Skin Care, Hair Care and Cosmetic Treatments in Pregnancy and

Skin C

are, Hair Care and Cosmetic Treatments in Pregnancy

and Breastfeeding

MotherSafe - Royal Hospital for Women

Updated April 2021

Information in this leaflet is general in nature and should not take the place of advice from your health care

provider. With every pregnancy there is a 3 to 5% risk of having a baby with a birth defect.

Issues for pregnancy

Many pregnant women have skin and hair concerns just as they did before pregnancy. Sometimes conditions such

as acne actually worsen during pregnancy (because of hormonal changes) and often women notice darkening of

their skin (melasma). However, due to concern about potentially hazardous exposures to their unborn babies,

pregnant women are often uncertain about which products are safe for them to use.

There are several considerations when evaluating whether a specific skin or hair product is unsafe in pregnancy.

• The specific active ingredient(s) in the product needs to be considered unsafe.

• The ingredients have to be able to reach the unborn baby in its mother’s womb by inhalation or direct

absorption through the mother’s skin (topical application).

Although there is often limited information about the actual safety of specific ingredients in skin products during

pregnancy, if it is known that skin absorption is minimal then the exposure to the unborn baby is generally

insignificant and the product or treatment is regarded as safe. However, cosmetic treatments are discretionary (not

medically necessary) and if safety is uncertain, women should consider whether the product or treatment is really

required. Nonetheless most cosmetics and skincare products are considered safe to use.

Below is a summary of current advice.

Cosmetics, Moisturisers and other Skin Care Products

Cosmetics and over the counter skin products generally contain ingredients that are unlikely to be harmful in

pregnancy as they are used by applying directly to the surface of the skin (rather than swallowing a tablet).

Benzoyl peroxide, salicylic acid and glycolic acid are ingredients found in many acne treatments and cosmetics.

They are considered safe to use in pregnancy.

Salicylic acid can also be an ingredient in direct to skin

medications which treat musculoskeletal pain and scaly skin conditions (eg. warts). Quantities of salicylic acid

absorbed may be higher in specific situations so safety of use should be confirmed with MotherSafe or your

healthcare provider.

Hydroquinone, an over the counter skin product for skin bleaching absorbs through skin in larger amounts and

therefore should be avoided while pregnant.

Minoxidil for hair growth or tretinoin for acne are skin products

requiring a prescription and should also not be used.

1,2

There has also been concern over use of vitamin A in pregnancy. However, these concerns are associated with

amounts of vitamin A taken by mouth in large doses. Vitamin A (or retinol) that is present in cosmetics is generally

in insignificant quantities and is minimally absorbed through the skin.

It is therefore acceptable to use over the

counter skin products that contain vitamin A.

Unbranded products, particularly if sourced over the internet, are not recommended as the actual ingredients

cannot be verified.

Royal Hospital for Women

Barker Street, Randwick, NSW 2031

Telephone : 02 9382 6111

www.seslhd.health.nsw.gov.au/rhw/

Hair removal creams and bleaching agents

Hair removal creams usually contain a product called thioglycolic acid. Although there is no specific data on its

absorption, because the concentration of the chemical is low and the time applied to the skin is short, it would not

be anticipated to be harmful in pregnancy.

The creams may also contain low levels of the chemicals, sodium and

calcium hydroxide. These chemicals form a normal part of dietary intake and use on the skin would not be

expected to cause any alteration to levels in the body. Therefore, hair removal creams are safe to use in

pregnancy.

Agents such as hydrogen peroxide are used for hair bleaching. Because they are generally applied for short

periods and in low concentrations, they would not be considered a significant exposure.

However, products with

hydroquinone should be avoided.

Sunscreens

Sunscreens contain various ingredients including oxybenzone, octocrylene and octisalate.

Absorption through the skin is generally minimal and as a result, sunscreens do not pose a risk to pregnant and

breastfeeding women.

Using sunscreen is advisable as it is just as important to avoid sunburn in pregnancy and

while breastfeeding as it is at other stages of life.

Hair and nails

Many pregnant women express concern about chemical exposure from various treatments such as hair colouring

and hair straightening. However, it is considered that the actual exposure to an unborn baby is minimal because

hair dyes and other treatments are applied directly to the hair and scalp (as opposed to swallowing the chemicals).

Furthermore, treating hair is common in pregnant women and no harmful outcomes have been noted. Pregnant

women can therefore safely have their hair done during pregnancy without putting their unborn baby at increased

risk.

Women may have concerns about having their nails done during pregnancy. This is due to concern regarding

chemical and dust exposure via inhalation or through the skin. However, because exposure is for a relatively brief

period, it is not anticipated that any nail work would cause problems in pregnancy.

