Retinol Room.

Retinol During Pregnancy

The guidance is to stop. Not because topical retinol has been shown to cause harm, but because the evidence needed to say it doesn't cannot ethically be gathered — and dermatology defaults to caution when that is the situation.

By Stephen V.Last updated How we pick

This is the one question on this site where the answer is not a product recommendation, and where the honest version is shorter than most articles make it. Dermatological guidance is to avoid retinoids during pregnancy, including the over-the-counter retinol in a cosmetic serum. The American Academy of Dermatology’s pregnancy skin care advice lists retinoids among the products to avoid, naming isotretinoin, tretinoin and tazarotene alongside over-the-counter skin care containing retinol.

What follows is the reasoning behind that, because understanding why it is phrased the way it is answers most of the follow-up questions people actually have.

The evidence situation, stated plainly

The AAD is unusually candid about this in its guidance on treating acne during pregnancy: researchers do not give pregnant women medications, so there are no studies to tell us what happens when pregnant women use a treatment. What is known comes from animal studies and from women who used a treatment while pregnant.

That is the whole shape of the problem. It is not that topical retinol has been tested and found harmful. It is that the trial which would establish safety cannot be run, so the field reasons from what it does know — that high-dose oral vitamin A derivatives are established teratogens — and applies caution to the topical relatives.

Anyone telling you confidently that cosmetic retinol is definitely dangerous in pregnancy is overstating the evidence. Anyone telling you it is definitely fine is doing the same thing in the other direction. The guidance exists because neither claim can be supported, and because the asymmetry of consequences makes caution the reasonable default.

What the AAD actually says about specific treatments

Its acne guidance is more granular than the general pregnancy advice, and worth knowing if you are trying to keep breakouts under control:

  • Tretinoin (Retin-A): most experts recommend stopping during pregnancy.
  • Adapalene (Differin): most experts recommend stopping during pregnancy. This is worth flagging, because adapalene is the one over-the-counter product in this family that is a regulated drug — see our Differin review for what it is otherwise good for.
  • Azelaic acid: thought to be safe to use during pregnancy; animal studies have not shown birth defects.
  • Benzoyl peroxide and salicylic acid: described as safe in limited amounts or when used for a limited time, with the recommendation to check with your obstetrician or dermatologist first.

The recurring instruction in every one of those lines is to ask your own doctor. That is not a disclaimer added for form’s sake — your history, your medications and your pregnancy are the variables that decide this, and none of them are visible from here.

“I used it before I knew”

This is the most common version of the question, and it is usually asked in a state of some distress. The useful framing: a cosmetic retinol applied to the face is a small topical exposure and a completely different thing from an oral retinoid drug taken systemically. The advice to stop is precautionary, and stopping now is the action available to you.

Tell your obstetrician what you were using, at what strength, and for how long. They have the full picture and the ability to reassure you properly, which an article cannot. Then stop reading forums about it, because they are not a source of information about your pregnancy.

What to do with the routine instead

Pregnancy tends to produce two skin complaints at once: pigmentation, especially the patterned kind, and breakouts. Retinol was the tool for both. Losing it does not leave you with nothing.

Sunscreen, first and by a distance

For pregnancy-related pigmentation, daily broad-spectrum sunscreen does more than any product you could substitute for the retinol. Melasma in particular is driven by UV and visible light, and no topical treatment competes with prevention. Our sunscreen guide covers the practical dose problem, and our melasma page covers why the pattern recurs.

Azelaic acid

The AAD describes azelaic acid as thought to be safe in pregnancy, and the published evidence base outside pregnancy is decent: a 2023 systematic review of 43 randomized trials found it more effective than vehicle for rosacea, acne and melasma, and often equivalent to comparator treatments. Notably, that same review found no eligible trials evaluating it for skin aging — so it is a reasonable substitute for the acne and pigmentation half of what retinol was doing, not the fine-lines half. Our retinol vs azelaic acid comparison sets out the trade properly.

