Concerns About Using Retinol and Acne Injections During Early Pregnancy

The use of retinol (vitamin A) and acne injections during pregnancy is not recommended?

Hello Doctor, I have irregular menstrual cycles, and my cycles are long due to polycystic ovary syndrome (PCOS), which makes me prone to acne and difficult to conceive.
My period was expected on April 13 (my cycle length is about 37 days, so April 13 would be the 38th day according to my calendar app).
After taking a pregnancy test, I found out I was pregnant.
During a visit to the obstetrics and gynecology department, an abdominal ultrasound confirmed the presence of an embryo, and the doctor mentioned that I am currently within 4 weeks, so the gestational age cannot be determined yet.

Prior to knowing I was pregnant, I used a 0.1% topical retinol until I discovered the pregnancy, applying it mainly on my face, including my forehead, cheeks, and chin, once a day.
Additionally, on April 8, I visited a dermatologist for acne injections (a total of 4 large acne spots) and applied a gel called Adapalene.
Since learning about my pregnancy, I have stopped using all these products, but I am very concerned.

I would like to ask if there could be any effects on the baby (such as teratogenic effects) due to these prior treatments.
Are there any specific items or additional precautions I should be aware of for my subsequent prenatal check-ups? Thank you, Doctor.

Xiao Miao, 20~29 year old female. Ask Date: 2024/04/17

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description, the likelihood of impact may be low.
However, I recommend discussing the dosage with your treating physician and undergoing a detailed prenatal examination.
Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2024/04/17

More Info

Using retinol and acne injections during early pregnancy raises valid concerns, especially considering the potential effects on fetal development. Retinol, a derivative of vitamin A, is known for its effectiveness in treating acne and other skin conditions. However, it is also classified as a teratogen, meaning it can cause birth defects if used during pregnancy. The FDA categorizes retinoids, including topical retinol, as Category X, indicating that studies in animals or humans have demonstrated fetal abnormalities, and the risks involved in use during pregnancy clearly outweigh any potential benefits.

In your case, since you were using a 0.1% topical retinol until you discovered your pregnancy, it's important to note that the risk of teratogenic effects is primarily associated with systemic exposure to high doses of vitamin A, rather than topical application. However, caution is still advised. The general recommendation is to avoid all forms of retinoids during pregnancy, especially in the first trimester when the fetus is most vulnerable to developmental issues.

Regarding the acne injections you received, it depends on the specific medication used. If the injections contained corticosteroids or other non-teratogenic substances, the risk may be lower. However, if they involved any retinoid-based treatments, similar caution applies. Since you mentioned using a gel (雅若凝膠), it would be essential to check its active ingredients to determine if it poses any risk.

As for your concerns about the potential impact on your baby, it is understandable to feel anxious. The best course of action is to maintain open communication with your healthcare provider. They can monitor your pregnancy closely and may recommend additional ultrasounds or screenings to ensure the baby's development is on track. Regular prenatal visits are crucial, and you should inform your obstetrician about your previous use of retinol and any other medications.

In terms of additional precautions, consider the following:
1. Prenatal Vitamins: Ensure you are taking prenatal vitamins that contain folic acid, which is essential for fetal development and can help reduce the risk of neural tube defects.

2. Healthy Lifestyle: Maintain a balanced diet, stay hydrated, and engage in regular, moderate exercise as advised by your healthcare provider.

3. Avoid Harmful Substances: Stay away from alcohol, tobacco, and any recreational drugs, as these can adversely affect fetal development.

4. Skin Care: Opt for pregnancy-safe skin care products. Many brands offer formulations specifically designed for pregnant women that avoid harmful ingredients.

5. Monitor Symptoms: Keep track of any unusual symptoms or changes in your health and report them to your doctor promptly.

6. Emotional Support: Pregnancy can be a time of heightened anxiety, especially with concerns about fetal health. Consider seeking support from friends, family, or professional counselors if needed.

In summary, while the use of retinol and acne injections during early pregnancy can be concerning, the actual risk may vary based on the specific products used and the extent of exposure. The best approach is to consult with your healthcare provider, who can offer personalized advice and reassurance based on your unique situation. Regular prenatal care will help ensure the health and well-being of both you and your baby.

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