Photographed by Annie Leibovitz, Vogue, August 2006
Pregnancy can be a glorious time, but it can also be a confusing time, particularly when it comes to matters of beauty. Hormones throw your usual skin balance out of whack, and a glow on some complexions might be a greasy slick on others. Hair is simply different. And then there’s the more pressing matter of whether the products in your medicine cabinet are safe to use; even seasoned beauty editors find themselves squinting at the complex lists of ingredients, trying to discern which formulas are fair game and which aren’t. And products that may seem harmless on first impression—such as natural skin care—may actually be the opposite: Though it’s less commonly known, some essential oils have potentially risky side effects.
Fortunately, the FDA already does some of the work for us, as Macrene Alexiades-Armenakas, MD, a dermatologist in Manhattan, points out. The governmental organization categorizes ingredients by letters of the alphabet, ranging from safest to those that should be avoided at all costs: A, B, C, D, and X. Generally, only categories A and B are considered safe to use during pregnancy, but it can be challenging to parse which ingredients on the list are found in beauty products, and it’s up to women to scrutinize labels closely. As Dendy Engelman, MD, a Manhattan dermatologist who recently gave birth to a baby boy, puts it: “Just like you want to be on your A-game with food and health when you’re pregnant, you have to be that way with beauty and skin care, too.”
Below, a doctor-approved cheat sheet on beauty ingredients, products, and services to avoid.
Retin-A, retinol, and retinyl palmitate: Though it also resides in FDA category C, which technically means risk to the fetus cannot be ruled out, Albert Sassoon, MD, an ob-gyn in Manhattan, says this family of products is to be avoided at all costs. While vitamin A is crucial to the proper development of the fetus, “getting too much can cause serious birth defects and liver toxicity,” he says. Also, though Retin-A is usually associated with prescription medication and skin care, plenty of over-the-counter formulations contain vitamin A derivatives like retinol and retinyl palmitate, both of which should be banned from your pregnancy beauty kit.
Benzoyl peroxide: Though pregnancy can often cause hormonal acne, unfortunately, the typical zit-zappers found over the counter, like benzoyl peroxide, fall in category C. “That means there’s some possible risk to the fetus, and a majority of ob-gyns I work with would say to avoid,” says Dr. Alexiades-Armenakas.
Essential oils: Essential oils are not assessed by the FDA, yet they are increasingly used in beauty products marketed as safe. “In general, essential oils can be extremely harmful if not used appropriately,” Dr. Sassoon says. “Often they have 50 times the concentration used in a cup of tea and can be harmful even in a nonpregnancy state. The problem also is that we don’t know how much of a specific oil is absorbed.” Dr. Engelman suggests that diluted essential oils are generally considered safe, but because there are so many different types available, it’s best to go over the safety of any product or individual oil with your doctor. Two commonly used essential oils, though, ring warning bells: tea tree oil and rosemary oil. “Tea tree oil is very potent and toxic when ingested,” says Dr. Alexiades-Armenakas. “Its adverse effects include dermatitis, drug reactions, a blistering disease called linear IgA, and estrogenic effects.” Pregnant women should steer clear of it because “possibly these hormonal effects are to blame for premature contractions.” Meanwhile, rosemary oil can “raise blood pressure and cause uterine contractions at high doses,” Dr. Alexiades-Armenakas adds. “To avoid.”
Salicylic acid: Also in category C, this ingredient is a particularly pesky one to sidestep. “It’s traditionally been used for acne, but now I see it in all kinds of exfoliating products, particularly cleansers,” Dr. Alexiades-Armenakas says. “So much of what’s out there right now are combination peels,” adds Dr. Engelman. “When you’re pregnant, you have to seek out the purer products—the ones that feature just one of the acids that are approved.” She points out that glycolic, lactic, and mandelic acids are all considered safe and are good options for someone who still wants some sloughing action.
Hydroquinone: This powerful skin lightener may be tempting to use—particularly when pregnancy brings on dark spots or full-on melasma—but the ingredient is a no-no, says Dr. Alexiades-Armenakas, noting it falls into category C.
Tazorac, Accutane: Both are also vitamin A–derived formulations, but they’re prescription only and reside in category X: known to cause birth defects.
Aluminum chloride hexahydrate: If you’re pregnant, now is the time to switch to simple deodorants or natural alternatives. Found in antiperspirants, aluminum chloride hexahydrate affects the cells that produce sweat and is in FDA pregnancy category C, which means “to avoid,” says Dr. Alexiades-Armenakas.
Formaldehyde: Though the chemical is not currently classified under the FDA categories, many ob-gyns and dermatologists will advise pregnant women to limit their exposure. Stick with nail polishes labeled “3-Free” or “5-Free,” which exclude the chemical, says Dr. Engelman: “Gel manicures, in particular, tend to be higher in formaldehyde.” The same goes for Japanese and Brazilian hair-straightening procedures, which use formaldehyde during processing, Dr. Engelman adds. Salon workers are at particular risk. The National Institute for Occupational Safety and Health states working with formaldehyde may increase the chances of fertility problems or miscarriage.
Hair dye: “The frequent change in product formulation makes it very difficult to assess the potential risks,” Dr. Sassoon says. To err on the safe side, he recommends pregnant patients steer clear of hair coloring for the first 12 weeks, when the fetus is busy forming integral body parts and organs. Afterward, he says, occasional appointments are okay: “Such small amounts of chemical is absorbed through the scalp that the potential risk is very small if the appointments are infrequent.”
Chemical sunscreens: Again, ingredients in chemical sunscreens are not all classified under the FDA categories, but Dr. Engelman recommends sticking to mineral ingredients like zinc oxide and titanium dioxide. “There has been some suggestive evidence of chemical sunscreen risks, but they haven’t been fully substantiated yet,” Dr. Engelman says. “But since there are excellent physical blockers out there that are safe, why not take the risk out of it altogether?”
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