If there’s one thing we thought we’d got rid of once we were out of our teens, it was zits. But during pregnancy, you may find that pimples rear their ugly heads to haunt you once more because acne is a common affliction for pregnant women.

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“With all my pregnancies I have ended up with spots on my face, chest, tops of my arms and back,” says dairymilk chatting on the MFM forum. “I’m 7 weeks pregnant now and its back, it is a nightmare as I seem to suffer all the way through”.

Why do pregnant women get spots?

Acne in pregnancy or acne vulgaris (as if we needed the reminder!), tends to hit from early pregnancy, at around six weeks. If you don't usually get spots, this could even be a sign that you are pregnant. Spots can appear on your face, hairline, neck, breasts, back, and even your bum!

No surprises that hormones are behind your breakouts! Progesterone causes your glands to secrete more oil called sebum, which can clog up pores and allow bacteria to build up, leading to breakouts. And because you're pregnant, your body retains more fluids, which in turn contain toxins which may lead to spots popping up all over your body.

“Essential as it is, progesterone is to blame for many of pregnancy’s less desirable effects,” explains GP Dr Jenni Worden.“For many pregnant women, progesterone causes a flare up of the teenage acne that you thought you’d ditched years ago,” she says.

Tommysmum2 says, “My hormones have gone absolutely wild and I have spots on my back and I haven’t had that since back in the day when I was a teenager!”

Can I use any acne treatment during pregnancy?

No. Mums-to-be need to be careful when it comes to treating acne as some medications can be harmful to your baby. Many prescription and OTC acne medications contain retinoids, a type of vitamin A. Pregnant and breastfeeding mums should avoid using these altogether. Below are some treatments that you should steer clear of when pregnant.

Retinoids: theseare known to cause birth defects and some retinoids may also increase the risk of miscarriage, especially the acne drug isotretinoin. They can be absorbed into the skin and your breast milk, as well as into both your and your baby’s bloodstream so check both oral and topical treatments for this ingredient.

Oral antibiotics: some antibiotics such as tetracycline, doxycycline, lymecycline and minocycline can cause discolouration to your unborn or nursing baby's teeth.

Salicylic acid: thisis another skincare ingredient that pregnant women need to be wary of, and use sparingly. Salicylic acid is part of the aspirin family and can help to reduces redness and inflammation. Whilst it's super effective at cleansing pores (you’ll find it in many cleansers and toners), in high doses it’s been shown to cause birth defects and can cause pregnancy complications. So until your baby is born and you stop breastfeeding, it’s best avoided.

Before you buy any OTC treatments, just make sure you check the ingredients label carefully. Low concentrations of salicylic acid should be ok to use as very small amounts of the acid are unlikely to harm you or your baby so if you have been using it, don’t worry. Just follow the old adage, "If in doubt, don't use it."

Can my doctor prescribe any acne treatments?

For most women, outbreaks flair up and then go away again or are limited to a few spots here and there. While getting spots aren't particularly attractive and may be irritating, at least they are not harmful so unless you are suffering from a severe case of acne, it's probably best to avoid treating them with medication.

However, if your symptoms are really troublesome, there are several treatments that you can use safely in pregnancy, so it is worth speaking to your GP.

Most doctors recommend the use of topical (applied to the skin) medication as a first-line treatment for acne in pregnant and breastfeeding women. Antibiotic creams such as erythromycin, clindamycin, metronidazole and dapsone can also be prescribed, as well as benzoyl peroxide, azelaic acid and fruit acids. In some cases, low dosage salicylic acid may be suggested.

The authors of one American review study into the treatment of acne in pregnant patients found that the "treatment regimen will likely shift throughout the different stages of fetal development…as well as during each of the trimesters of pregnancy” so it's worth remembering that what works at one point during your pregnancy might not necessarily work at another time.

Kel4 says, “Benzole peroxide is safe to use in pregnancy. I used in my last pregnancy and I am using it in this one. I worked with dermatologists that told me it was fine [and] used by many in pregnancy. 2.5% bp is advisable as the skin is more sensitive. Start very sparingly and work up as initial reactions can be redness. This will go after a few weeks when the skin gets used to it. I use Panoxyl 2.5%."

So what can I use to get rid of the spots?

There are many ways to help improve your skin, often starting with the most obvious.

“I know it sounds silly,” says MFM forum member laughingharder, “but more water and no chocolate or cakes always sorted it for me, in addition to not using soap-based products, and then cleansing with tree tea oil and/or witch hazel oil overnight.”

Spend time on your beauty regime

Start by taking a caring attitude towards your skin. Think back to the zit-busting rituals of your teen years.

Gently cleanse: use a mild, soap-free cleanser twice a day. Wash your face gently, paying special attention to your hairline and jaw, where pores tend to get clogged.

Don’t scrub: obsessively cleansing or using harsh face scrubs and exfoliators will only make things worse. Over-cleansing strips the skin of its natural moisture, which in turn will set your oil glands into overdrive, resulting in more breakouts.

Never squeeze: tempting as it may be, leave those spots alone! Squeezing your spots will only make them last longer and can cause scarring.

Moisturise: this might feel counter-intuitive but using an oil-free moisturiser can actually help reduce the irritation.

Read before you buy: make sure your skincare and makeup products do not contain retinoids or high doses of salicylic acid. Look for creams and lotions that are oil-free and labeled ‘non-comedogenic’ or ‘non-acnegenic’ as these are specifically formulated not to cause acne.

Your body is a temple

You are what you eat, as they say so pay attention to your diet.

Eat smart: while your diet may not have much bearing on whether you get acne during pregnancy, it may be worth avoiding foods that can aggravate your skin such as saturated fats. Replace these instead with skin-boosting healthy fats such as olive oil, avocado, walnuts and almonds. Cutting out (or simply cutting back) on refined sugar and grains (white pasta, rice and bread) can also help improve your skin.

And last but not least, drink water: it's the elixir of the gods (well, pregnant women at least) and you just can't have enough of it! One of the best things you can do for your skin is to drink plenty of water. Water helps flush out your skin, keeping it moist and clearer. You may need to pop to the loo more often but trust us, it'll be worth it!

You can blame those raging hormones for your outbreaks but it’s not all doom and gloom, at least you won't have to go through puberty again! And if all else fails, there's always make up!

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