Is salicylic acid safe during pregnancy?

What does the evidence say about salicylic acid during pregnancy?

1. Only a small amount of a topical product like this actually reaches your bloodstream, which is why ACOG includes salicylic acid on its short list of over-the-counter acne ingredients that's fine to reach for during pregnancy. 1
2. Regular over-the-counter acne washes and spot gels haven't caused reported problems, but researchers still group salicylic acid with retinoids as an ingredient to use cautiously in pregnancy based on animal research. 2
3. Chemical peels that use salicylic acid are the kind dermatology reviewers say to skip or only do with your doctor's okay during pregnancy, unlike gentler glycolic or lactic acid peels. 3
4. Salicylic acid is one of the first topical options doctors reach for when acne shows up during pregnancy or nursing. 4
5. Salicylic acid still makes the list of topical acne options doctors consider fine during pregnancy, even in the newest reviews of the evidence. 5

Is salicylic acid safe in each trimester?

• First trimester. Hormone shifts can bring on breakouts right when morning sickness hits hardest. A normal-strength salicylic acid wash or leave-on gel is a reasonable first pick, and it's fine to keep using one you already have.
• Second trimester. If breakouts are still showing up, a low-strength wash-off cleanser or leave-on gel is fine to continue. This is a good trimester to skip in-office chemical peels and save anything stronger for after delivery.
• Third trimester. Keep doing what's working for your skin. There's no evidence a normal skincare routine needs to change this late in pregnancy, but check with your provider before adding a new stronger product or an in-office peel.