From the first moment you begin to think about becoming pregnant, you are suddenly faced with thousands of questions with seemingly infinite possible answers. Not only do you have to worry about the intricacies of fertility, but it can feel like everything you eat, touch, or do could potentially affect your future child. It doesn’t help that figuring out the do’s and don’ts of pregnancy can often seem like solving an impossible puzzle.

One important area that can send you down an agonizing rabbit hole is what to do about what products you use on your face. Fortunately, the answer to how to approach your skincare regime while trying to conceive, undergoing fertility treatments, or during pregnancy and breastfeeding—all times that can also cause skin changes and disruptions—is a lot simpler than it at first may seem.

Always Avoid

There are a number of common skincare products that doctors recommend avoiding during fertility treatments, pregnancy, and breastfeeding. To be extra cautious, it’s best to remove these from your skincare routine as soon as you think about trying to conceive. 

Hydroquinone

Hydroquinone is a skin-lightening ingredient that dermatologists often use to treat hormone-driven hyperpigmentation. The U.S. Food and Drug Administration (FDA) officially gave a greenlight to this ingredient in up to 2% concentrations in 1982, though questions about its safety have periodically been revived. As recently as 2006, the FDA proposed reclassifying the ingredient for all users as not “generally recognized as safe and effective.”

While the FDA may be reconsidering the product, many dermatologists remain proponents of hydroquinone for use in treating hyperpigmentation issues. But it makes the “definite no” list for women who are pregnant or breastfeeding. Studies show that up to 45% of the ingredient can be soaked up by the skin, which is an unusually high systemic absorption rate. For this reason, doctors recommend cutting it out of your skincare regimen completely during this time. If a product claims to be “brightening” or “lightening,” that’s a tip-off to check the label for this culprit.

Retinoids (also known as tretinoins)

Retinoids are a group of chemical compounds that are created from vitamin A and that are something of a superhero when it comes to skincare. Retinoids (also known as retinol and tretinoin) are touted for their power to treat acne, prevent wrinkles, boost collagen production, and otherwise do the work the beauty industry labels “anti-aging.” Because of their many benefits, they are widely recommended by dermatologists.

While retinoids are mostly found in serums and lotions, they can also be taken in oral form, the most well-known of which is Accutane. Dr. Angela Lamb explains that oral retinoids have been shown to cause birth defects when taken during pregnancy. Because of this, warnings to avoid them were also extended to their topical application, and it is now recommended that you stay away from the ingredient in all forms.

Topical antibiotics

Similar to retinoids, some oral antibiotics are also potentially harmful to use during pregnancy. For this reason, Dr. Lamb recommends avoiding topical antibiotics like bacitracin in an effort to be as safe as possible.

Chemical sunscreens

Recently, there has been a lot of buzz around the choice between mineral or chemical sunscreens. Mineral sunscreens are those made using zinc or titanium, which sit on top of the skin and act as a barrier; chemical (or “physical”) sunscreens are those made with anything other than those two ingredients, and they work by being absorbed into the skin.

While sun protection is very important during pregnancy, expectant and breastfeeding mothers should opt for mineral sunscreens rather than chemical, which typically contain the ingredient oxybenzone. In recent years, the use of oxybenzone has been linked to Hirschsprung’s disease, an ultra-rare birth defect.

Avoid Out of Caution

Salicylic acid 

Topical salicylic acid is a beta hydroxy acid that acts as an exfoliant and is often prescribed to treat acne. It is made from the same chemical, salicylate, as aspirin, a drug that is generally not recommended for use during pregnancy except in some cases when there is a history of miscarriage or preeclampsia. (The natural form of salicylate — willow’s bark — is also cautioned against during this time.)

Dr. Marisa Garshick emphasizes that, while it is best to avoid salicylic acid, this recommendation is an extra precaution. Because “such a relatively small proportion is absorbed through the skin, it is unlikely to pose any risk to a developing baby,” Dr. Garshick says. “Some reports say in small or limited areas it is okay at low concentrations (less than 2%), though most experts say to avoid.

Azelaic acid

Azelaic acid is a workhorse when it comes to everything having to do with the skin’s surface appearance, but emerging research suggests that it might also impact testosterone production by disrupting the process that converts this hormone into its more potent form, DHT. While further study is needed, the potential for azelaic acid to impact testosterone in a developing fetus means it is best to avoid this skincare staple while pregnant.

Benzoyl Peroxide

Another go-to acne fighter, the antiseptic known as benzoyl peroxide, is also an ingredient that some doctors recommend steering clear of as there are no specific studies on its use during pregnancy. Although there are experts, Dr. Garshick says, who do “believe, because very little gets absorbed systemically, it may be okay to use in limited areas.”

Essential Oils

While often lauded for their “natural” properties, essential oils are also something to keep an eye on. “Essential oils can be used in moderation during pregnancy, but I recommend avoiding direct contact with skin due to their ability to induce intense skin allergies,” says Dr. Samantha Ellis. She notes that some essential oils like cinnamon, clove, rosemary, and sage “have been touted for their ability to induce contractions, which typically should be avoided until late in the third trimester.”

Neurotoxin Treatments

This is also the time to skip out on your neurotoxin treatments (aka, Botox and fillers), since there have been very limited studies on their effects on pregnancy. Because of this, doctors recommend avoiding injecting toxins into your skin during this time. 

Use Freely

It’s understandable to be cautious about what you’re using on your face and body during fertility treatments and pregnancy, but as long as you keep an eye out for the ingredients to avoid, you should feel comfortable with your preferred skincare regime.

“There are two key things to keep in mind. One, is that we have very few current clinical studies with the use of these products in regard to their safety during pregnancy,” says dermatology nurse practitioner, Allie McAllister. The second is that “very little — like, less than 5% — is absorbed systemically.”

But there are also plenty of high-results ingredients that are completely safe (and effective) to use during pregnancy.

Glycolic acid and lactic acid

Often touted for its exfoliant powers, glycolic acid is a popular ingredient in the fight against acne, but it can also boost the skin’s collagen production and help treat any discoloration issues due to hyperpigmentation or acne-scarring. McAllister notes that while alpha hydroxy acids (AHAs) like glycolic acid have not been studied topically in humans, “In theory much smaller amounts would be absorbed through a topical treatment and would be considered moderately safe during pregnancy.” Lactic acid, another AHA, “is across the board considered a safe option for pregnancy.” 

L-ascorbic acid (or vitamin C)

McAllister also emphasizes that L-ascorbic acid — aka vitamin C — is considered safe during pregnancy and “is something everyone should be using in their AM routine.” A potent antioxidant, L-ascorbic acid can help address conditions ranging from hyperpigmentation to redness and is generally recognized for giving skin that coveted healthy glow. (But don’t forget to be a good label reader and make sure that whatever vitamin C product you use doesn’t also contain hydroquinone, the other common hyperpigmentation ingredient that is on the “avoid” list.)

Hyaluronic acid

Dr. Garshick also recommends hyaluronic acid, which, she explains, “naturally occurs in our skin so it is considered safe for topical use.” This ingredient, which often comes as a serum, is a powerful moisturizing agent that helps skin stay hydrated, dewy, and smooth.   

Niacinamide

Niacinamide is another ingredient doctors often choose for pregnant and breastfeeding patients. A form of vitamin B3 often found in moisturizers and serums, niacinamide is praised for its ability to treat both acne and skin discoloration issues, including hyperpigmentation and rosacea.

And after you have a baby? Experts say just keep doing what you’re doing until you are finished breastfeeding. Then, you can celebrate your skincare freedom with whatever products strike your skin’s fancy!