A COMMON-SENSE GUIDE TO SKINCARE IN PREGNANCY

Being pregnant is a precious, terrifying, and thrilling time, when your hormones are vacillating like a metronome and everyone you know is doling out unsolicited advice. Between the "wisdom" being passed down from aunts you've never met to all the pregnancy information on the interwebs, you could work yourself into a frothing, worried frenzy before the pee dries on the stick. So, take a breath and start with this reminder: pregnancy is a time for celebration, and for finding as many ways to nurture yourself and that sweet peanut as you possibly can!

Looking for products that are safe to use during pregnancy?

Of course, you want to keep yourself and your baby safe. You'll do your homework and exercise caution with sushi and unpasteurized cheeses, as you should. You'll wear sensible shoes in the wintertime, and drink extra water in the summer. And, you'll research skin care products, and probably be left scratching your head, wondering how on earth to decide what’s safe and what isn't.

The simple truth is that there is no standardized set of rules to guide you. So, I've used my doctor brain to do the homework and create some rules. I’ve analyzed the (few) available studies and the most reliable sources of information on the topic. I’ve left out fearmongering - I’ll just let the science speak for itself.

What to Avoid

This is the easy part. We have learned so much in the last decade about the effects of certain chemicals on the body. The ingredients with the most potential for harm to you and your developing baby fall into a few categories, listed below.

THE ENDOCRINE DISRUPTORS

Endocrine disruptors are ingredients that interfere with the normal function of our endocrine glands, which include the ovaries, testes, thyroid, parathyroid, thymus, adrenals, pineal, pituitary, hypothalamus, and pancreas. Skincare ingredients proving disruptive to these glands include parabens, phthalates, BPA, triclosan, and nonylphenol. Skincare companies use these chemicals for various reasons: preservation (parabens), fragrance (phthalates), packaging (BPA), surfactants (nonylphenol ethoxylates) and antibacterial effects (triclosan). To be fair, these were not always known to be toxic, and serve worthy purposes: everyone wants a bacteria-free product that smells good! But times are changing, and we need to evolve with the science. These ingredients should be avoided in personal care products - in pregnancy, and always. Specifically, there is mounting confirmation that these EDCs (endocrine-disrupting chemicals), absorbed through the skin, accumulate in human blood and tissues over time and have hormone-disrupting effects. Some (parabens) have been shown to decrease birth weight and gestational age at birth, and to shorten menstrual cycles in non-pregnant women. Others (phthalates) have been linked to thyroid dysfunction, endometriosis, and possibly autism. * These are compelling reasons to switch to natural skin care products during your pregnancy - and beyond. (You should tell your fella to stop using synthetic fragrance, too - phthalates may decrease sperm count and quality!)

THE SKIN IRRITANTS

This category comes down to three words: sodium lauryl sulfate. As someone who has suffered with and become an expert in facial dermatitis, I can tell you this pesky chemical causes more trouble than you can imagine - and it’s in everything that foams. It’s found in laundry detergent (even natural brands!), toothpaste (even natural brands!), shampoo (even… okay, got the idea?), face wash, and body wash. It causes, contributes to, or exacerbates dermatitis (all forms), eczema, and psoriasis. Sometimes you’ll see sodium laureth sulfate, a gentler form of this surfactant, but don’t be fooled: not only does it cause dermatitis, it has also been ethoxylated.

THE SNEAKY TOXINS

When I think of toxic things that could sneak into the skin care routine of even an educated consumer, I think of the word ethoxylation. It’s a hard concept to explain without substantial risk of making your eyes glaze over, but ethoxylation involves being treated with ethylene oxide, a gnarly carcinogen. The reaction creates a by-product called 1,4-dioxane, which is a likely contaminant in any ethoxylated ingredient. 1,4-dioxane is not only a potential carcinogen for you and your family, it’s a bio-accumulative, environmental toxin on par with microplastics and nanoparticles. (It’s harder to pronounce, so it doesn’t get as much press.) By using ethoxylated ingredients, you’re not only putting yourself at risk, you’re impacting the environment every time those ingredients wash down your drain. The easiest way to avoid them is to avoid ingredients that end in “eth” (sodium laureth sulfate), have dashes and numbers (polysorbate-20), or have the letters PEG in the name. Also, look for an ingredient called Emulsifying Wax NF - even some companies using it probably don’t know it’s ethoxylated!

THE OTHER STUFF

Synthetic colors and petrochemicals are two categories I recommend avoiding, but the evidence is not as strong. FD&C colors are under investigation for links to behavioral disturbances and allergy syndromes, but hard data remains to be established. (The anecdotal evidence is concerning, though.) Regarding petrochemicals, there is sufficient evidence to support avoiding the aggro ones like polycyclic aromatic hydrocarbons (think gasoline, coal, tar) during pregnancy, but no evidence that a little petroleum jelly or mineral oil will harm a developing fetus. This choice may involve more ethical and lifestyle considerations than toxicological ones.

OSMIA PRODUCTS SAFE FOR PREGNANCY AND NEWBORNS 

No essential oils used.

OSMIA PRODUCTS GENERALLY CONSIDERED SAFE DURING PREGNANCY 

Low concentrations of pregnancy safe essential oils or rinse-off applications.

