When you start to notice pregnancy breakouts and hyperpigmentation, your first instinct might be to use salicylic acid—especially if it was a regular in your skincare routine pre-pregnancy. Not unlike other powerful ingredients, it can carry with it a number of potential risks and side effects when used while pregnant. Rest assured, though: growing a baby doesn’t mean you have to kiss salicylic acid goodbye entirely. There are still plenty of ways to still reap its myriad benefits while prioritizing safety, as well as incorporate several alternatives into your routine. Here, we’ll share more about when and when not to use salicylic acid during pregnancy.
What Is Salicylic Acid?
Salicylic acid is a skincare ingredient available in varying concentrations and topical forms from cleansers to toners to spot treatments. It’s primarily used to treat acne, but salicylic acid’s antibacterial, anti-comedogenic (doesn’t block or clog pores), and keratolytic (addresses shedding dead skin) properties make it a favorite for treating other skin concerns as well. “Salicylic acid is a beta hydroxy acid (BHA) that helps to regulate cell turnover and prevents pores from becoming too congested,” explains Dendy Engelman, MD, a board-certified dermatologist in New York City. “It penetrates into the pores to dissolve dead skin cell buildup, encouraging the top layer of skin to shed.” Salicylic acid can be used on many skin types, but it is especially popular among those with oily or acne-prone skin. “It can be used as a mild chemical exfoliant to remove bacteria and pore-clogging debris from the skin and treat acne,” Dr. Engelman says.
Salicylic Acid in Pregnancy
With all the skin changes happening during pregnancy, you might find yourself dealing with acne breakouts, hyperpigmentation, and more. Reaching for salicylic acid, an otherwise obvious solution, is slightly more complicated when pregnant. Put simply, it’s okay to use salicylic acid while pregnant, but you’ll need to take some precautions. “Salicylic acid is definitely not my first line of choice for what you should use during pregnancy or while nursing,” says Doris Day, MD, a board-certified dermatologist in New York City. “However, in lower strengths and when washed off immediately, there is little harm."
Why You Should Not Use Salicylic Acid While Pregnant
Although salicylic acid traditionally offers a long list of benefits, the risks of using it during pregnancy can outweigh them. “You can get some absorption of salicylic acid, and there is a toxicity called salicylism,” Dr. Day explains. “So, if it is absorbed, it can potentially cross the placenta and cause salicylism in the fetus.” Salicylism, a toxic syndrome caused by excessive intake of salicylic acid, can lead to serious symptoms for the person who is pregnant, including tinnitus, nausea, dizziness, coma, and even death. While further research needs to be conducted, if salicylic acid is absorbed and crosses into the placenta, it could cause fetal death, antepartum and postpartum bleeding, or prolonged pregnancy and labor.
Safety Precautions
Despite the potential risks, there are ways to safely incorporate salicylic acid into your skincare while pregnant.
Use a Cleanser Rather Than a Leave-On Treatment
While many salicylic acid treatments are intended to be left on the skin overnight, Dr. Day recommends using the ingredient only in products that will be removed quickly, like cleansers. “If it’s on for a minute, it’s going to be absorbed less than if it’s on for many hours,” she says. “I don’t see any harm in that because so little is absorbed at that point that it’s not really a risk.” Unlike a cream or gel that you would leave on overnight or throughout the day, a cleanser will be washed off within a few minutes, so there is little risk associated with it.
Use a Low Concentration of Salicylic Acid
To avoid the chance of salicylism, dermatologists suggest using salicylic acid in no higher than a 2% concentration during pregnancy. Anything more carries an increased risk. Check the label to figure out the concentration of salicylic acid in any given product. The majority of lotions, creams, and toners with the ingredient will have low concentrations, but it’s always important to make sure.
Avoid Oral Salicylic Acid
Salicylic acid is related to the common pain relief drug Aspirin, which is generally considered unsafe or risky for use while pregnant. Taking an oral form of salicylic acid is also not advised. “Oral consumption of salicylic acid is safer in earlier stages of pregnancy, but not after 20 weeks, as it can cause premature closure of the ductus arteriosus in the heart,” Dr. Engelman adds. Premature closure of the ductus arteriosus, the blood vessel that connects two major arteries before birth and typically closes after a baby is born, can result in pulmonary hypertension, and if left untreated, can result in fetal death.
Do Not Use Salicylic Acid on Your Body
While a salicylic acid cleanser is considered safe to use on your face, you should avoid using it on your body, even in cleanser form. “You can wash your face with it because it’s a relatively smaller surface area,” Dr. Day notes. “But I wouldn’t use it over a large surface area of the body as a cleanser or as a leave-on.”
Consult A Healthcare Provider Before Use
Although a dermatologist is a great starting point for determining what to use on your skin, it’s important to speak to an OBGYN as well. “I always tell my pregnant patients that it’s whatever their OBGYNs say. They’re the boss of your pregnancy,” explains Dr. Day. “So, I can tell you what I would do for the skin and the things that are absolutely not okay during pregnancy, like Azelac or Accutane, but for things like salicylic acid that can be a bit iffier, you want to make sure your OB is on board with it.”
When Can I Resume Using Salicylic Acid?
As noted above, there are certain ways to continue using salicylic acid during pregnancy, but it will be a little while until you can resume using it free of restrictions. Although it’s rare for salicylic acid to be absorbed into breastmilk, it’s not impossible. You should continue to take the same precautions if you choose to breastfeed. If you are not breastfeeding, you can resume unlimited use of salicylic acid after giving birth.
Pregnancy Safe Alternatives
Salicylic acid is a go-to ingredient for a reason, but that doesn’t mean it’s the only option for treating skin concerns like acne. There are a handful of alternatives that are considered safer for people during their pregnancies. These alternatives rank lower on the FDA’s pregnancy risk categories, which measure the risks and side effects associated with taking or using a given ingredient during pregnancy.
Azelaic Acid
Azelaic acid is a naturally occurring acid that has antimicrobial and anti-inflammatory properties. “Unlike salicylic acid, which is considered a category C for pregnancy, this is a category B, which is relatively safer for pregnancy," says Dr. Day. Azelaic acid is also keratolytic and achieves a similar effect as salicylic acid by penetrating the follicle to even out skin tone and unclog pores. It is available in both prescription and over-the-counter strengths and in a variety of forms, including cleansers, creams, and toners.
Glycolic Acid
For another alternative to salicylic acid, Dr. Engelman suggests glycolic acid, an alpha hydroxy acid (AHA) that’s derived from sugarcane. “It’s an effective anti-acne ingredient that’s safe to use during pregnancy,” she says. When applied to skin, glycolic acid breaks the bonds between the outer and inner layers of skin cells to effectively peel off dead skin. It can be found in cleansers, creams, toners, and more, in ranging concentrations.
Lactic Acid
Lactic acid is another common ingredient in the AHA family and is safe for people during pregnancy. It works well for treating and preventing acne, treating discoloration, dark spots, and dull or uneven skin texture, and is thought to be gentler than salicylic acid and other alternatives. You can find lactic acid most commonly in serums, though it’s available in a variety of products.
A Word From Verywell
Salicylic acid is a popular ingredient in skin care products for good reason. But during pregnancy, the general rule of thumb is to keep the concentration at 2% or below and to avoid any leave-on treatments. Even when taking every safety precaution though, It’s important to consult both a dermatologist and an OBGYN about what will work for your specific needs.
