Before we talk about what to expect when you’re expecting, please let your Curology provider know if you decide to try to conceive, learn that you’re pregnant, or are breastfeeding if you are a current Curology subscriber. Meanwhile, stop using your Curology personalized prescription formula until you speak with your medical provider—not all skincare ingredients are confirmed to be safe for use during pregnancy or breastfeeding.

Welcoming a new life into the world can be a thrilling time—but one that isn’t without its surprises, especially as your body enters the postpartum period. Many people anticipate sleepless nights after giving birth, but they might not expect to experience postpartum acne.

The thing is, it’s very common! Nearly 90 percent of pregnant people experience skin changes which frequently include pigmentation changes, stretch marks, and, of course, acne.¹ Here we’ll explain the most common sources of postpartum acne and some of the best oral and topical acne treatments available to fight it. 

Causes of postpartum acne

Your body goes through a lot of changes during pregnancy—your skin included! Skin changes can be frustrating, but the good news is, with time and patience things often return back to normal post-pregnancy. There may be a few changes that become permanent, but acne usually isn’t one of them.

Changing hormones

The acne experienced during and after pregnancy is often hormonal acne. During this time, your hormones are shifting through the various stages, which may cause fluctuations that affect your skin. 

The high levels of estrogen and progesterone during pregnancy are believed to cause changes in skin pigmentation.² And elevated progesterone levels have been known to aggravate acne by increasing oil (sebum) production.³ Sebum is your skin’s natural oil that’s made and secreted by the sebaceous glands. It helps your skin stay hydrated and protected but it can sometimes be a case of too much of a good thing. 

Studies linking progesterone to postpartum acne are few and far between for one glaring reason—pregnant and postpartum women aren’t typically asked to participate in studies for ethical reasons. 

While more studies are needed to understand how postpartum hormonal changes affect acne, as your body adapts to its postpartum state, your hormonal mix will eventually regulate, which can help ease your acne.

Diet changes

Postpartum diet changes can also affect your skin health. Myths about diet and acne are many, but a few have some scientific evidence to back them up, including high glycemic diets and dairy consumption. 

The glycemic index ranks foods from 0 to 100. The higher a food’s rank, the more it affects blood sugar levels. The index was initially used as a way to help control the blood sugar levels of people with diabetes. However, high glycemic index foods may also affect acne in some people.⁴ 

If you eat a lot of foods that are high on the glycemic index, your blood sugar may go up, which triggers the release of more insulin. And high insulin can affect other hormones which may lead to an increase in breakouts.⁵ 

High glycemic index foods include:⁶

• White and wheat bread

• Watermelon

• Potatoes

• Rice crackers

High glycemic index foods aren’t always foods you would normally think of eating in moderation. They’re not categorically unhealthy foods. Chocolate, for example, is low on the glycemic index, but the fat content makes it a food to eat in moderation. But for some people, monitoring diet for high glycemic index foods can help control breakouts.

Dairy, whether whole milk, skim milk, yogurt, cheese or other dairy sources, may also affect breakouts because dairy, too, can influence insulin levels.⁷ ⁸ Milk and other dairy products are full of important nutrients that postpartum women need, like calcium and vitamin D (in fortified milk products). 

Keeping a food diary is a good way to see how your diet might be affecting your skin. However, before making any diet changes, talk to your doctor. Eliminating dairy or any other food group from your diet, especially if you’re breastfeeding, could deprive you of important nutrients. 

Increased stress

Adding a new person to your household is joyful and exciting, but it also comes with a certain amount of stress. That stress is often magnified by the lack of sleep and general fatigue that comes from caring for a newborn. 

Stress has been linked to acne, though the exact reasons why stress may trigger acne aren’t fully understood.⁹ ¹⁰ Stress may be a normal part of the postpartum period, but be open to talking to your partner, family, friends, or medical provider if stress overwhelms you. 