Hairdressers and nail salon workers are exposed to chemicals for longer periods of time. Most studies have shown

no significant increase in risk of birth defects or any other pregnancy complications.

3,4

However, it is important to

minimise chemical exposure by general occupational health and safety measures. These measures include

maximising ventilation of work areas, using gloves, washing hands before eating and practising safe storage and

disposal of chemicals. Avoiding standing on feet for prolonged periods and working long hours is also advisable.

Most available masks do not prevent inhalation of chemicals although they may prevent inhalation of dust particles.

Tanning products

Self-tanning involves artificially tanning the skin by applying products containing dihydroxyacetone in cream or gel

form in varying concentrations. It is thought that absorption via the skin is very low and it is therefore considered

safe in pregnant women.

For spray tanning (which also uses dihydroxyacetone but in higher concentrations), it is

advisable to use protective measures such as nose plugs or masks to avoid excess inhalation. This is particularly

important for women who are exposed occupationally.

Botox

Botulinum toxin is used medically for treatment of conditions related to muscle spasm, although it is used more

commonly for cosmetic treatment of facial wrinkles. There is minimal research regarding its use in pregnancy, but

small doses of botox injected into a muscle are unlikely to enter the circulation. Furthermore, it does not cross the

placenta so even if used, it is unlikely to be able to reach an unborn baby. As such, inadvertent exposure would not

be a cause for concern. Nonetheless, botox for cosmetic reasons is not medically necessary so its use cannot be

recommended during pregnancy.

Laser

Laser treatment is most commonly used for hair removal. The laser is a light that heats the surface of the skin only.

It does not penetrate beyond the skin and thus poses no risk to an unborn baby during pregnancy.

Royal Hospital for Women

Barker Street, Randwick, NSW 2031

Telephone : 02 9382 6111

www.seslhd.health.nsw.gov.au/rhw/

Breastfeeding

Cosmetics, skincare products, sunscreen and hair removal or bleaching creams are generally considered safe to

use while breastfeeding. However, hydroquinone should be avoided as the absorption is high.

It is also safe to

have any hair, nail or tanning treatments. Nonetheless, breastfeeding women should avoid application of spray tan

to the nipple and areola of their breast as this comes into direct contact with their baby.

Although there is no research in breastfeeding mothers, Botox if injected properly should not enter breastmilk. No

specific breastfeeding precautions are required if a mother has botox while breastfeeding.

Laser treatment is

considered safe while breastfeeding.

References

1. Bozzo P, Chua-Gochero A and Einarson A. Safety of skincare products during pregnancy. Canadian Family Physician. 2011; 57(6):665-7

2. IBM Micromedex®: Reprotox® (electronic version). IBM Watson Health, Greenwood Village, Colorado, USA. Available at:

https://www.micromedexsolutions.com.acs.hcn.com.au/ Accessed January 4 2021

3. Chua-Gochero A, Bozzo P and Einarson E. Safety of hair products during pregnancy: personal use and occupational exposure. Canadian

Family Physician. 2008; 54 (10): 1386-1388

4. Henrotin JB et al. Reproductive disorders in hairdressers and cosmetologists: a meta-analytical approach. Occupational Health 2015; 57:

485–496

5. Tan M et al. Botulinum toxin type A in pregnancy. Canadian Family Physician. 2013; 59(11):1183-4

6. Pregnancy and radiation exposure. Health Physics Society: Available at

http://hps.org/publicinformation/ate/faqs/pregnancyandradiationexposure.html

Accessed April 2021

7. Lactmed: Drug and Lactation Database. Onabotulinumtoxin A. National Library of Medicine, Maryland. Available at

https://www.ncbi.nlm.nih.gov/books/NBK562677/

Accessed April 2021

Other resources

Otis. Hair treatments in pregnancy. Organization of Teratology Information Specialists. July 2020. Available at https://mothertobaby.org/fact-

sheets/hair-treatments-pregnancy/

Otis. Working in a nail salon. Organization of Teratology Information Specialists. January 2020. Available at https://mothertobaby.org/fact-

sheets/working-nail-salon-pregnancy/

Otis. Self-tanners, tanning pills, tanning booths and pregnancy. Organization of Teratology Information Specialists. February 2020. Available at

https://mothertobaby.org/fact-sheets/self-tanners-tanning-pills-tanning-booths-pregnancy/

NSW Medications in Pregnancy &

Breastfeeding Service

For more information call MotherSafe: NSW Medications in Pregnancy and Breastfeeding Service on 9382 6539 (Sydney

Metropolitan Area) or 1800 647 848 (Non-Metropolitan Area) Monday –Friday 9am-5pm (excluding public holidays)