salycic acid and pregnancy

Salicylic Acid in Pregnancy: Is It Safe?

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Question Many of my female patients complained about acne, unwanted hair growth, and other skin problems are just growing since they became pregnant. Are the products used for this type of benign skin condition that is safe for use in pregnancy, such as it is understandable that women want to see the best at this important time in their lives?

Answer With the exception of hydroquinone, which has a relatively high level of systemic absorption, and tretinoin, which is evidence of a controversial, these products act locally and therefore produce minimal systemic level. As a result, in many cases women can handle unattractive cosmetic skin conditions without compromising the safety of their children who have not been born.

Question Plusieurs de mes se patientes plaignent d'avoir de l'acne, des Poils indésirables et d'autres problèmes de peau qui ne sont que depuis leur apparus grossesse. Est-ce que l'utilization des produits pour ces problèmes habituels dermatologiques bénins sécuritaire Durant est la grossesse, étant donné qu'il est que les femmes souhaitent understood avoir durant cette belle apparence de leur vie importante period?

responses À l'exception de l'hydroquinone, dont le taux d'absorption systémique est relativement Eleve, et de la tretinoin, au sujet de laquelle les données sont probantes controversées, ces produits et produisent des agissent localement niveaux systémiques Minimes. Par consequent, dans la plupart des cas, les femmes peuvent prendre en charge ces problèmes de peau non attrayants sur le plan Cosmetique compromettre sans la sécurité de l'enfant à naître.

The woman experiences during pregnancy many physiological changes, including increased levels of androgens. This may lead to the development or worsening of acne vulgaris and increased hair growth in various parts of the body.

topical treatment options for acne often include retinoids, antibacterial, and agents such as benzoyl peroxide and salicylic acid. Other agents are used to improve the appearance of skin, or used in the maintenance of skin, including the following: hydroquinone is found in skin lightening agent; avobenzone, Octinoxate, and oxybenxone found in sunscreens; and dihydroxyacetone found in self-tanning agent. Topical agents are commonly used to eliminate or reduce the appearance of hair including thioglycolic acid salts and sodium, calcium, and potassium hydroxide found in depilatory creams, or hydrogen peroxide which is found in hair bleaching creams. , - gift absorption of topical agents

The absorption of the product following topical use

The amount of drug absorbed from the skin while using this product is very low; However, there were four reports published in the literature cases of birth defects associated with the use of topical tretinoin, which is consistent with the retinoid embryopathy. Topical retinoids role in this case is still controversial - as the two prospective studies that examined the use during the first trimester of pregnancy by 96 and 106 women found no increased risk of major malformations or retinoid embryopathy evidence, however, until. collected data on a large cohort, women should not be encouraged to use topical retinoids during pregnancy.

Clindamycin and erythromycin are used either alone or in combination with other agents as a topical treatment of acne. A surveillance study examining the use of oral or topical clindamycin reported no increased risk of malformations among 647 women with first-trimester use. Similarly, there is a tribe no increase in adverse outcomes documented in several studies evaluating the systemic use of clindamycin in the second or third trimester of pregnancy., In addition, the use of oral erythromycin in pregnancy has not been associated with teratogenic in several thousand women.

When benzoyl peroxide is applied, only 5% is absorbed through the skin, and then completely metabolized to benzoic acid in the skin and is excreted unchanged in the urine., there are no studies on the use of this preparation in pregnant patients has been published; However, the systemic effects on pregnant women and children would not be expected and therefore use this product during pregnancy will not be a concern.

Topical salicylic acid is an ingredient in a number of cosmetics and acne products and systemic absorption varies. A number of large studies have beenpublished in which researchers examined the results of the women who had been taking low-dose acetylsalicylic acid during pregnancy and no increase in baseline risk of side effects, such as major malformations, premature birth, or low birth weight. No studies have been done on pregnancy in topical use; However, as a relatively small proportion is absorbed through the skin, it is unlikely to pose any risk to the developing baby.

Glycolic acid is an alpha hydroxy acid found in many cosmetics that are used to treat acne. There are several animal studies show adverse reproductive effects when glycolic acid given in high doses, much larger than those used in topical cosmetic product in humans. Studies examining the use of glycolic acid in human pregnancy has not been done; However, using a topical glycolic acid during pregnancy does not have to be a concern, because only minimal amounts are expected to be absorbed systemically.

Hydroquinone is used clinically as a topical depigmentation agents for conditions such as chloasma and melasma, and use cosmetics as a skin-whitening agent. It is estimated that 35% to 45% is absorbed systemically following topical use on humans. A single study has been published involving the use of hydroquinone during pregnancy without increased side effects; However, the sample size was small pregnant women. Based on available data, the use of hydroquinone during pregnancy apparently not associated with increased risk of major malformations or other adverse effects. However, because of the large absorption compared to other products, it is best to minimize exposure until further studies can confirm the safety.

Sunscreen is used generally to protect the skin from the sun's harmful rays, and have been found to cause little toxicity in animals. The products have very limited dermal or systemic absorption. Sunscreen has been used in pregnancy to treat or prevent melasma, and side effects have not been reported.

Dihydroxyacetone is an additive color found in self-tanning products to produce an artificial tan. Color develops following topical application as dihydroxyacetone binding amino acids in the stratum corneum. These products contain dihydroxyacetone in concentrations ranging from 1% to 15%, and when applied topically, systemic levels are minimal (0.5%); Therefore, use during pregnancy will not be a concern.

When addressing the issue of hair removal, or reduce the appearance of hair, various topical agents available, such as depilatory creams and hair-bleaching. According to Health Canada guidelines, thioglycolic acid allowed in depilatory products at a concentration equal to or less than 5% with a pH of 7 to 12.7.

Sodium, calcium, and potassium hydroxide, which is also found in depilatory creams, disassociate into sodium, calcium, potassium and hydroxide ions. These ions are found abundantly in the body, and the amount of these chemicals found in consumer products coming into contact with the skin will be negligible, especially compared with the average daily food intake. Moreover, even though they may penetrate the skin, systemic absorption of these ions is minimal and therefore they do not increase serum levels and would not be considered a problem to use during pregnancy.

In an in vitro study involving human skin, hydrogen peroxide was detected in the dermis only after the application of high concentrations of hydrogen peroxide for several hours. However, because the cosmetic products such as hair bleaching creams containing low concentrations of hydrogen peroxide, it is unlikely that a large number of absorbed after topical application. In addition, once absorbed, hydrogen peroxide is rapidly metabolized. Therefore, the use of this product during pregnancy is not expected to be a concern when done in moderation.

Regardless of hydroquinone (absorbed systemically in large enough quantities and should be used very sparingly) and topical retinoids (because of case reports intrusive), skin care products are not expected to increase the risk of malformations or other adverse effects on the the developing fetus. As a result, pregnant women can look the best without compromising the health of their children unborn.

Motherisk questions are prepared by the Motherisk Team at the Hospital for Sick Children in Toronto, Ontario. Dr Chua-Gocheco is a member of and Ms. Bozzo is Assistant Director of the Motherisk Program. Ms. Einarson continues to be a member of the Motherisk team as a consultant.

Do you have any questions about the effects of drugs, chemicals, radiation, or infection in women who are pregnant or breast-feeding? We invite you to send them to the Motherisk Program by fax at 416 813-7562; they will be addressed in future Motherisk Update.

Published Motherisk Updates are available on the Canadian Family Physician website () and also on the Motherisk website ().

Competing interests

Not stated

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