Retinoids and Retinol have become a common ingredient of many skincare and anti-aging products. You will have been aware that these products are not advised when you were pregnant. But is it also the case that nursing mothers should avoid retinoids and retinol products when breastfeeding.
What do experts say about breastfeeding and retinol? There are no studies to prove that Retinoids and Retinol can harm a breastfed baby. However, there are studies suggesting that it has teratogenic effects on the developing fetus inside the womb. This is why experts are reluctant to advise the use of products containing Retinoids and Retinol while breastfeeding. Taking retinoid containing drugs orally is not advised. There is some ambiguity regarding the topical use of these skincare products. The amounts absorbed if used on a small area of skin is minimal. However, as a general precaution, health practitioners advise against the oral or topical use of retinoids or retinol containing products.
Let’s have a closer look at these Vitamin A derivatives and where they are commonly found.
Should I avoid using retinoids and Retinol Products while Breastfeeding?
It is unknown exactly how much is secreted into breast milk, however, it is advised to avoid taking retinoid containing medications when breastfeeding. Some experts suggest that when used topically the risks are minimal, however, there are safer alternatives that can be taken when breastfeeding your baby. Here are examples of the most common types of retinoids.
Tretinoin (Retin-A, Renova, Stieva-A)
Hale’s Medications and Mothers Milk (2019) mentions that the absorption of tretinoin containing drug Retin-A via topical sources is reported to be minimal. Topical tretinoin belongs to Lactation Risk Category L3 or moderately safe for breastfeeding. However, the FDA has advised that nursing mothers should postpone using a tretinoin cream called Renova (0.02% tretinoin) as it is not known whether this drug is excreted in human milk.
Tazarotene (Tazorac, Zorac)
There is currently no data to establish whether this medication can transfer into breast milk. It is primarily used topically to treat stable plaque psoriasis and acne. Dr. Hale mentions when applied to large surface areas, the absorption rate is increased. Caution should be taken if using this medication. Consult with your doctor regarding the safety of using this medication when nursing.
Similar to tretinoin, adapalene is used topically for the treatment of acne. This can be bought without a prescription. Again there is no data available regarding its transfer to human milk. However, McHale says that it is virtually unabsorbed when applied topically to the skin and probably undetectable in breast milk.
Isotretinoin (Accutane, Roaccutane, Isotrex, Absorica)
A popular isotretinoin called Absorica is used for the treatment of severe acne. It is strongly recommended that breastfeeding mothers not use this drug when nursing and up until one month after having finished treatment. Isotretinoin belongs to Lactation Risk Category L5 or contraindicated for breastfeeding.
Always consult with your doctor before considering taking these medications.
Retinol is a non-prescription retinoid that is much less potent than prescription-strength retinoids. It is commonly found in creams and serums that are designed to minimize fine lines, dark spots, and wrinkles. It can boost collagen production in the skin and improve your skin tone.
However, despite the risk being low of transferring to breast milk, it’s best to avoid retinol containing products when nursing your baby. There have been no studies carried out to conclusively establish their safety for a breastfeeding mother. Instead, there are safer alternatives that can be used during this time.
Accidentally used Retinoids and Retinol Products while Breastfeeding
Some nursing mothers may have accidentally applied a retinol containing product when breastfeeding. If you think you may have used a retinol-containing product, call your health care provider for advice.
Being aware of retinol containing products will enable you to avoid accidentally using it. Retinols are usually found in anti-aging and anti-acne products.
Always read the label of the product you are intending to purchase. Usually, retinoids are listed using the following names:
- Retinoic acid
- Retinyl linoleate
- Retinyl palmitate
- adapalene (Differin)
- tretinoin (Retin-A and Renova)
- tazarotene (Tazorac, Fabior, Zorac, and Avage)
Safe acne treatment while Breastfeeding
Acne is a common problem postpartum and one of the main reasons retinoids are used. Here are some of the common acne medications that are considered safe for breastfeeding mothers.
Salicylic acid is a topical over-the-counter medication that is used to treat acne. When applied to the skin, its absorption rate is very low. This makes it safe for women who are breastfeeding.
Benzoyl Peroxide (Proactiv)
The topical use of Benzoyl peroxide works in a similar way to salicylic acid. There is minimal absorption to the skin. Peroxides in this medication are rapidly metabolized by the body and unlikely to reach the mother’s milk.
Both the oral and topical use of erythromycin is compatible with breastfeeding, making it the antibiotic of choice for acne while you are still nursing your baby. The American Academy of Pediatrics (AAP) rated erythromycin as Lactation Risk Category L1 or the safest for breastfeeding mothers.
The topical use of Metrogel as an acne antibiotic is generally considered safe for breastfeeding. According to Dr. Hale (Medications and Mothers’ Milk), metronidazole gel has very low plasma levels and has very little to no presence in a mother’s breast milk.
Azelaic acid (Azelex)
Azelex is another topical acne treatment with minimal absorption through the skin. It has a low absorption rate and metabolizes rapidly within the body. There is a very low chance that it will be transferred to breast milk. In fact, small amounts of azelaic acid are naturally found in our food, particularly in animal products and whole grains.
Skincare tips while Breastfeeding
Though there are many skin care products that are compatible with breastfeeding, it is best to choose natural products to take care of your skin.
Consume foods rich in Vitamin C
Vitamin C or ascorbic acid improves collagen production, which can make your skin appear radiant with an even tone. Vitamin C is a common ingredient in facial creams and serums, but you can also get this vitamin from citrus fruits and green vegetables.
Drink plenty of water
Dehydration is not only bad for our health, but it is also bad for our skin. Lack of water in our body can make our skin appear dull and flaky. Drink at least 8 glasses of water a day or to thirst to keep your skin moisturized.
This may seem impossible at times, particularly in the early weeks for breastfeeding mothers. However, getting a good night’s sleep helps your skin glow and appear a lot healthier. If you cannot get 8 hours of sleep at night, take a nap during the day with your baby or whenever you get a chance.
Avoid oily and fatty foods
Deep-fried foods are sometimes the easier option but they can also make your skin appear more aged or cause acne to appear. Limit your intake of fried and fatty foods to prevent oily skin and switch to healthier alternatives instead. Steaming and grilling can similarly make a tasty meal, but with less oil.
Eat fruits high in antioxidants
Keep those free-radicals away from your skin by consuming nutritious foods and fruits that are rich in antioxidants. You can get high levels of antioxidants particularly from berries such as blueberries, strawberries, and raspberries.
It not as easy to carry out your usual skincare regimen now that you are breastfeeding as looking after a little one leaves little time for yourself. However, to maintain skin health, it’s important to cleanse your skin regularly. Wash your face with a gentle facewash as part of your morning and nighttime routine.
Overall, it is safer to avoid using retinoids and retinol products while breastfeeding. Although the risk of transfer to breast milk may be minimal in some of these products experts advise to avoid them altogether when you are nursing. If you feel you need to use a retinoid or retinol product, always consult a professional. Your doctor will offer you the best treatment options that are compatible with breastfeeding.
Rockville MD, United States Pharmacopoeia Dispensing Information. United States Pharmacopoeial Convention. (1997). US Pharmacopoeial Convention ( via https://aestheticsjournal.com/feature/using-skincare-during-pregnancy-and-breastfeeding)
L Shapiro, A Pastuszak, G Curto, G Koren, Is topical tretinoin safe during the first trimester? Canada Fam Physician. (1998) Mar. 44:495-8. ( via https://aestheticsjournal.com/feature/using-skincare-during-pregnancy-and-breastfeeding)