Retinol Alternatives During Pregnancy: What to Use Instead

During pregnancy, the American Academy of Dermatology advises avoiding retinol and prescription retinoids. The American College of Obstetricians and Gynecologists (ACOG) lists benzoyl peroxide, azelaic acid, topical salicylic acid and glycolic acid as over-the-counter ingredients that can be used. Bakuchiol is often sold as a gentle substitute, but its pregnancy safety has not been established. This guide covers each option, what it does for the skin, and how to keep a routine simple and gentle.

TL;DR

• Avoid retinol, prescription retinoids (isotretinoin, tretinoin, tazarotene) and newer retinoid-like ingredients while pregnant or trying to conceive.
• ACOG says benzoyl peroxide, azelaic acid, topical salicylic acid and glycolic acid can be used in pregnancy.
• Azelaic acid is the most useful single substitute for breakouts, redness and uneven tone.
• Bakuchiol has no studies proving pregnancy safety and no FDA pregnancy safety rating. Ask your obstetrician or dermatologist first.
• Keep the routine short: gentle cleanser, moisturizer, mineral sunscreen, and one active at most.

Table of Contents

• Why retinol is avoided in pregnancy
• What you can use instead of retinol
• Is bakuchiol safe during pregnancy?
• Retinoid-like ingredients that hide behind gentle names
• A short routine that replaces a retinol step
• Checks for sensitive skin
• Our perspective
• Makeup that supports a simple routine
• After pregnancy and while breastfeeding
• FAQ
• Sources

Why retinol is avoided in pregnancy

Topical retinoids are forms of vitamin A in the same drug family as isotretinoin. ACOG notes that the amount absorbed through the skin is low, but use is generally recommended to be avoided during pregnancy. The reason is the oral drug. ACOG states that isotretinoin may cause severe fetal birth defects, including intellectual disabilities and life-threatening heart and brain defects.

The evidence on creams is more nuanced. MotherToBaby reports that studies of topical tretinoin have not found a greater chance of birth defects with proper skin application. Case reports exist, though, so the safest approach may be to avoid it. That is why the guidance stays consistent: when a safe alternative exists, use it.

The AAD names the products to skip: prescription retinoids such as isotretinoin, tretinoin and tazarotene, and over-the-counter products containing retinol. The same page also lists hydroquinone, finasteride, spironolactone, tetracycline antibiotics and 5-fluorouracil among ingredients and medicines to avoid.

What you can use instead of retinol

Retinol is used for fine lines, uneven tone, clogged pores and dullness. No single pregnancy-compatible ingredient does all of that. It is more practical to decide which concern matters most and choose one ingredient for it.

Azelaic acid for breakouts and uneven tone

Azelaic acid is the closest thing to an all-round substitute. A 2022 peer-reviewed review reports that it is absorbed through the skin at approximately 4% to 8%, has anti-inflammatory and comedolytic properties, and has no reported adverse fetal effects in the limited pregnancy literature. The review considers it safe in all trimesters and says twice-daily use at a maximum strength of 20% is acceptable during pregnancy and lactation.

The same review says it can treat inflammatory and non-inflammatory acne and post-inflammatory hyperpigmentation. That covers the concerns many people had been treating with retinol: breakouts and the marks they leave. A 2026 dermatologist-authored guide also recommends it for acne, pigmentation and inflammation.

Salicylic, glycolic and lactic acid for texture

For congested pores and rough texture, ACOG lists topical salicylic acid and glycolic acid as usable over the counter. Strength and frequency matter. A 2026 Medical News Today evidence review says glycolic acid has no FDA pregnancy safety rating but is considered by experts to have negligible absorption and may be used in low concentrations according to tolerance. It also says higher-strength glycolic masks and peels are more likely to cause adverse effects, particularly in sensitive skin.

The dermatologist-authored guide mentions gentle lactic acid, preferably below 10%, for selected patients. Daily SPF 30 or higher is recommended when using any exfoliating acid.

Niacinamide for barrier support

The same dermatologist-authored guide recommends niacinamide for barrier support, oil regulation and redness. It is a calm, low-drama ingredient, which suits skin that has become more reactive. Pregnancy can increase reactivity, so many people find a barrier-focused product easier to live with than a strong active.

Benzoyl peroxide for pimples

ACOG includes benzoyl peroxide among the over-the-counter options. It targets blemishes rather than aging or tone, and it can dry the skin, so it fits people whose main issue is active breakouts.

Is bakuchiol safe during pregnancy?

The honest answer is that nobody has established it. Many product pages call bakuchiol “pregnancy-safe” because it is a plant-derived ingredient and not a retinoid. Medical News Today reports that no studies prove its safety and it has no FDA pregnancy safety rating. Its advice is to ask your obstetrician or dermatologist before using it.

Two points help explain the gap. A plant origin does not equal pregnancy safety. And an absence of studies is not proof that something is safe. If you want to use bakuchiol, bring the exact product to your next prenatal visit and let your clinician decide. If you are comfortable with products that have clearer pregnancy guidance, azelaic acid and the ACOG-listed ingredients are the better-documented route.

Our own article on how bakuchiol compared with retinol for sensitive skin covers the skin-feel side of the comparison. That is a different question from pregnancy safety, and it should be read that way.

Retinoid-like ingredients that hide behind gentle names

The word “retinol” is not the only one to look for. Medical News Today says newer or gentler retinoid-like ingredients, including retinaldehyde, retinyl retinoate, hydroxypinacolone retinoate, adapalene and seletinoid G, should not be used during pregnancy or while trying to conceive. Anti-aging serums, “nighttime” creams and eye creams can contain them under labels such as “vitamin A complex” or “retinoid ester”.

