- Over-the-counter retinol and prescription retinoids are very popular skincare products.
- They contain vitamin A, which is linked to birth defects when ingested too much.
As skincare routines get simpler, one product that dermatologists recommend keeping in the rotation is retinol, which stimulates collagen, fades discoloration, and reduces acne. Whether they come in the form of an over-the-counter serum or prescription cream, retinoids are a key part of many people's nighttime regimens.
However, there's a time to cut retinol out completely, according to dermatologists: Pregnancy.
Vitamin A medications have been linked to birth defects
Retinol is a derivative of vitamin A, which is linked to several congenital malformations "involving the central nervous and cardiovascular systems," according to a 2019 study.
For example, there is some evidence that taking vitamin A medications (particularly during the first trimester) may lead to babies developing a condition known as retinoid embryopathy, or physical and mental birth defects, Dr. Joshua Zeichner, an associate professor of dermatology at the Mount Sinai Hospital in New York City, told Insider.
The evidence tying vitamin A to birth defects is the reason Accutane (an oral retinoid used to treat acne) carries a black box warning saying it should not be prescribed to pregnant patients.
It's unclear if retinol, specifically, can cause pregnancy issues
Here's where the science gets tricky: While there's plenty of evidence that taking oral vitamin A medications is tied to pregnancy risks, there isn't direct evidence that topical vitamin A — retinoids — can harm fetuses.
Dr. Ivy Lee, a board-certified dermatologist practicing in Los Angeles, points to a retrospective meta-analysis in 2015 that found there was "no significantly increased risk of adverse outcomes" when pregnant people used retinoids during the first trimester. However, the study concluded that this isn't enough to confidently say retinoids are safe to use while pregnant.
Doctors advise exercising caution, even after giving birth
Zeichner doesn't recommend using retinol during any point in pregnancy and noted that some doctors recommend avoiding retinol when breastfeeding. He said "the theoretical issue" is retinol being absorbed into the bloodstream and transferred into the milk.
Lee emphasized that pregnancy is "naturally a stressful time" and because of the uncertainty around the safety of using topical retinoids, she recommends that patients drop the product temporarily to avoid giving themselves added worry.
You can swap retinol for other products, like vitamin C serum
Zeichner said vitamin C is considered safe to use during pregnancy and has some of the same collagen-boosting, hyperpigmentation-fading benefits. You can also talk to your dermatologist about any skincare products in your routine ahead of or during pregnancy.
After breastfeeding, Zeichner recommends talking to your doctor to figure out when to incorporate retinol back into your skincare routine.