title: Treatment of acne vulgaris during pregnancy and lactation.
abstract: Acne vulgaris is a common problem encountered by pregnant and lactating women. Unfortunately, in clinical practice, treatment is often not optimized as a result of the lack of safety data and unified recommendations on the use of the various anti-acne therapies. In this narrative review, current data on their safety is summarized. We recommend the use of topical medications as first-line treatment for acne vulgaris in pregnant and lactating women. These include antibiotics (erythromycin, clindamycin, metronidazole and dapsone), benzoyl peroxide, azelaic acid and salicylic acid. Oral agents and/or light-based therapy may be considered as second-line treatment. The former consists of oral macrolides (erythromycin and azithromycin), cephalexin or zinc compounds. Blue-violet or red light phototherapy may be used as monotherapy or in addition to topical and/or oral therapies. Hormonal therapy, antibiotics consisting of tetracyclines, co-trimoxazole and fluoroquinolones, and both oral and topical retinoids should be avoided.
authors: National Skin Centre, 1 Mandalay Road, Singapore 308205, Singapore.
authors: Y L
authors: YL
authors: Kong
authors: H L
authors: HL
authors: Tey
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000284:Administration, Oral; D000287:Administration, Topical; D000726:Androgen Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007774:Lactation / Q000187:drug effects*; D010789:Phototherapy / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012176:Retinoids / Q000008:administration & dosage* / Q000009:adverse effects; D018570:Risk Assessment
chemical_list: D000726:Androgen Antagonists; D000900:Anti-Bacterial Agents; D012176:Retinoids
references: Int J Dermatol. 2002 Apr;41(4):197-203
references: 12031026
references: Med Ref Serv Q. 2007 Spring;26(1):51-8
references: 17210549
references: Lancet. 1997 Aug 2;350(9074):339
references: 9251645
references: Clin Exp Dermatol. 2012 May;37 Suppl 1:1-6
references: 22486762
references: Ann Intern Med. 1982 Apr;96(4):465-6
references: 7065565
references: J Clin Pharmacol. 2012 Dec;52(12):1844-51
references: 22174426
references: Brain Dev. 2000 Jun;22(4):218-20
references: 10838106
references: J Pediatr Surg. 1992 Jun;27(6):744-6
references: 1501036
references: J Am Acad Dermatol. 2011 Aug;65(2):418-419
references: 21763564
references: Chin Med J (Engl). 2012 Aug;125(16):2925-8
references: 22932092
references: J Reprod Med. 1981 Mar;26(3):135-41
references: 7230149
references: Dermatol Ther. 2008 Mar-Apr;21(2):86-95
references: 18394082
references: Reprod Toxicol. 2005 Jul-Aug;20(2):209-14
references: 15907655
references: J Dermatol. 2011 Feb;38(2):111-9
references: 21269305
references: Pediatrics. 2001 Sep;108(3):776-89
references: 11533352
references: J Am Acad Dermatol. 2007 Apr;56(4):651-63
references: 17276540
references: J Am Acad Dermatol. 2002 Aug;47(2):231-40
references: 12140469
references: J Perinatol. 2001 Jul-Aug;21(5):288-92
references: 11536021
references: Pediatrics. 1985 Mar;75(3):443-55
references: 3883303
references: Clin Cosmet Investig Dermatol. 2011;4:79-92
references: 21760743
references: Arch Dermatol. 1982 Nov;118(11):876
references: 7138039
references: Ann Pharmacother. 2006 May;40(5):986-9
references: 16551765
references: Am Fam Physician. 2001 Jul 1;64(1):119-26
references: 11456429
references: Dermatol Ther. 2012 Jan-Feb;25(1):23-37
references: 22591497
references: Antimicrob Agents Chemother. 1977 Nov;12(5):630-5
references: 21610
references: Ann Dermatol Venereol. 2008 Jan;135(1):27-33
references: 18342070
references: CMAJ. 2011 Nov 8;183(16):1851-8
references: 21989472
references: Int J Dermatol. 2012 Oct;51(10):1162-74
references: 22994662
references: J Postgrad Med. 2011 Apr-Jun;57(2):91-5
references: 21654128
references: J Drugs Dermatol. 2010 May;9(5):532-6
references: 20480797
references: Scand J Infect Dis. 2003;35(2):104-6
references: 12693559
references: Int J Dermatol. 2011 Mar;50(3):350-7
references: 21342170
references: Can Fam Physician. 2011 Jun;57(6):665-7
references: 21673209
references: Am J Clin Dermatol. 2003;4(7):473-92
references: 12814337
references: J Am Acad Dermatol. 1988 Sep;19(3):431-42
references: 2971690
references: Dermatology. 2001;203(2):135-40
references: 11586012
references: Dermatol Ther. 2006 Jul-Aug;19(4):237-40
references: 17004999
references: Cutis. 1996 Jan;57(1 Suppl):20-35
references: 8654128
references: Pediatr Dermatol. 2008 Mar-Apr;25(2):179-83
references: 18429774
references: Acta Obstet Gynecol Scand. 2000 Mar;79(3):234-7
references: 10716307
references: Dermatol Clin. 2006 Apr;24(2):167-97, vi
references: 16677965
references: Am J Med Genet A. 2005 Jul 15;136(2):117-21
references: 15940677
references: Contraception. 1984 Dec;30(6):505-22
references: 6241559
references: Dermatol Ther. 2005 May-Jun;18(3):253-66
references: 16229726
references: Dermatol Online J. 2012 Oct 15;18(10):15
references: 23122022