salicylic acid or benzoyl peroxide in acne meds

MuffinMom14 · May 2014

So. My acne is awful. I posted about it, a long time ago, maybe at 8 or 9 weeks? And there were a lot of good ideas in there, and I tried them all. It's just gotten worse.

The only things that seem to help me are the things with salicylic acid or benzoyl peroxide in them, but apparently, while pregnant, you can't use those, as they are linked to birth defects or development defects.

While going through the studies, it seems like those are oral or prescription strength? Or, they just don't KNOW the effects, so they say "just best to avoid?" The information I can find is confusing at best. Some sites say don't use either at all, some say it's ok under 2%, and some say just the benzoyl peroxide is ok.

I'm all for just being ugly for 9 months, I guess, but I don't want to if I don't HAVE to. It's to the point where makeup doesn't cover it up, and I work--it's embarrassing as shit. I don't know where to draw the line here--listen to the studies? I've been trying everything from tea tree oil, natural soaps, apple cider vinegar, etc. and it's just going and going strong. Or, should I just go back to using Proactiv like I was before?

For what it's worth, I'm going to ask my doctor, but I don't see her for another two weeks.

golfingdarwinfish · May 2014

I work in drug development and I will say that acquiring human data in pregnancy isn't a real forte for us. Human data is often retrospective which leaves it open to much criticism and controversy. Drug labels typically include rat or primate data regarding the dose required to harm a fetus or cause teratogenicity.

I haven't read any of the studies regarding SA to offer a scientifically valid response, but with all medications/chemicals, I would advise working with your OB to make a decision and to determine your comfort level with any risk-benefit profile that is proposed by your HCP.

archi35 · May 2014

I have spoken to my OB here in Switzerland as well as with the genetic counselor I recently went to in the US (obviously the genetic counselor is not a doctor). Both had the same feedback that moderate topical use (ie: a once a day wash with SA and then spot treatment with BP) was not a problem. To each their own, and their own doc's advisement but I haven't stopped using either as needed. They also both okay'd the Proactiv clay spot treatment I'd used before, also as needed.

TheOtherJacobsons · May 2014

In would say you could email your doctor is you cannot wait. I email mine about stuff like this all the time.

Waterlilly11 · May 2014

My dermatologist said absolutely NOT to use benzol or sycilic in any amount it can cause problems for baby's bones and teeth. There's only so much you can do to fight your hormones, I know it sucks I am also struggling. Remeber less is more. Try using products that are natrual/organic. What kind of makeup are you using? Getting out I the sun had helped me a little bit now that it's finally getting warm. Hang in there beautiful, it will all be worth it in the end!

MrsL2B · May 2014

My dermatologist said that it's if it's available over the counter, it's probably fine, but he suggested that I not risk it anyway. I have tried toner with SA on my problem areas, but all it does is dry out my skin, and then I still have the acne plus flaky red skin. Not ideal.

SusieBW · May 2014

dorothyzbornak97 said:

starla487 said:

I asked my OB at my last appt because the acne everywhere else on my body is getting uncomfortable. She said OTC salicylic acid fine. (The stuff I have is 0.5%.) She also said the studies are controversial, so you may get different responses from different docs. I don't use it daily, but started it up again.

This.

Yup. I don't use it anymore, but when I was pregnant with DD, my OB told me that as long as I'm not eating the SA, using an OTC face wash with SA in it once a day was fine.

IrishHoney123 · May 2014

Good question. This drives me crazy, along with sunscreen and everything else. Docs will give you different answers because it is a little hazy (meaning no conclusive evidence to recommend no one should EVER use in any amount). My midwife said OTC topical is fine, but I had an OB in the past who told me to never use SA. I'm trying not to stress about it, I still use my topical SA every other day and my normal non organic sunscreen.

NavyFlyer · May 2014

This probably isn't helpful at all since it seems docs have different opinions, but mine said NO! Also my husband who is a paramedic and had no idea SA was in acne meds said "oh yea, we don't give meds with SA to pregnant women". I guess its in some regular meds too? But point is, he knew that as a rule. Something about blood thinning? Whatever, I'm not taking a chance.

My doc DID say BP is ok for light use. I use neutrogena Acne on the Spot treatment for spot treatment of blemishes. Its BP, not SA. I used to use the orange neutrogena soap but it's SA so I stopped :0(

JessAnnJ · May 2014

I don't use it often but I do use the neutrogina benzoyl peroxide spot treatment when I get large sore pimples. My acne gets really painful. I only put it on the pimple. I did stop using the SA soap as PP also mentioned.

ETA - My chin is pretty much a minefield of pimples at all times, but I reserve the treatment for when it starts to hurt.

MuffinMom14 · May 2014

The answers in this thread are the reason why I'm confused. So many people believe different things, and I can't decide where I'm going with this.

