t touch your skin, it’s likely not a risk. If it touches your skin, there is some small absorption. We don’t know what that risk is to your unborn child. Later use in pregnancy is better than early use in pregnancy.