Vitamin C and gentle acids

The AAD’s pregnancy skin care guidance points toward vitamin C in the morning and glycolic acid in the evening for changes in skin color. Both are reasonable, both are available everywhere, and both should still be run past your doctor first. See retinol vs vitamin C and retinol vs glycolic acid for what each one realistically does.

The thing to be skeptical about

Bakuchiol is sold hard as the pregnancy-safe retinol, and that positioning is marketing rather than a safety finding. It is a plant compound with a small, interesting evidence base for retinol-like effects — and no established safety data in pregnancy, because nobody has studied it there either. “Not known to be unsafe” and “known to be safe” are different statements, and the label will not distinguish them for you. Our bakuchiol comparison is deliberately unenthusiastic on this point.

Coming back to it afterwards

When you and your clinician agree the time is right — for many people, once breastfeeding has ended — restart as a beginner rather than resuming where you left off. Tolerance fades, postpartum skin is often drier and more reactive, and a year away is long enough that your old nightly 0.5% will not feel the way it used to.

Two nights a week, a low and clearly-stated strength, moisturizer either side. Our beginner roundup and start-here guide are written for exactly this, and there is no penalty for taking the slow route back.

The bottom line

Stop the retinoid, tell your doctor, and let sunscreen carry the pigmentation work. Use the alternatives your clinician signs off on rather than the ones with the best marketing. And treat the nine months as a pause rather than a loss — retinol’s benefits accumulate over years, and the schedule is forgiving enough to survive a break.

General guidance, not medical advice. Retinol Room is written by an enthusiast, not a dermatologist. For a diagnosis, a reaction, or a prescription active like tretinoin, see a qualified professional. Introduce any new active slowly and patch-test first.

Frequently asked questions

Can you use retinol while pregnant?

The standard dermatological advice is no. The American Academy of Dermatology's pregnancy skin care guidance lists retinoids among the products to avoid, naming both prescription retinoids — isotretinoin, tretinoin, tazarotene — and over-the-counter skin care containing retinol. If you are pregnant or trying to conceive, the sensible move is to stop and tell your obstetrician and dermatologist what you have been using.

Why is retinol not recommended in pregnancy if it's only topical?

Because the evidence that would settle it does not exist and cannot ethically be produced. As the AAD puts it in its acne guidance, researchers do not give pregnant women medications, so there are no trials; what is known comes from animal studies and from women who happened to use a treatment. High-dose oral vitamin A derivatives are established teratogens, and in the absence of data the field extends that caution to topical relatives rather than assuming safety.

I used retinol before I knew I was pregnant. Should I worry?

Stop using it and tell your doctor, but this is a conversation to have rather than a crisis. Topical retinol applied to skin at cosmetic strengths is a very different exposure from an oral retinoid drug, and the guidance to avoid it is precautionary. Your obstetrician has the context and the history to give you a real answer, and this site is written by an enthusiast rather than a clinician.

Is retinol safe while breastfeeding?

The same precautionary logic applies, and the same instruction: raise it with your doctor rather than deciding from an article. Keep any topical retinoid well away from areas an infant's skin or mouth may contact regardless of what you are told about the rest.

What can I use instead during pregnancy?

Talk to your obstetrician or dermatologist first, because your history matters. In its acne guidance the AAD describes azelaic acid as thought to be safe in pregnancy, and its pregnancy skin care advice points toward vitamin C in the morning and glycolic acid in the evening for pigmentation. Broad-spectrum sunscreen does more for pregnancy-related pigmentation than any of them.

What about bakuchiol?

Bakuchiol is marketed heavily as the pregnancy-safe retinol alternative, and that framing runs ahead of the evidence. It is a plant-derived compound with a small number of studies suggesting retinol-like effects on lines and pigmentation, and it has not been established as safe in pregnancy — it simply has not been studied there. Absence of a warning is not a safety finding. Ask your doctor.

When can I start retinol again after pregnancy?

Once you and your clinician agree it is appropriate, which for many people is after breastfeeding ends. Restart as if you were new to it: a low, clearly-stated strength, twice a week, sandwiched with moisturizer. Postpartum skin is frequently drier and more reactive than you remember, and picking up where you left off is the common way to end up flaking.

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