I'm not even certain I'd trust my doctor on this, either. She's so old school. I never got a do/don't list, I have to ask every little thing or I get no answers. So, I was taking melatonin for the first 13 weeks, because no one told me not to and it's on my chart. Found out it's bad for pregnant women. She never said a thing about what to eat/not eat. I had to look up the lunch meat business and make my own decision. I was told "no alcohol/no caffeine." Both things that I disagree with in moderation. I was told NOT to run, and not to exercise in a house alone. That's absurd. And the thing is, I'm not switching doctors at this point because she's the best this area has to offer, and I can't afford the PTO that I'd have to take to go to a doctor in the next town over (an hour drive). She's what I have to work with here. I believe that she's the best at labor and delivery here in town. But she's SO cautious and old school about the pregnancy that leads up to labor/delivery that I just roll my eyes.

JessAnnJ · May 2014

What made me decide to use it sparingly are the studies which like you said have to do with oral use. I don't even know if there is a such thing as oral use of benzoyl peroxide, but when they do most studies they inject animals with massive amounts of various things and judge based on what happens. You can't have clinical trials of all of these things with pregnant people. I don't think there will ever be a clear cut answer. I'm pretty sure I asked my doctor last pregnancy and he said topical use occasionally is fine.

IrishHoney123 · May 2014

SA is in aspirin so paramedics are advised not to give to pregnant women. Topical use isn't shown to have blood thinning effects. I feel for you, @SPurp13. You have to be your own advocate.

bumpuser10309732 · May 2014

I've been using Clinique's acne system. My doctor is one of those that said it was fine to use. But she's also told me anything over the counter is going to be safe. Like they've told me I can use benedryl but I'm really not comfortable with it. My skin has been absolutely horrible too, but I've always had skin issues. It has SA in it but it's the only thing I've ever used that was gentle on my face and didn't dry it out.Good luck to you!

ADH0906 · May 2014

I decided to use SA in small-dose topical creams for the same reason that everyone mentioned above...there doesn't seem to be a real answer.

It isn't helping me, and my back is so broken out and painful that I'm heading to the dermatologist. In the past, I used prescription Finacea (sp?). I stopped using it because my skin reacted better to another prescription, but the Mayo book does say that it's safe for use (warning: I'm at work and can't check that citation right now, but I'm pretty sure). Even my dermatologist told me she can't technically tell me that SA or BP are okay for use during pregnancy, but there are prescription options. Good luck!

MuffinMom14 · May 2014

I really DO have to be my own advocate, and this board has really helped fill in gaps where my doctor didn't bother to tell me shit.

It's like. There are tons of internet sources saying this or that. So I have to comb through and make a decision...however, I also feel like there are sources that say DON'T DO THIS just because there's no evidence there is NO harm. So, it hasn't been tested.

I'm trying to sift through the scare tactics and bullshit. Until my next appointment (next Thursday), I'm just going to keep using the stuff I'm using, which doesn't have that in there, that topical BP at night before bed. I figure it's the SA that tends to be more of a sticking point in these studies, and I'll try to get my answers from my doctor next week, since it's really not life or death, here.

ADH0906 · May 2014

Nicb13 said:

ADH0906 said:

I decided to use SA in small-dose topical creams for the same reason that everyone mentioned above...there doesn't seem to be a real answer.

It isn't helping me, and my back is so broken out and painful that I'm heading to the dermatologist. In the past, I used prescription Finacea (sp?). I stopped using it because my skin reacted better to another prescription, but the Mayo book does say that it's safe for use (warning: I'm at work and can't check that citation right now, but I'm pretty sure). Even my dermatologist told me she can't technically tell me that SA or BP are okay for use during pregnancy, but there are prescription options. Good luck!

I had 3 dermatologists tell me they wouldn't prescribe ANYTHING acne treatment related to a pregnant person

Maybe you'll have different/better luck.

Wow, that sucks. I guess I'll find out if that's really her policy. There is definitely one (I believe it's Finacea) that's even listed in te Mayo book, so that seems overly cautious to me. Why can't doctors all get on the same page about this kind of thing!

Maggie6424 · May 2014

I still use my face wash that has salicylic acid. However, I'm pretty dry so I only use it a few times a week. I also have clean and clear spot treatment that I use when I have a really bad one. I think if it were really bad to use otc stuff like that, there would be much more warnings and our docs/midwives would be all over it at the first appt.

michellebrosnan@optonline.net · May 2014

Going to derm in three days. Will let you know. Mine is out of control right now!! Where's my beautiful pregnancy glow!?!

annejulie26 · May 2014

I use proactive every other day and did with my last pregnancy and everything was fine. Do what feels right in your gut.

golfingdarwinfish · May 2014

At the American Academy of Dermatology congress in March pregnancy and various medications was an incredibly hot topic. Yes, derms often err on the side of caution, especially with medications that are not required. Part of this is the lack of data, and another large portion is liability. Derms will even pull medications for severe psoriasis (which means they are also being used to treat severe systemic inflammation) that are category B (I'm not saying this is a bad thing!). They are known for being one of the most conservative of all specialists.

I would recommend bringing the research to your derm or ob and discussing it directly with them. If you find their explanations to be insufficient, ask your ob to consult a MFM. At the end of the day the evidence is the evidence and needs to be taken in the appropriate context, and the context should be set by a medical professional. If the HCP is comfortable with treatment s/he will often leave it to the discretion of the patient.

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