Benzoyl Peroxide During Pregnancy: Is It Safe?.

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Is it safe to use benzac during pregnancy

 

All rights reserved. Treating acne in pregnancy requires familiarity with FDA medication categories and having thorough discussions with patients. Treating acne in pregnant patients requires being proactive and willing to ask for help, said an expert.

Although it's difficult to find consistent figures, said Jonette E. Keri, M. To set the stage for a healthy pregnancy, she advised getting acne as well-controlled as possible before the patient starts trying to conceive, and managing expectations throughout the treatment process.

On the other hand, we also want to help them. Talk to them at the beginning about these issues," and about the fact that treatment might not clear their skin, but it will help them feel better about their skin during their pregnancy. Along with discussing expectations, Dr. Keri's treatment algorithm includes grading the patient's acne, using whichever grading system one prefers. Her regimen typically includes mild nonabrasive washes containing glycolic acid, plus topical azelaic acid and clindamycin and oral antibiotics.

She also recommends a physical sunscreen. When counseling patients, Dr. Keri covers FDA risk categories. Under the Pregnancy and Lactation Labeling Rule, "The new FDA categories are 'safe in pregnancy,' 'not safe in pregnancy' and 'uncertain safety in pregnancy.

Among first-line topical medications, she recommended those in category B presumed safe based on animal studies versus category C uncertain safety — human and animal studies show no adverse events. Topical agents in the former category include azelaic acid, clindamycin, erythromycin and metronidazole.

Topical retinoids require caution. With tretinoin and adapalene, there have been case reports of otocerebral anomalies and anophthalmia with agenesis of the optic chiasma, respectively. Tazarotene is contraindicated in pregnancy. But if a patient has been exposed to a topical retinoid, you can tell them based on a retrospective study there's a very good chance it will have no effect on the baby.

The best and most widely used example of a category N not classified topical is glycolic acid, said Dr. Category A systemic medications include zinc supplements, recommended at mg daily. Although gastrointestinal disturbances can occur, one study shows no fetal harm from 75 mg daily of elemental zinc.

Excessive zinc amounts, however, can lead to hypocupremia. Category B systemic medications that have been used safely in pregnant patients with acne include cephalexin, cefadroxil, amoxicillin, azithromycin and erythromycin.

Rare cases of pyloric stenosis have occurred in infants exposed to other forms of erythromycin. One study looked at the safety of trimethoprim sulfonamide during the first trimester and found birth defects ranging from cardiovascular abnormalities 1.

When compared to penicillins, cephalexin and no antibiotic exposure, however, trimethoprim sulfonamide had no statistically significant impact on the rate of these abnormalities, or of clubfoot and urinary system defects. A recent review showed a slightly increased risk of spontaneous abortion at less than 20 weeks' gestational age associated with macrolides excluding erythromycin , quinolones, tetracyclines, sulfonamides and metronidazole in early pregnancy.

However, said Dr. Keri, investigators did not consider the severity of patients' infections. Most patients do well with 0. She also recommended combining prednisone with a systemic antibiotic and providing bone and gastrointestinal prophylaxis for pregnant patients on prednisone. Treating pregnant patients with acne often requires asking for help, Dr.

Keri added. Are you comfortable with a steroid medication? An antibiotic? Guidance can come from other dermatologists as well. Keri said. New FDA categories also characterize the safety of drugs during lactation. Or have her ask her pediatrician. Keri's take-home message is that "There are some very safe treatments that you can use during pregnancy. The ones people will probably feel most comfortable with are glycolic acid or benzoyl peroxide washes.

Don't be afraid to treat. But if you don't want to treat pregnant patients, send them to somebody who will. Acne in pregnancy. March 16, John Jesitus. Category C agents generally considered safe in pregnancy include the following: Benzoyl peroxide — Systemic absorption is minimal, and benzoyl peroxide is metabolized to benzoic acid a food additive in the skin, according to a review. Salicylic acid — Low-dose aspirin is used to treat preeclampsia.

The key in acne is to use low concentrations over limited body surface areas, said Dr. Topical dapsone — Oral dapsone has been used to treat dermatitis herpetiformis in pregnancy, according to a report ; topical dapsone is likely safe but studies are lacking.