Are chemical peels safe during pregnancy?

What does the evidence say about chemical peels during pregnancy?

1. Glycolic and lactic acid peels were rated as safe in a systematic review of cosmetic procedures during pregnancy and lactation, while trichloroacetic and salicylic acid peels were listed to avoid or approach with caution. 1
2. A second review placed chemical peeling in the safe-but-cautious category and concluded that only procedures which are both safe and necessary should go ahead during pregnancy. 2
3. The more serious reactions to alpha hydroxy acid products show up most often with the products that exfoliate hardest, the ones marketed as skin peelers, and FDA logged 114 adverse skin reports for these products between 1992 and 2004 led by burning, rash, swelling, and pigment changes. 3
4. ACOG names topical salicylic acid and glycolic acid among the over-the-counter ingredients acceptable in pregnancy and advises checking anything outside that list with your ob-gyn, which is the line a clinic-strength peel crosses. 4
5. Absorption of a topical product is low through intact skin but rises when the skin barrier is broken or a large area is covered, which is exactly what a peel is designed to do. 5

Is chemical peels safe in each trimester?

• First trimester. The window most clinicians protect. Organ development is underway and the research base here rests on case reports rather than trials, so elective peels are usually pushed later or skipped altogether.
• Second trimester. If a peel happens at all, this is when providers are most comfortable, and only at the light glycolic or lactic end. Say you are pregnant when you book, not when you arrive.
• Third trimester. Skin is more reactive and more pigment-prone now, which raises the odds of a blotchy result. Most people get more from waiting than from squeezing in a session before delivery.