Acne Treatment During Pregnancy
Not all topical medicines are considered safe for pregnant women. For example, tazarotene (Avage®, Fabior®, Tazorac®), an acne medicine that comes in the form of a gel, cream, and foam, has been classified as a pregnancy Category X medication by the FDA. The FDA assigns medications to pregnancy Category X when they are considered unsafe for use during pregnancy.
Tazarotene belongs to a class of medicines known as retinoids. Retinoids are known for causing miscarriage and serious birth defects, like hydrocephalus (a buildup of fluid in the brain), cleft palate, and heart problems. You've probably heard of isotretinoin (Accutane®, Absorica®, Amnesteem®, Claravis™, Sotret®), the powerful acne medicine approved to treat severe forms of acne. It's also a retinoid. The risk for miscarriage and birth defects from Accutane is so high that a woman must have a negative pregnancy test each month before picking up her prescription.
Accutane is taken by mouth, and probably carries a higher risk for miscarriage and birth defects than topical retinoids. Although the amount of topical retinoids absorbed through the skin is expected to be low, the birth defects caused by them can be so serious, many healthcare providers consider it safest for pregnant women to avoid medicines in this class altogether.
Adapalene (Differin®) and tretinoin (Atralin®, Avita®, Retin-A®) are two other topical retinoids generally not recommended for pregnant women.