Treatment for postpartum acne

Because there are many potential causes of postpartum acne, there’s no single all-encompassing solution for it. At Curology, our licensed dermatology providers can work one-on-one with pregnant and postpartum women, nursing or bottle feeding, to address acne on a case-by-case basis. We also encourage you to discuss care during this time with your OB/GYN. The safest postpartum acne treatment is often influenced by your feeding method—breastfeeding vs. bottle feeding. 

Acne treatments if you’re bottle feeding

There are a few restrictions when it comes to acne treatment options when you’re bottle feeding, but they are far fewer than if you breastfeed. Most of the major topical and oral medications are open to you. 

Many topical treatments, which are ointments, creams, gels, or lotions that you rub into your skin, are generally safe for use postpartum depending on your medical history. Some, like alpha-hydroxy acids (such as glycolic acid) or beta-hydroxy acids (such as salicylic acid) are found in over-the-counter acne products.¹¹ 

Some common topical antimicrobials may be considered, such as:¹²

• Azelaic acid

• Benzoyl peroxide

• Sodium sulfacetamide

Topical antibiotics are another ingredient that may be considered, which include:

• Clindamycin

• Erythromycin

• Metronidazole

• Dapsone

Retinoids, which are derivatives of vitamin A, may be an option postpartum. You might have stopped using topical retinoids before and during pregnancy to avoid potentially harmful effects on your baby. However, you’ll need to consult with a licensed dermatology provider for topical retinoids like tretinoin, as this is available by prescription only. (Breastfeeding moms need to be a little more cautious, as we’ll discuss in a moment.)

However, you do need to be careful about where you apply topical treatments. Some, like clindamycin, erythromycin, and retinoids, should not be applied in the breast area or areas where your baby may come into frequent contact.¹³

Topical treatments may not be your only option, depending on the severity of your breakout. Oral medications are another class of treatments available, and they include:¹⁴

• Penicillin

• Erythromycin

• Azithromycin

• Clindamycin

• Tetracyclines

• Trimethoprim-sulfamethoxazole

Acne treatments if you’re breastfeeding

Breastfeeding moms face a few more restrictions when it comes to acne treatment because there is a potential for ingredients to get into breast milk. While there are no acne treatments strictly off-limits during lactation, isotretinoin and topical dapsone should be avoided due to unclear risks to the breastfed infant.¹⁵ Although adverse effects of isotretinoin from ingested breast milk haven’t been identified, because of its known risks during pregnancy and its ability to be found in breast milk, it is not recommended for nursing mothers.¹⁶

Topical treatments that are generally considered to be safe while breastfeeding include benzoyl peroxide, salicylic acid, and zinc pyrithione. Skincare products derived from sugar cane such as glycolic acid, lactic acid, or other alpha hydroxy acid (AHA) products and peels may also be an option.

Curology offers personalized formulas that are generally considered safe while breastfeeding. In fact, custom treatments can be a great way to treat acne while breastfeeding. That said, please review all prescriptions and skincare products with your primary care provider and/or OB/GYN prior to use during this time.

At Curology, we can work with postpartum people to determine safe, effective acne treatments. We have options like Curology Acne Cleanser, which contains benzoyl peroxide, and Curology Acne Body Wash, which contains salicylic acid, that can complement your routine. Additionally, our dermatology team can adjust ingredients to personalize your treatment to your specific skin and postpartum issues. However, we always recommend that you get approval from your primary care provider or OB/GYN first.

Daily skincare tips to control postpartum acne

Your daily skincare routine is your best offense and defense against postpartum acne. A daily routine may keep your natural oil levels under control and help prevent clogged pores and acne breakouts. What you include in that routine may also make a difference in the severity of your acne.

• Cleanse: In general, wash your face twice a day with a gentle or acne-fighting cleanser, like Curology Acne Cleanser. 

• Spot treatments: Acne creams with high concentrations of acne-fighting ingredients can be placed directly on problem areas. Treatments could include products with glycolic or salicylic acids, and benzoyl peroxide. Another option is Curology’s Emergency Spot Patches, which absorb oil and help hide small blemishes. 