All body soaps
All facial soaps
Purely Simple Face Cream
Restore Facial Serum
Brighten Facial Serum
Balance Facial Serum
Purely Gentle Mud Cleanser
Lip Repair
Himalayan Body Buff
Adzuki Nourishing Mask
Nectar Nourishing Drops
Serenity Milk Bath
Recovery Salt Bath
Lavender Body Mousse
Sandalwood Body Mousse
Water Body Oil
Sunset Body Oil
Night Body Oil

USE SPARINGLY DURING PREGNANCY

Some of these oils are cautioned against, although there are no significant studies to support the warnings.

Spotless Blemish Oil 
Light Body Oil 
Rosemary Body Mousse 

WHAT TO USE INSTEAD

Use beautiful, natural skincare, like the products in the above chart, and stick to a less-is-more philosophy. Your body is experiencing huge, internal chemical shifts during pregnancy - not a great time to change up your skincare routine frequently. If you’re looking for a quick, effective way to decrease the number of chemicals you’re being exposed to, start with the products that cover the largest surface area. Switch from body wash to an organic bar of soap, and from body lotion to body oil on wet skin. Why? Read this.

Here are a few pregnancy-specific skin concerns that come up frequently:

STRETCH MARKS

Ask your mom if she has them. That’s all that matters. You can apply shea butter to your belly to keep the skin supple and relieve itching, but if your mom had stretch marks, you may get them, too. Genetics win.

MELASMA

Huge, dorky hats and sunscreen are your best friends. For the sunscreen, look for a mineral-based, unscented sunblock with no parabens, and apply daily - especially to melasma-prone areas like the forehead, cheeks, upper lip, and edges of the face. After you deliver, if you still have melasma, you can work with your dermatologist for solutions.

ACNE

It’s so unfair. You’re moody, you feel fat, AND you get zits? Because you don’t have the option of resorting to big guns like Retin-A, antibiotic, benzoyl peroxide or salicylic acid, you really have to focus on cleaning up your diet, stress management, and not touching your face! (Here are some more tips for managing acne naturally.)

THINGS THAT ITCH

Skin gets itchy during pregnancy for lots of reasons. The simplest is just dry skin, easily remedied by a balanced diet (don’t skip the healthy fats), water consumption, and taking care of your skin with gentle dry-brushing and natural products. Persistent itching of the palms and soles could indicate liver issues, so you should see your provider. Hives or itchy bumps all over could indicate PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy) - not scary, despite the title, but super annoying. For all itchy skin conditions, hot water will exacerbate things, so stick to lukewarm showers and baths until it resolves.

Lastly, remember that your mom probably did some stuff way more scary than anything in this article while she was pregnant with you, and you turned out just fine. Use these rules as a guide, do all things in moderation, and focus on the miracle in your belly - it’s the coolest thing a human body can do.

With much love for your growing belly from us to you, 

A version of this article was first published in Well + Good NYC - see it here!

References:

• Jeddi MZ, Janani L, Memari AH, Akhondzadeh S, Yunesian M. The role of phthalate esters in autism development: A systematic review. Environ Res. 2016 Aug 24;151:493-504
• Nishihama Y, Yoshinaga J, Iida A, Konishi S, Imai H, Yoneyama M, Nakajima D,Shiraishi H. Association between paraben exposure and menstrual cycle in femaleuniversity students in Japan. Reprod Toxicol. 2016 Aug;63:107-13.
• Geer LA, Pycke BF, Waxenbaum J, Sherer DM, Abulafia O, Halden RU. Association of birth outcomes with fetal exposure to parabens, triclosan and triclocarban in an immigrant population in Brooklyn, New York. J Hazard Mater. 2016 Mar 11. doi:pii:S0304-3894(16)30250-3. 10.1016/j.jhazmat.2016.03.028. 
• Ozaki H, Sugihara K, Watanabe Y, Ohta S, Kitamura S. Cytochrome P450-inhibitory activity of parabens and phthalates used in consumer products. J Toxicol Sci. 2016;41(4):551-60. 
• Ihde ES, Loh JM, Rosen L. Association of environmental chemicals & estrogen metabolites in children. BMC Endocr Disord. 2015 Dec 17;15:83. doi:10.1186/s12902-015-0079-1. Erratum in: BMC Endocr Disord. 2016;16:6. 
• Smarr MM, Kannan K, Buck Louis GM. Endocrine disrupting chemicals andn endometriosis. Fertil Steril. 2016 Jul 15.
• Huang PC, Tsai CH, Liang WY, Li SS, Huang HB, Kuo PL. Early Phthalates Exposure in Pregnant Women Is Associated with Alteration of Thyroid Hormones. PLoS One.2016;11(7):e0159398. 
• Kano H, Umeda Y, Kasai T, Sasaki T, Matsumoto M, Yamazaki K, Nagano K, Arito H, Fukushima S. Carcinogenicity studies of 1,4-dioxane administered indrinking-water to rats and mice for 2 years. Food Chem Toxicol. 2009Nov;47(11):2776-84. 
• Xu X, Cho SI, Sammel M, You L, Cui S, Huang Y, Ma G, Padungtod C, Pothier L, Niu T, Christiani D, Smith T, Ryan L, Wang L. Association of petrochemical exposure with spontaneous abortion. Occupational and Environmental Medicine. 1998 Jan; 55(1): 31-36