Pregnancy is one of the most beautiful, transformative and challenging human experiences. Such a transformation requires the mother to consider many new lifestyle changes, for her own wellbeing and her baby’s. Skincare, not least during pregnancy, is by no means a separate matter from our overall health and wellbeing and may need to be adapted, alongside the wider lifestyle changes adopted by a new mother.

Many of us have become aware of retinol and its use as a common ingredient in many skincare products. It is essentially a derivative of Vitamin A that boasts a proven track record of treating the effects of aging on the skin, and is often prescribed as a last-resort treatment for persistent acne. It works in several ways and is active not only on the surface of the skin but also the middle and dermis layers too, meaning it plays a major role in reducing wrinkles and fine lines.

However, being this active both at the skin’s surface level and deeper, retinol isn’t without side effects and it certainly demands further personal research before use. Medical professionals are often asked, can pregnant women use retinol? Most commonly, the short answer is that pregnant women should not use retinol.

WHAT DOES THE SCIENCE TELL US?

Retinol is one of the most researched ingredients in skincare, with well-established, proven scientific results for dealing with certain skin concerns. Medical professionals naturally take a more cautious position where pregnancy and breastfeeding is concerned. In many cases this is simply because research on this study group is still limited, however by looking at the wider population, there is enough scientific evidence to suggest that this vitamin A derivative is safe for most people. 

There is some concern among the medical profession that topical retinoids may be absorbed directly into the skin, excreted into breast milk and passed on to a baby in this way. Additionally, it is possible that topical retinoids are transferred to a baby through routine skin to skin contact, which is naturally common between mother and baby. The data surrounding this is limited, but is certainly a notable point that requires further research to produce a scientific consensus surrounding any risks.

While some studies report a risk after using retinoids during pregnancy, others do not. Generally, the amount absorbed from the skin when using topical retinol is very low, however there are still some concerns over the absorption of retinol into breast milk when breastfeeding. The data isn’t conclusive, so always err on the side of caution. Don’t use retinol during pregnancy or breastfeeding, without consulting a medical professional first.

JUST ADD RETINOL - A FALSE ASSUMPTION

Given the efficacy of retinol, one would be forgiven for assuming that any product that lists it as an ingredient would be effective, but this isn’t a supported conclusion. Skincare products vary in their composition and may have one or more active ingredients. This can be for many reasons such as; the frequency of use, how it fits into a wider skincare routine, and recommended duration of use to name just a few. What this means for you as the consumer, especially during pregnancy and breastfeeding, is that it’s important to understand what goes into skincare products you choose to try and not focusing solely on one part of it.  The method of administration is also relevant to its efficacy and how it interacts with you. An example of this would be topical (i.e. applied to the body) retinoid derivatives, which are typically weaker than a prescribed oral alternative such as tretinoin or accutane. Regardless of this, all varieties should be avoided by pregnant or breastfeeding women.

In the case of retinol, it’s important to note that this ingredient comes in many different forms and different strengths, some much stronger than others. In fact, our skin can only use the ‘active form’ of vitamin A known as retinoic acid. This means every other retinol derivative has to be converted into this form within your skin before it can be used. The more conversion steps away from retinoic acid, the less potent and effective. Below are the conversion steps in descending order of potency, from strongest to weakest:

• Retinoic acid (tretinoin, adapalene): Biologically active form, which means it starts working immediately. Research shows that it’s the most effective but also the most irritating, so it’s often prescription only.
• Retinaldehyde (retinal): Precursor to retinoic acid. It’s more tolerable than retinoic acid, but slightly stronger than retinol. It’s often found in the highest-priced skincare products.
• Retinol: The most popular derivative, because it’s effective and only moderately irritating. Retinol is 20 times less potent than retinaldehyde.
• Granactive retinoid: This anomaly is known in chemistry as an ester, meaning it doesn’t need to be converted into retinoic acid. Instead, it works immediately and is much gentler.
• Retinol esters (retinyl palmitate): The weakest form of retinol, meaning it’s the least irritating but takes time to see results.
  
  
  
  
  

WHAT ARE THE ALTERNATIVES TO RETINOL DURING PREGNANCY?

• Alpha Hydroxy Acids (AHA)s: Lactic acid and mandelic acid help to speed up skin cell turnover, to reduce fine lines and wrinkles.
• Bakuchiol: Helps reduce signs of aging without any irritation, however more research is needed on this new ingredient. 
• Linoleic acid: Rebalances natural oil levels in oily and acne-prone skin, making it a safer alternative for those experiencing hormonal acne during pregnancy.

IS VITAMIN E A SAFER ALTERNATIVE TO RETINOL DURING PREGNANCY?

During pregnancy, the use of vitamin E as an alternative to vitamin A or retinol, is safe when used in moderation. At present, the amount of vitamin E intake during pregnancy is recommended to be approximately 3 mg per day. Of course, this is a broad recommendation so ask a medical professional to be sure this level is right for you. The antioxidant properties of vitamin E help to prevent the visible signs of premature skin aging, in the form of fine lines and wrinkles. This, alongside its known ability to contribute positively to the structure of cells throughout your body makes vitamin E a safer alternative to retinol during pregnancy and doesn’t sacrifice a great deal of the benefits.