Pregnancy Acne: Causes, Cures & What to Do

Pregnancy acne left you in a spot (ahem) of bother? You’re not alone.

Skin eruptions can be par for the pregnancy course. In fact, the word from The American College of Obstetricians and Gynecologists (ACOG) is that acne is one of the most common skin changes you might experience during pregnancy. [1]

Luckily, safe treatments are available. We’ll take you through the details.

📝 In this article:

What is acne?

Acne is a skin condition that causes your hair follicles to get plugged with oil and dead skin cells, leading to inflammation. The result? The dreaded zit. And sometimes a whole army of them.

These spots come in all shapes and sizes. From whiteheads to blackheads to papules to pimples, your skin can react to blocked pores in some creative ways. Nobody is immune to the odd spot (and, for some reason, they always seem to appear just before an important event. 🤔)

But it’s more common to get acne when you’re going through hormonal changes (we’re looking at you, puberty), if other people in your family have acne, or if you’re on certain medications. And although they don’t actually cause it, things like diet, stress, and pollution may also worsen the condition.

What does pregnancy acne look like?

Pregnancy acne usually looks a lot like “regular” acne, just with extra hormonal drama. 🙃

You might notice:

• Whiteheads (tiny white bumps)
• Blackheads (tiny dark dots)
• Red, tender bumps (papules)
• Pus-filled pimples (pustules)
• Deeper, sore lumps (sometimes)

It can show up on your face (especially chin/jawline), but also your chest, back, neck, and shoulders, where oil glands are most active.

What is the difference between pregnancy acne and normal acne?

Here’s the honest truth: the bumps can look the same. The difference is usually the why (and the timing). Pregnancy acne is more likely to be driven by hormonal shifts that can increase oil production and clog pores, according to the American College of Obstetricians and Gynecologists (ACOG). [2]

What might feel different in pregnancy:

• You break out even if you never used to. (Rude, but common.)
• Your usual “holy grail” products may be off-limits right now (more on that below). ACOG lists several OTC ingredients that can be used in pregnancy and also flags acne meds that should be avoided. [2]
• Skin can be more sensitive, so harsh scrubs or over-washing can make things angrier, not better.

Is acne common in early pregnancy?

Yep, it can be. We get it — with all the other symptoms you may be experiencing at this point

(Hello, Pregnancy Nausea! Hello, Oh-so-frequent Peeing!), spotty skin is the last thing you probably want in your life.

So what’s at the root of these breakouts? Well, like most pregnancy symptoms, we don’t know for sure, and the answer is probably different for everyone.

But what we do know is that hormones play a role. One of the culprits is androgens, the so-called “male” hormones your body produces. In most people, testosterone levels increase from less than 50 ng/dL (that’s nanograms per 100ml) before pregnancy to between 50 and 120 ng/dL during pregnancy. The increase is usually higher for people with PCOS. [3]

Upping androgen production is another way your body supports you and your growing peanut during pregnancy and prepares you for labor when the time comes. But it could also have some other effects. High levels of androgens may lead to acne. That’s because these hormones are known to over-stimulate oil production in your skin cells. Androgens levels tend to make a jump early in pregnancy and then continue to grow as your belly does. [4,5]

So the not-so-straight bottom line? Acne can be common early in pregnancy, but it can also spring up later.

What foods trigger acne during pregnancy?

Let’s not blame your snack cravings for everything. The evidence overall is mixed, and lots of people get pregnancy acne regardless of diet. That said, research in non-pregnant populations suggests acne may flare more for some people with: [6]

• High-glycemic foods (think: sugary drinks, candy, white bread, ultra-processed carbs), which can spike blood sugar and insulin.
• Cow’s milk (some studies show an association for some people).

And the AAP (HealthyChildren.org) notes that diet may play a role for some teens, but it’s not a simple “eat chocolate = acne” situation. Translation: if you notice a pattern, it’s worth paying attention, but you don’t need to live on lettuce to have “good skin.” [7]

If you suspect a food trigger, try a gentle 2–3 week experiment (swap, don’t restrict), and see if your skin calms down. No punishment smoothies required.

What week does acne start in pregnancy?

So when does pregnancy acne start? Well, the reality is that it’s different for everyone.

Because your hormones go on a pretty wild ride in the first trimester, it’s common to start noticing some pimples at around six weeks into your pregnancy. But it’s also possible for pregnancy acne to peak in the third trimester when your levels of androgens are at their highest. [8,9]

Some people may notice acne for the first time during pregnancy. For others who’ve already had it, it may get worse.

