Acne is a chronic inflammatory disease of the skin, which affects most of us at some stage in our lives. According to American Academy of Dermatology, acne is the most common skin condition in the United States, affecting up to 50 million Americans annually; Acne occurring in adults is increasing, affecting up to 15 percent of women. Women during pregnancy have significant hormonal changes, which may directly affect skin conditions. According to a report in the Archives of Dermatology, over 29% of the pregnant women reported that their acne got worse.
Understanding the causes of acne and its physical conditions could be very helpful for acne prevention and treatments. In addition, knowledge of drug facts can help to choose safe acne treatments during pregnancy.
Most common causes of acne
Hormones are influenced by many of your lifestyle choices and the stages of life. They are one of the key elements that you see on the path of having problematic skin.
Hormones change with your stages of life, and also with stress and diet.
- Skincare routine
Improper skin care routine, such as using high PH cleansers (e.g. soap bar) and pore blocking makeups, may raise acne issue.
The acid mantle is a slightly acidic layer of the skin. It is our body’s first defense mechanism against bacteria and fungus. This layer has a pH of 5.5 for adult and 7 for child.
When skin maintains at the PH level around 5.5 the acne-causing bacteria grow slowly. Higher PH may help bacteria grow faster on the skin. Besides that, higher PH may increase sweat production; the skin will feel dry and produce more oil.
- Candida overgrowth
Candida or a yeast overgrowth may also possibly cause or aggravate a pre-existing acne condition. Candida overgrowth can occur as a result of repeated, chronic antibiotic use for acne which also kills the beneficial bacteria that can limit the growth of candida.
Drug-induced acne is an adverse effect of a series of systemic drugs, eg. corticosteroids, lithium, vitamin B12, thyroid hormones, halogen compounds (iodine, bromine, fluorine, and chlorine), antibiotics (tetracycline and streptomycin), antituberculosis drugs (INH), lithium carbonate, antiepileptic drugs (phenobarbital and hydantoin derivatives), cyclosporin A, antimycotics, gold salts, isotretinoin, clofazimine, epidermal growth factor receptor inhibitors (cetuximab, gefitinib, and erlotinib), and interferon-beta.
How to prevent or treat acne?
Maintain healthy skin acid mantle PH level
Scientific studies show that skin PH of acne patients are higher than skin PH of normal references. In their study, normal skin PH has a mean value of 5.09, acne skin PH has a mean value of 6.35. Maintain a proper PH level of skin acid mantle is the first step of defense to acne.
- Avoid alkaline cleansers, such as soap bar, not well PH balanced gel or milky cleansers. Cleansing oil is one of the good choices of everyday cleansing, as most of the oil ingredients used in the cleansing oils are slightly acidic. One study used PH=5 oil in water emulsion to treat skin. The tested pH 5 O/W emulsion seems to improve regeneration and stabilization of skin acid mantle PH.
- Use a moisturizer with PH level 4.5-5.5. ByNatural moisturizers are all have PH levels from 5.3 to 5.5.
Over the counter medical treatments
Safe topical treatments:
Azelaic acid is Azelaic acid is a naturally occurring dicarboxylic acid with antimicrobial, comedolytic, and mild anti-inflammatory properties. It is safe to be used in pregnancy. Azelaic acid products.
Benzoyl Peroxide has antimicrobial, comedolytic, and anti-inflammatory properties. Benzoyl peroxide is considered safe during pregnancy. Benzoyl Peroxide topical products.
Unsafe topical treatments:
Topical Retinoids has been used to treat acne for over 30 years. Due to its high topical absorption rate, retinoids are not safe to be used during pregnancy.
Topical Dapsone is synthetic sulfone with antimicrobial and anti-inflammatory properties. It is approved for acne treatment in 2005. It should be prescribed during pregnancy.
Salicylic Acid is the most used over the counter treatment ingredient. Due to higher systemic absorption (9–25%), and an association between the use of anti-inflammatory medications in the third trimester and adverse effects to the developing fetus, it is not recommended for use during pregnancy. Salicylic topical products are available in most pharmacies and department stores.
Oral treatments including antibiotics, oral corticosteroids, oral retinoids and zinc. Zinc at a level of 75mg/day is safe for pregnancy. Retinoids are restricted and unsafe during pregnancy. Other oral treatments need to be prescribed.