• Moisturize: Apply moisturizer after cleansing and spot-treating your skin. All skin types—dry, combo, oily—can benefit from daily moisturization, though the product type may differ. Dry skin may need a richer moisturizer, while oily skin may respond better to something lighter. Curology’s team can recommend a moisturizer for your unique skin needs. 

• Sun protection: All skin needs protection from daily sun exposure. Use a broad spectrum sunscreen with SPF 30 or higher to protect your skin from UV damage. Just remember to avoid products with pore-clogging ingredients! 

Postpartum skincare

Postpartum acne may be unpleasant, but it’s not uncommon. It takes time for your hormone levels to return to their pre-pregnancy state of balance. In the meantime, one of our licensed dermatology providers can prescribe a personalized formula and offer other dermatologist-designed and noncomedogenic products like cleansers, moisturizers, and sunscreen that can be helpful in your skincare journey.

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

Start your skin quiz

Start your 30-day trial* today by answering a few questions and snapping a few selfies of your skin. If Curology is right for you, a licensed dermatology provider will prescribe a personalized formula to help address the challenges of your postpartum skin.

P.S. We did the homework so you don’t have to:

1. Putra, I.B., et al. Skin Changes and Safety Profile of Topical Products During Pregnancy. The Journal of Clinical and Aesthetic Dermatology. (February 2022). 

2. Chauhan, G. and Tadi, P. Physiology, Postpartum Changes. StatPearls. National Library of Medicine. (2022, November 14). 

3. Bakry, O.A., et al. Role of hormones and blood lipids in the pathogenesis of acne vulgaris in non-obese, non-hirsute females. Indian Dermatology Online Journal. (November 2014). 

4. Pappas, A. The relationship of diet and acne. Dermato Endocrinology. (September-October 2009). 

5. Smith, R.N., et al. A low-glycemic diet improves symptoms in acne vulgaris patients: A randomized controlled trial. The American Journal of Clinical Nutrition. (July 2007). 

6. Atkinson, F.S., et al. International Tables of Glycemic Index and Glycemic Load Values: 2008. Diabetes Care. (December 2008). 

7. Juhl, C.R., et al. Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults. Nutrients. (2018, August 9).

8. Hoyt, G., et al. Dissociation of the glycaemic and insulinaemic response to whole and skimmed milk. The British Journal of Nutrition. (February 2005).

9. Jusuf, N.K., et al. Correlation Between Stress Scale and Serum Substance P Level in Acne Vulgaris. International Journal of General Medicine. (2022, November 30).

10. Zari, S. and Alrahmani, D. The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clinical, Cosmetic and Investigational Dermatology. (2022, December 17).

11. Ly, S., et al. Treatment of Acne Vulgaris During Pregnancy Lactation: A Narrative Review. Dermatology and Therapy. (2022, November 29). 

12. Ly, S., et al. Treatment of Acne Vulgaris During Pregnancy Lactation: A Narrative Review. Dermatology and Therapy. Ibid.

13. Ly, S., et al. Treatment of Acne Vulgaris During Pregnancy Lactation: A Narrative Review. Dermatology and Therapy. Ibid.

14. Ly, S., et al. Treatment of Acne Vulgaris During Pregnancy Lactation: A Narrative Review. Dermatology and Therapy. Ibid.

15. Ly, S., et al. Treatment of Acne Vulgaris During Pregnancy Lactation: A Narrative Review. Dermatology and Therapy. Ibid.

16. Ly, S., et al. Treatment of Acne Vulgaris During Pregnancy Lactation: A Narrative Review. Dermatology and Therapy. Ibid.

Laura Phelan is a board-certified Family Nurse Practitioner at Curology. She earned her Masters of Science in Nursing at Benedictine University and went on to get her post-master’s certificate as a Family Nurse Practitioner at the University of Cincinnati.

*Cancel anytime. Subject to consultation. Results may vary.

Written by

Curology Team

Medically reviewed by

Laura Phelan, NP-C