User:Mkeomani/Drugs in pregnancy

Antiacne
Acne vulgaris (acne) can occur in pregnancy possibly due to the hormonal changes influencing sebum production. There are limited antiacne medications that are safe in pregnancy. External applications of azelaic acid, glycolic acid, or benzoyl peroxide (alone or combined with clindamycin or erythromycin) are the safest options to treat mild to moderate acne. Erythromycin is the antibiotic of choice for severe acne, barring the use of its estolate salt which risks maternal hepatotoxicity. Topical nicotinamide and topical zinc are safe, however, there are no FDA pregnancy category ratings. Topical salicylic acid and topical dapsone are classified as FDA pregnancy category C. Acne medications to avoid during pregnancy include oral isotretinoin and topical tazarotene as there have been reports of birth defects. As safety data is lacking, the use of topical retinoids, such as adapalene and tretinoin, is not recommended. Antiandrogenic drugs, including spironolactone and cyproterone acetate, should be avoided. If planning to conceive while using contraindicated medications, a washout and waiting period before conception is advised. A herbal product, vitex agnus-castus should not be used during gestation due to undesirable hormonal effects.

Safety data supports the use of blue and red light therapy as non-drug treatments to consider. Personal hygiene and a healthy lifestyle also help, however dietary restriction and abrasive agents found in facial cleaning products are not beneficial. As there are limited options to safely treat acne in pregnancy, shared decision-making between the health care provider and client is recommended.