Is azelaic acid safe during pregnancy?
Tap your actives or paste a label. See what to avoid, with sources.
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Not medical advice: bring it to your OB-GYN.
Not medical advice: bring it to your OB-GYN.
Three stamps. The cautious one wins.
Avoid while pregnant: an FDA label, the AAD, ACOG or a peer-reviewed review advises against it. Ask your doctor first: a source says to limit it or to check with a doctor, the sources we read disagree, or we found too little to go on. Generally considered OK: every source we read that covers it says it can be used. No stamp replaces your OB-GYN.
Three stamps. The cautious one wins.
Avoid while pregnant: an FDA label, the AAD, ACOG or a peer-reviewed review advises against it. Ask your doctor first: a source says to limit it or to check with a doctor, the sources we read disagree, or we found too little to go on. Generally considered OK: every source we read that covers it says it can be used. No stamp replaces your OB-GYN.
Everything in this tool, in full
Educational, not medical advice. Every line below points to the source it comes from — bring it to your doctor.
What the sources say
The AAD says it’s thought to be safe to use during pregnancy, and animal studies haven’t shown birth defects. ACOG lists it among the over-the-counter products that can be used, and a 2023 American Family Physician review calls it a preferred, safe option.
The Azelex prescription label says to use it during pregnancy only if clearly needed.
SourcesAmerican Academy of Dermatology: Is any acne treatment safe to use during pregnancy?ACOG (American College of Obstetricians and Gynecologists): Skin Conditions During Pregnancy, patient FAQErlandson, Wertz & Rosenfeld, Common Skin Conditions During Pregnancy, Am Fam Physician, 2023Chien et al., Treatment of Acne in Pregnancy, J Am Board Fam Med, 2016Yaghi, Baboun & Keri, Acne and Pregnancy: A Clinical Review and Practice Pearls, Cutis, 2024Azelex (azelaic acid 20%): FDA label, 2024Dermatology Times (September 3, 2026), news summary of Kovacs et al., Cosmetic Dermatology in Pregnancy and Lactation: A Risk-Benefit Framework for Clinical Practice, Int J Dermatol, 2026 (a narrative review; news summary only, the review itself not read)
What about breastfeeding?
Its label says less than 4% is absorbed, so it isn’t expected to change azelaic acid levels in breast milk much. A 2026 review, as summarized in Dermatology Times, calls it acceptable while breastfeeding.
SourcesAmerican Academy of Dermatology: Is any acne treatment safe to use during pregnancy?ACOG (American College of Obstetricians and Gynecologists): Skin Conditions During Pregnancy, patient FAQErlandson, Wertz & Rosenfeld, Common Skin Conditions During Pregnancy, Am Fam Physician, 2023Chien et al., Treatment of Acne in Pregnancy, J Am Board Fam Med, 2016Yaghi, Baboun & Keri, Acne and Pregnancy: A Clinical Review and Practice Pearls, Cutis, 2024Azelex (azelaic acid 20%): FDA label, 2024Dermatology Times (September 3, 2026), news summary of Kovacs et al., Cosmetic Dermatology in Pregnancy and Lactation: A Risk-Benefit Framework for Clinical Practice, Int J Dermatol, 2026 (a narrative review; news summary only, the review itself not read)
Why it’s a go-to in pregnancy
Azelaic acid is one of the few acne ingredients every source we read is comfortable with. The AAD says it’s thought to be safe, a 2023 American Family Physician review calls it a preferred option, a 2024 review calls 20% azelaic acid safe in pregnancy, and a 2026 review, as summarized in Dermatology Times, calls it acceptable during pregnancy and breastfeeding. Its prescription label says less than 4% of the dose is absorbed.
SourcesAmerican Academy of Dermatology: Is any acne treatment safe to use during pregnancy?Erlandson, Wertz & Rosenfeld, Common Skin Conditions During Pregnancy, Am Fam Physician, 2023Yaghi, Baboun & Keri, Acne and Pregnancy: A Clinical Review and Practice Pearls, Cutis, 2024Azelex (azelaic acid 20%): FDA label, 2024Dermatology Times (September 3, 2026), news summary of Kovacs et al., Cosmetic Dermatology in Pregnancy and Lactation: A Risk-Benefit Framework for Clinical Practice, Int J Dermatol, 2026 (a narrative review; news summary only, the review itself not read)
Check your whole routine
One ingredient is a start. The pregnancy-safe skincare checker stamps every active you use — tap them or paste a label — each with the reason and its source. Educational, not medical advice.
One face scan. Your whole routine, sorted.
This page answered your question. MySkincare starts from your own skin, and the products you already use.
- 1Scan your face3 photos: front, left profile, right profile.
- 2See your skin scoreFree6 zones scored separately: forehead, eye area, T-zone, both cheeks, chin.
- 3Scan your productsIt reads each ingredient list and says: keep it, watch it or replace it.
- 4Follow your routineMorning and night, checked so your products work together. With reminders.
MySkincare reads the products you already use and builds a routine for your skin. It doesn’t judge whether an ingredient is pregnancy-safe — for that, this page and your OB-GYN or dermatologist are the guide.
Questions people ask
Is azelaic acid safe to use while pregnant?
The AAD says it’s thought to be safe to use during pregnancy, and animal studies haven’t shown birth defects. ACOG lists it among the over-the-counter products that can be used, and a 2023 American Family Physician review calls it a preferred, safe option.
The Azelex prescription label says to use it during pregnancy only if clearly needed.
