Retinoid gels and creams (‘topical retinoids’)

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Date: October 2024, Version 5.0

Quick take

Retinoid creams and gels should not be used in pregnancy. 

What are they?

Prescribed skin creams and gels that contain retinoids like tretinoin (Aknemycin®, Treclin®) or adapalene (Differin®, Epiduo®) are mainly used to treat severe acne.

Benefits

What are the benefits of using topical retinoids in pregnancy?

Although retinoid creams and gels can be an effective treatment for acne, they should not be used in pregnancy.

Risks

Are there any risks of using topical retinoids during pregnancy?

Possibly. Use of topical retinoids in pregnancy should be avoided as a precaution because:

•    It is well-known that the much higher doses of these medicines taken in tablet form can cause miscarriage and birth defects.

•    While only tiny amounts are likely to reach the baby when these products are applied to the skin as recommended in the instructions, some women will absorb the medicines in creams and gels better than others. 

•    Most reports of women who used topical retinoids in pregnancy show that their babies were unaffected, but there are also case reports of babies with birth defects. It is not yet possible to rule out that these birth defects were caused by the retinoids.

Alternatives

Are there any alternatives to using topical retinoids in pregnancy?

Yes. Creams and gels with active ingredients that are not retinoids can also be used to treat acne and will not harm your baby.

No treatment

What if I prefer not to use medicines to treat acne during pregnancy?

It is likely to be safe to stop acne treatment during pregnancy. Speak to your doctor or specialist if you need further advice.

Will my baby need extra monitoring?

Women in the UK will be offered a very detailed scan at around 20 weeks of pregnancy as part of routine antenatal care. No extra monitoring for major birth defects is required following topical retinoid use in pregnancy. 

Are there any risks to my baby if the father has used topical retinoids?

We do not expect any increased risk to your baby if the father uses topical retinoids. 

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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