And to really confuse the issue, for others, pregnancy means clear skin. There’s no one way for your body to do this thing.

What week is acne the worst in pregnancy?

There isn’t one universal “worst week” (because bodies love being unique), but many people notice flares in the first trimester. Pregnancy, Birth & Baby (by the Australian Department of Health, Disability, and Ageing) notes that acne may get worse in the first trimester and often improves by the third trimester. [10]

If yours peaks later, you’re not doing pregnancy “wrong.” You’re just… pregnant.

When will pregnancy acne go away?

For many people, pregnancy acne eases later in pregnancy and may even improve or go away by the third trimester.

After delivery, hormones shift again (because of course they do), so some people improve quickly, while others can see postpartum breakouts for a bit. And breastfeeding may help keep acne away for some.

If it’s sticking around or getting painful/scarring: it’s worth asking your OB-GYN or a dermatologist about pregnancy-safe options. ACOG lists OTC ingredients that can be used and also calls out meds to avoid. [4]

Is acne a sign of pregnancy?

This is a tricky one, as pregnancy hormones affect us differently. For some, early pregnancy means acne.

But acne doesn’t necessarily mean early pregnancy. Things like breast changes, nausea, and fatigue can all give you clues as to whether you’re pregnant — but they can also be signs of other things.

The most trustworthy signal is a missed period, but even this is not foolproof. There are many reasons why periods can be late. And if you are pregnant, it’s possible to confuse implantation bleeding with the arrival of your period.

The best thing to do?

If you think you might be pregnant, take a home test. We’ll take you through when to do that here.

Does acne during pregnancy mean a boy or girl?

Nope. Sorry to every auntie who swears she’s “never been wrong.” 😄

Pregnancy acne does not reliably predict baby’s sex. It’s much more likely related to hormones, oil production, and genetics than whether you’re having a boy or a girl.

If you want to know sex, the reliable routes are things like ultrasound or genetic screening/testing (if you choose it with your provider), not the state of your chin in week 9.

What does pregnancy acne look like?

Not all spots are created equal, and there are a few different types that might make an appearance while you’re pregnant. Pregnancy acne may simply look like little clusters of red bumps.

Sometimes, these bumps are filled with yellowish pus (these are appropriately called “pustules”). Another variation is “comedones”, which have a solid peak in the middle of a small flesh-colored bump. [11]

They can be open (AKA “whiteheads”) or closed (AKA “blackheads”). It’s also possible to develop cysts deeper under the skin. This cystic acne can be quite sore.

If your acne is causing you pain or discomfort, it’s important to talk to your doctor. You don’t have to suffer through this.

How do you get rid of pregnancy acne?

Unfortunately, if you’re wondering how to get rid of pregnancy acne, we can’t promise a miracle cure. But the ACOG does have a list of recommended — and effective — treatments for pregnancy acne. [4]

For most people, these include over-the-countre products with:

• Topical benzoyl peroxide
• Azelaic acid
• Topical salicylic acid
• Glycollic acid

But always speak to your doctor about whether particular medications are appropriate for you when you’re pregnant — we all have different bodies and needs. As for prescription drugs, it’s particularly important to steer clear of acne treatments that impact your hormones — like contraceptive pills and anti-androgen meds — as these may impact your baby’s development.

Other drugs to avoid while you’re pregnant include:

• Isotretinoin: A form of vitamin A that can have serious risks for your baby if taken when you’re pregnant. [12]
• Oral tetracycline: An antibiotic that can have negative effects on your liver and may affect the development of your baby’s teeth and bones. [13]
• Topical retinoids: Which are also a form of vitamin A and could impact the health and development of your baby. [14]

Then there are some other things you can do, either alongside a pregnancy acne treatment or on their own, to minimize the acne effect:

• Wash your face twice a day with a mild cleanser and water that Goldilocks would approve of (not too hot and not too cold)
• Keep your hair clean to avoid hair oil from getting onto your skin
• Opt for oil-free make-up
• Try not to pick or squeeze (eek — the temptation, we know!)

There’s so much about pregnancy that’s awe-inspiring. There’s also so much that’s tough to navigate — and sometimes downright uncomfortable.

The good news is we don’t have to go through these challenges alone. Check-in with your Peanut community. We’re having the conversation.

All the best! ❤️