Retinol is an ingredient found in scores of over-the-counter skin care products. You might not think twice about using topical products containing retinol during pregnancy. But this common ingredient may be harmful to your developing baby.

Read on to learn more about retinol and pregnancy, and for ideas about safe alternatives you can use while pregnant.

Retinol is a retinoid subtype derived from vitamin A. Unlike retinoids that require a prescription, retinol is sold over the counter as an ingredient in skin creams, gels, serums, lotions, and more.

Retinol has pro-aging and anti-acne effects. Retinol works by boosting the production of collagen and elastin deep within the inner layer of skin (dermis). Increased collagen may reduce fine lines and wrinkles, and may make mature skin look smoother.

Retinol also works to exfoliate surface skin by removing dead skin cells, debris, and bacteria, which can help with blemishes.

Fetal retinoid syndrome and oral retinoids

Never take prescription oral retinoids — such as isotretinoin (brand names: Absorica, Absorica LD, Claravis, Amnesteem, Myorisan, or Zenatane and formerly called Accutane) — during pregnancy.

These medications, prescribed to treat cystic acne, may lead to a condition called fetal retinoid syndrome that causes serious birth defects.

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Retinol use is not recommended during pregnancy.

Do take your prenatal vitamins and eat a well-balanced diet including foods that contain beta carotene (from dark leafy greens or red, orange, and yellow vegetables), which is a safe form of vitamin A. If you are pregnant, always ask a doctor or healthcare professional before you take any supplements.

Vitamin A is a fat-soluble vitamin that is essential for supporting fetal growth. It supports fetal eye health, the immune system, and skeletal growth.

When you ingest vitamin A or vitamin A derivates, such as retinol it crosses the placenta and is absorbed by the fetus.

So, why is retinol use during pregnancy discouraged?

Vitamin A can build up to toxic levels if you have too much in your system. Excess amounts get stored in the body’s fatty tissue and liver rather than being eliminated daily.

Even though retinol is used topically – on your skin, it can be absorbed into the bloodstream and may contribute to vitamin A toxicity.

It’s not fully understood how much vitamin A that a developing fetus needs or at what point this important nutrient becomes harmful.

Out of an abundance of caution, most doctors recommend eliminating the use of retinol products during pregnancy for this reason. They may also recommend that you stop using retinol while you are trying to conceive and while you are nursing.

I’ve been using retinol creams, and I’m pregnant and worried. What should I do?

If you’ve been using retinol products and you’re pregnant, don’t panic. Chances are good that you haven’t overdone it and don’t need to worry.

Talk with your doctor or healthcare professional about your concerns.

However, out of an abundance of caution, stow your retinol products away for future use or give them to a friend.

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Retinol used in over-the-counter products has not been shown to cause birth defects.

However, medications containing retinoids, like isotretinoin (brand names: Absorica, Absorica LD, Claravis, Amnesteem, Myorisan, or Zenatane and formerly called Accutane), have been shown to cause a condition in the fetus called fetal retinoid syndrome (FRS) that may cause serious birth defects.

If you take these medications, your doctor will require that you participate in the iPLEDGE program to avoid pregnancy.

FRS causes a range of physical and mental developmental issues. They can vary from mild to severe.

Issues caused by FRS include:

  • growth delays before birth or during infancy
  • skull and facial malformations (craniofacial), including cleft palate and hypertelorism (widely spaced eyes)
  • small, low set ears, missing ears, and hearing loss
  • central nervous system issues, such as hydrocephalus
  • developmental delays and learning disabilities
  • microcephaly
  • heart abnormalities
  • issues with the renal gland, thymus gland, and parathyroid gland

Because of these known risks from oral retinoids, doctors recommend that you avoid products containing retinol as well during pregnancy. The exact level of risk to the fetus from retinol use is unclear.

There are many products that contain alternative ingredients you can swap out for retinol during pregnancy.

These include:

  • glycolic acid, an alpha-hydroxy acid that exfoliates the skin and has acne benefits
  • azelaic acid, another acne treatment that contains anti-inflammatory and antimicrobial properties
  • hyaluronic acid, which can help reduce wrinkles and hydrate skin

All-natural moisturizers with ingredients like green tea, aloe vera, and shea butter can also help keep skin soft and well moisturized during pregnancy.

Read the ingredients list on every product before you buy and use to make sure it’s safe during pregnancy.

It’s not clearly known whether retinol is safe to use while breastfeeding. For that reason, it’s not recommended.

If you’re not nursing, you can resume using retinol after your pregnancy ends.

The topical use of retinol and retinoids may contribute to high levels of vitamin A in the body. During pregnancy, this may cause serious harm to a fetus. Oral use of retinoids significantly increases this risk.

Fetal retinoid syndrome (FRS) is a condition caused by taking retinoids during pregnancy. FRS can cause physical and mental developmental issues in a baby.

Currently, there’s no clear understanding of how much retinol is safe during pregnancy. For that reason, it’s recommended that pregnant people avoid the use of products that contain retinol while they are pregnant and nursing.