The short list of skincare ingredients to genuinely avoid during pregnancy is smaller than the internet makes it seem. The two with the strongest evidence behind them are retinoids (vitamin A derivatives) and hydroquinone. Beyond those, a handful of chemical additives like certain sunscreen filters, phthalates, and formaldehyde-releasing preservatives deserve a closer look. Most other common skincare ingredients, including several that get flagged in online lists, are considered safe when used topically at normal concentrations.
Retinoids: The Clearest One to Skip
Retinoids are the ingredient family most universally flagged during pregnancy, and for good reason. Oral isotretinoin (prescription-strength vitamin A) causes severe birth defects, including heart, brain, and physical deformities. That much is not controversial. The question gets murkier with topical retinoids, the kind found in over-the-counter anti-aging serums and prescription acne creams labeled as tretinoin, retinol, retinaldehyde, or adapalene.
Topical retinoids absorb very little into the bloodstream. Studies show that applying 0.05% tretinoin cream repeatedly doesn’t change the body’s baseline vitamin A levels. Still, four published case reports describe birth defects consistent with retinoid embryopathy in women who used topical tretinoin during pregnancy. Two prospective studies, one with 96 women and another with 106, found no increased risk of malformations. The evidence is genuinely mixed, but those case reports are enough for most medical organizations to recommend avoiding all topical retinoids until larger safety studies exist.
On product labels, look for: retinol, retinaldehyde, retinyl palmitate, tretinoin, adapalene, tazarotene, or any ingredient with “retin” in the name.
Hydroquinone: High Absorption, Low Data
Hydroquinone is a skin-lightening agent commonly used for melasma, dark spots, and uneven skin tone. It stands out from most topical skincare ingredients because of how much the body absorbs: roughly 35% to 45% of the applied dose reaches the bloodstream. That’s a significantly higher absorption rate than nearly any other ingredient in your skincare routine.
Current studies haven’t shown an increased risk of malformations or adverse effects in pregnant women. But with nearly half the product entering systemic circulation, the precautionary recommendation is to minimize exposure. If you’re treating melasma or hyperpigmentation during pregnancy, safer alternatives exist (more on those below).
Chemical Sunscreen Filters
Oxybenzone, one of the most common UV filters in chemical sunscreens, is classified as an endocrine disruptor. It shows up not just in sunscreens but in cosmetics, moisturizers with SPF, and lip products. Animal research has found that even low-dose exposure during pregnancy and early development can disrupt hormone-sensitive tissue, altering the development of breast tissue in offspring and affecting hormone receptor expression. Some of these changes didn’t appear until later in life, well after the exposure window had closed.
The simplest swap is switching to a mineral sunscreen that uses zinc oxide or titanium dioxide as its active ingredient. These sit on top of the skin rather than absorbing into it, and they’re considered safe throughout pregnancy. You still need sun protection, especially since pregnancy hormones already make your skin more prone to dark spots.
Phthalates in Fragranced Products
Phthalates are plasticizing chemicals used in cosmetics, perfumes, and fragranced skincare to help scent last longer. They’re considered endocrine disruptors and can cross the placental barrier to reach the developing fetus. Research on prenatal phthalate exposure has linked it to lower scores on newborn neurological assessments and reduced mental and motor development measured at six months of age. One study of 350 mother-infant pairs found that higher levels of a common phthalate metabolite at 26 weeks of gestation were associated with nonoptimal reflexes in five-week-old male infants.
The tricky part is that phthalates rarely appear on ingredient labels by name. They typically hide behind the word “fragrance” or “parfum,” which companies aren’t required to break down into individual components. Choosing fragrance-free products is the most reliable way to reduce exposure.
Formaldehyde-Releasing Preservatives
Some cosmetic preservatives work by slowly releasing small amounts of formaldehyde to prevent bacterial and mold growth in the product. Formaldehyde is classified as a carcinogen by both the U.S. Department of Health and Human Services and the World Health Organization, and it’s a potent allergen on top of that.
These preservatives go by names that won’t mean much unless you know to look for them: DMDM hydantoin, imidazolidinyl urea, diazolidinyl urea, and quaternium-15. Check ingredient lists on shampoos, body washes, and moisturizers, where they’re most commonly found.
Salicylic Acid: Safer Than You Think
Salicylic acid ends up on many “avoid” lists because it’s chemically related to aspirin, and high-dose oral aspirin does carry pregnancy risks. But topical salicylic acid in the concentrations found in face washes and acne treatments (typically 0.5% to 2%) acts locally on the skin with minimal systemic absorption. The American College of Obstetricians and Gynecologists lists topical salicylic acid as safe to use during pregnancy. The concern applies to high-concentration chemical peels, not your daily cleanser.
What You Can Safely Use
ACOG specifically lists four over-the-counter active ingredients as safe during pregnancy: topical benzoyl peroxide, azelaic acid, topical salicylic acid, and glycolic acid. That covers a solid acne and brightening routine without needing to reach for anything risky.
Benzoyl peroxide is undetectable in the bloodstream after topical use. The small amount that breaks down gets converted to a compound the body eliminates easily. It’s recommended as a first-line acne treatment during any trimester at concentrations of 2.5% to 5%.
Azelaic acid is one of the most versatile pregnancy-safe actives. It treats acne, calms redness, and reduces hyperpigmentation, making it a practical substitute for both retinoids and hydroquinone. It’s available as a 15% gel or 20% cream, carries an FDA Category B rating (meaning animal studies show no fetal harm), and no adverse fetal effects have been reported in human use. If melasma is your concern, this is the ingredient to look at first.
Glycolic acid and other alpha hydroxy acids are considered safe at concentrations up to 10% with a pH above 3.5. Glycolic acid absorbs minimally through the skin, and while there’s no dedicated pregnancy study for topical use, the low absorption profile is reassuring. It’s effective for dullness, texture, and mild hyperpigmentation.
Vitamin C serums are another option for brightening and evening skin tone during pregnancy. They work topically as antioxidants and are not associated with absorption concerns.
For sun protection, mineral sunscreens with zinc oxide or titanium dioxide remain the go-to. They provide broad-spectrum coverage without the endocrine disruption concerns tied to chemical filters like oxybenzone.
How to Audit Your Current Routine
You don’t need to throw everything out. Pull out your products and scan for retinol or retinoid derivatives, hydroquinone, oxybenzone (sometimes listed as benzophenone-3), the formaldehyde releasers listed above, and the word “fragrance” when it’s not specified as naturally derived. If an ingredient isn’t on the short avoidance list and isn’t entering your bloodstream in meaningful amounts, it’s very likely fine.
The overall picture from the research is reassuring: apart from hydroquinone and topical retinoids, most skincare products are not expected to increase the risk of malformations or other adverse effects on a developing fetus. The goal isn’t a stripped-down routine with nothing in it. It’s swapping a few specific ingredients for effective alternatives that let you keep taking care of your skin through all three trimesters.