More on skincare tips & hacks
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Acne can be frustrating in pregnancy, however the following treatments are both safe, and in many cases effective-
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Azelaic acid is classed as category A, most physicians will agree it is safe in pregnancy. Azelaic acid is anti-inflammatory & anti-bacterial. It can also treat pigment in pregnancy, as it is a weak tyrosinase inhibitor. Pigmentation will often flare in pregnancy, a condition known as melasma (mask of pregnancy). Brands include Skinoren, Finacea, Azclear. Concentrations vary from 5-15%. Guideline; start once a day, increase to twice daily as tolerated. Azelaic acid has an extremely low irritation potential.
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Peels include lactic acid peels, glycolic, mandelic & citric acid. AHA or alpha hydroxy acid peels are considered super safe in pregnancy. Peels work by exfoliation of clogged pores. Higher concentrations can be bactericidal (kills p. acnes bacteria). Most dermatologists will not perform BHA or salicylic acid peels, however will prescribe BHA washes in low concentrations.
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Phototherapy is a super safe way of treating acne in pregnancy. Home LED masks , such as the one from Neutrogena, can in theory reduce bacterial counts, however the required energy measured in watts-millijoules are not sufficient in home kits to make a significant difference in acne lesion counts. Specialists employ LLEDs or low level laser emitting diodes in practice. Blue, & red light can activate naturally producing chemicals synthesised by p.acnes – the bacteria species implicated in pustules, pimples, cysts & zits
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Dietary changes can be effective in the control of acne. Some patients are sensitive to changes in glycaemic indices, others are more sensitive to dairy. A sensible acne diet includes dairy free products & exclusion of processed foods including sugar.
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Topical- oral antibiotics can be safe in pregnancy. Be guided by your physician. The most commonly prescribed topicals include erythromycin & clindamycin. Consideration of risk benefit ratio will be discussed with you & your prescribing dermatologist. Topical ABs are often used prior to oral antibiotics, brand names include Zineryt, Erycacne, & Clindatech. BPO or benzoyl peroxide in addition to zinc can be added for better efficacy.
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Exfoliation can reduce congestion. Either chemical or mechanical can reduce blackheads & whiteheads. Microdermabrasion is safe, as are Hydrafacials. Chemical exfoliation can be conducted at home with a Clarisonic (or even a pad). Addition of skin care acids can potentiate the amount of dead skin cells exfoliated.
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Unsafe drugs in pregnancy include retinoids & tetracycline class antibiotics. All forms of retinoids including the less potent retinol are not cleared for pregnancy, the later is converted to retinoic acid. Topicals including tretinoin, adapelene & tazoretene are not indicated in pregnancy.
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Post partum, acne usually resolves with changes in hormone levels. Discuss with your skin care provider topicals that can be introduced at this stage.
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Thanks for watching this video.
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Dr Davin Lim, Dermatologist, Brisbane. Australia
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Disclaimer: I am a procedural dermatologist, I do not treat acne. If you require an appointment my colleagues, nurses & dermal therapists can assist. @cliniccutis, Brisbane, Australia
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