title: Treatment of Acne in Pregnancy.
abstract: Acne vulgaris is a common disease of the pilosebaceous unit and affects adolescents and adults. Because high-quality guidelines regarding treatment of acne in pregnancy are scarce, management of this condition can be challenging. We describe the safety profile of common therapies and outline approaches based on available evidence. Topical azelaic acid or benzoyl peroxide can be recommended as baseline therapy. A combination of topical erythromycin or clindamycin with benzoyl peroxide is recommended for inflammatory acne. Oral erythromycin or cephalexin is generally considered safe for moderate to severe inflammatory acne when used for a few weeks. A short course of oral prednisolone may be useful for treating fulminant nodular cystic acne after the first trimester. In general, topical and oral antibiotics should not be used as monotherapy, but combined with topical benzoyl peroxide to decrease bacterial resistance. Oral retinoids are teratogenic and absolutely contraindicated for women who are pregnant or considering pregnancy. Although some complementary therapies including micronutrients and nonpharmacologic treatments seem to be well tolerated, limited data exist regarding their safety and efficacy, and they are not currently recommended during pregnancy. The risk-to-benefit ratio, efficacy, acceptability, and costs are considerations when choosing a treatment for acne in pregnancy.
authors.affiliation: From the Department of Dermatology, Johns Hopkins University, Baltimore, MD (ALC, JQ, BR); and the Department of Dermatology, University of Michigan, Ann Arbor (DLS, YRH). achien3@jhmi.edu.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Chien
authors.affiliation: From the Department of Dermatology, Johns Hopkins University, Baltimore, MD (ALC, JQ, BR); and the Department of Dermatology, University of Michigan, Ann Arbor (DLS, YRH).
authors.forename: Ji
authors.initials: J
authors.lastname: Qi
authors.affiliation: From the Department of Dermatology, Johns Hopkins University, Baltimore, MD (ALC, JQ, BR); and the Department of Dermatology, University of Michigan, Ann Arbor (DLS, YRH).
authors.forename: Barbara
authors.initials: B
authors.lastname: Rainer
authors.affiliation: From the Department of Dermatology, Johns Hopkins University, Baltimore, MD (ALC, JQ, BR); and the Department of Dermatology, University of Michigan, Ann Arbor (DLS, YRH).
authors.forename: Dana L
authors.initials: DL
authors.lastname: Sachs
authors.affiliation: From the Department of Dermatology, Johns Hopkins University, Baltimore, MD (ALC, JQ, BR); and the Department of Dermatology, University of Michigan, Ann Arbor (DLS, YRH).
authors.forename: Yolanda R
authors.initials: YR
authors.lastname: Helfrich
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000075202:Contraindications; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012176:Retinoids / Q000008:administration & dosage / Q000627:therapeutic use*; D015032:Zinc / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D005938:Glucocorticoids; D012176:Retinoids; D000622:Aminolevulinic Acid; D015032:Zinc
keywords: Acne; Dermatology; Maternal Health; Pregnancy