SourcesAmerican Academy of Dermatology: Is any acne treatment safe to use during pregnancy?ACOG (American College of Obstetricians and Gynecologists): Skin Conditions During Pregnancy, patient FAQErlandson, Wertz & Rosenfeld, Common Skin Conditions During Pregnancy, Am Fam Physician, 2023Chien et al., Treatment of Acne in Pregnancy, J Am Board Fam Med, 2016Yaghi, Baboun & Keri, Acne and Pregnancy: A Clinical Review and Practice Pearls, Cutis, 2024Azelex (azelaic acid 20%): FDA label, 2024Dermatology Times (September 3, 2026), news summary of Kovacs et al., Cosmetic Dermatology in Pregnancy and Lactation: A Risk-Benefit Framework for Clinical Practice, Int J Dermatol, 2026 (a narrative review; news summary only, the review itself not read)
Is azelaic acid safe while breastfeeding?
Its label says less than 4% is absorbed, so it isn’t expected to change azelaic acid levels in breast milk much. A 2026 review, as summarized in Dermatology Times, calls it acceptable while breastfeeding.
SourcesAmerican Academy of Dermatology: Is any acne treatment safe to use during pregnancy?ACOG (American College of Obstetricians and Gynecologists): Skin Conditions During Pregnancy, patient FAQErlandson, Wertz & Rosenfeld, Common Skin Conditions During Pregnancy, Am Fam Physician, 2023Chien et al., Treatment of Acne in Pregnancy, J Am Board Fam Med, 2016Yaghi, Baboun & Keri, Acne and Pregnancy: A Clinical Review and Practice Pearls, Cutis, 2024Azelex (azelaic acid 20%): FDA label, 2024Dermatology Times (September 3, 2026), news summary of Kovacs et al., Cosmetic Dermatology in Pregnancy and Lactation: A Risk-Benefit Framework for Clinical Practice, Int J Dermatol, 2026 (a narrative review; news summary only, the review itself not read)
Is 20% azelaic acid OK while pregnant?
A 2024 review calls 20% azelaic acid safe in pregnancy, and the AAD says azelaic acid is thought to be safe. The prescription label still says to use it only if clearly needed.
SourcesAmerican Academy of Dermatology: Is any acne treatment safe to use during pregnancy?Yaghi, Baboun & Keri, Acne and Pregnancy: A Clinical Review and Practice Pearls, Cutis, 2024Azelex (azelaic acid 20%): FDA label, 2024
Where can I check my whole routine?
Use the pregnancy-safe skincare checker: it stamps every active you use, with the reason and its source. It’s educational, not medical advice — bring the result to your OB-GYN or dermatologist.
SourceAmerican Academy of Dermatology: Is any acne treatment safe to use during pregnancy?
American Academy of Dermatologyaad.org
- Is any acne treatment safe to use during pregnancy?
Isotretinoin, tazarotene and spironolactone: never take during pregnancy; if you’re pregnant, stop them immediately. Doxycycline, minocycline or tetracycline: stop by your 15th week of pregnancy. Adapalene and tretinoin: most experts recommend stopping. Azelaic acid and clindamycin: thought to be safe. Benzoyl peroxide and salicylic acid: safe in limited amounts or for a limited time, ask first.
American College of Obstetricians and Gynecologistsacog.org
- Skin Conditions During Pregnancy, patient FAQ
Over-the-counter products with benzoyl peroxide, azelaic acid, salicylic acid or glycolic acid can be used; use of topical retinoids is generally avoided, and some OTC products contain them; isotretinoin should not be used; melasma and daily sunscreen.
US Food and Drug Administrationfda.gov
- Azelex (azelaic acid 20%): FDA label, 2024
Use during pregnancy only if clearly needed; less than 4% is absorbed, so breast milk levels aren’t expected to change much.
Studies and other sources
- Erlandson, Wertz & Rosenfeld, Common Skin Conditions During Pregnancy, Am Fam Physician, 2023aafp.org
Topical benzoyl peroxide, azelaic acid and antibiotics are preferred and considered safe for acne; melasma (mask of pregnancy) affects up to 75% of patients and resolves after delivery in 90%; broad-spectrum sunscreen; tretinoin and hydroquinone are melasma options after delivery; stretch-mark creams have limited evidence, with a modest benefit from Centella asiatica or hyaluronic acid plus daily massage.
- Chien et al., Treatment of Acne in Pregnancy, J Am Board Fam Med, 2016jabfm.org
Benzoyl peroxide considered safe; salicylic acid low risk if limited to local areas for a limited time; azelaic acid a baseline option; no reports of harm from glycolic acid; topical retinoids generally avoided, tazarotene contraindicated; short-term topical clindamycin safe.
- Yaghi, Baboun & Keri, Acne and Pregnancy: A Clinical Review and Practice Pearls, Cutis, 2024doi.org
Benzoyl peroxide and 20% azelaic acid safe in pregnancy; salicylic acid likely safe at low concentrations over limited body areas.
- Dermatology Times (September 3, 2026), news summary of Kovacs et al., Cosmetic Dermatology in Pregnancy and Lactation: A Risk-Benefit Framework for Clinical Practice, Int J Dermatol, 2026 (a narrative review; news summary only, the review itself not read)dermatologytimes.com
Vitamin C, azelaic acid, niacinamide and benzoyl peroxide considered acceptable in pregnancy and breastfeeding; low-strength glycolic or lactic acid may be used with caution in pregnancy, superficial glycolic peels preferably deferred; salicylic acid peels avoided in pregnancy, particularly at higher strengths; medium-depth TCA peels deferred; deep phenol peels avoided in pregnancy and breastfeeding (systemic toxicity, including heart rhythm problems); hydroquinone avoided; tazarotene avoided; injectables generally avoided or deferred in pregnancy, hyaluronic acid fillers may be considered while breastfeeding; reproductive safety data are limited.