A short label check before buying anything:

1. Read the full ingredient list, not only the front of the box.
2. Look for retinol, retinal or retinaldehyde, retinyl (any form), tretinoin, adapalene, tazarotene and hydroxypinacolone retinoate.
3. Look for hydroquinone in brightening products.
4. Check with your obstetrician or dermatologist about anything you are unsure of.

When products are listed in your routine, the AAD also advises telling both your obstetrician and your dermatologist what you use.

A short routine that replaces a retinol step

The dermatologist-authored 2026 guide recommends simplifying routines and prioritizing barrier maintenance instead of combining several actives. A routine built around that idea looks like this.

Morning

1. Wash with a mild cleanser and lukewarm water.
2. Apply a moisturizer suited to your skin type.
3. Finish with broad-spectrum, water-resistant sunscreen with SPF 30 or higher. The AAD suggests zinc oxide or titanium dioxide mineral sunscreen during pregnancy to reduce irritation.

Evening

1. Cleanse again. ACOG’s baseline for acne is washing twice daily with a mild cleanser and lukewarm water, and the AAD adds cleansing after sweating.
2. Apply one active, such as azelaic acid, on the areas that need it.
3. Moisturize to support the barrier.

Start one product at a time, and wait before adding the next. If something stings or turns red, you will know the cause. Our guide to a three-step clean routine for barrier repair and the minimalist three-step routine follow the same logic.

ACOG’s other baseline advice for breakouts is practical: keep oily hair off the face, avoid picking, and choose oil-free cosmetics.

Checks for sensitive skin

MotherToBaby says topical acne products are usually absorbed only in small amounts. Absorption can increase when the skin is broken or irritated, when products are used frequently, or when applied over a large area. OTC topical acne treatments have not been associated with an increased chance of birth defects when used as directed. For sensitive skin, that points to a few habits:

• Use the smallest amount and the lowest frequency that works.
• Treat the affected area, not the whole face, when possible.
• Stop a product that irritates the skin, since irritated skin absorbs more.
• Patch test new products on a small area before applying them to the face.
• Pair every exfoliating acid with daily SPF.

If you are choosing an oil, our guide to rosehip oil with a 7-day patch test explains the patch-test method. Ask your clinician whether any oil or botanical is right for you during pregnancy.

We also outline pregnancy skincare for sensitive skin and the retinoids to avoid in a separate guide.

Our perspective

Sensitive skin and pregnancy often arrive together. Skin that was calm becomes reactive, and the instinct is to add products. We take the opposite view. A short routine, with clear ingredient lists, is the approach we design for.

Our products are formulated for sensitive skin with clean, cruelty-free ingredients and nourishing natural ingredients. Our aim is to combine skincare and makeup so that a product hydrates and nourishes, not only covers. For someone who has had to retire a retinol step, that means finishing a routine with base products designed to be kind to the skin, while the clinical decisions stay with an obstetrician or dermatologist.

We recommend that every reader check the ingredient list against the guidance from ACOG and the AAD, and speak to a clinician about anything in doubt. Clear labels make that conversation easy, and clear labels are what we want from our own range.

Miranda Carmichael

Makeup that supports a simple routine

Once the skincare steps are settled, the base layer matters too. Our FACE collection includes foundations and tinted moisturizers, designed to hydrate and nourish the skin as they even out tone. They suit a short routine because one product can replace two steps. Our tinted moisturizers come in several shades. Review each ingredient list with your obstetrician or dermatologist as you would any new product.

For eyes and lips, see the EYES and LIPS collections. Our guide to choosing clean makeup for sensitive skin with a 48-hour patch test explains how to test a new shade before wearing it all over.

After pregnancy and while breastfeeding

Retinol does not automatically come back the day after delivery. If you are breastfeeding, ask your clinician about timing. MotherToBaby advises not applying topical acne treatments directly to the nipple or areola and washing products off the breast or chest before nursing. Discuss any plan to restart a retinoid with your dermatologist and your child’s pediatrician if you nurse.

In the meantime, the habits above carry over: gentle cleansing, a moisturizer, daily sunscreen, and one active at a time.

FAQ

Can I use bakuchiol while pregnant?

Its safety in pregnancy has not been established. Medical News Today reports no studies proving safety and no FDA pregnancy safety rating. Ask your obstetrician or dermatologist before using it, and bring the product’s ingredient list.

What can I use instead of retinol for acne?

ACOG lists benzoyl peroxide, azelaic acid, topical salicylic acid and glycolic acid as over-the-counter options for use during pregnancy. Azelaic acid also helps with the dark marks that breakouts leave. Use a gentle cleanser twice daily and avoid picking.

Is the small amount of retinol in a cream really a risk?

The amount absorbed through the skin is low, but ACOG and the AAD still advise avoiding topical retinoids and retinol during pregnancy. Because safer options exist, the usual guidance is to skip them. Tell your clinician if you used a product before you knew you were pregnant.

Are exfoliating acids safe on sensitive skin?

Low-strength glycolic, salicylic or lactic acid may suit some skin, but higher-strength masks and peels are more likely to cause side effects. Use daily SPF 30 or higher with any exfoliating acid. Stop if skin becomes irritated.

Sources

• Skin Conditions During Pregnancy, ACOG
• Dermatologist-approved pregnancy skin care, American Academy of Dermatology
• Topical Acne Treatments, MotherToBaby
• Topical Tretinoin, MotherToBaby
• Treatment of Acne Vulgaris During Pregnancy and Lactation, PubMed Central
• Retinol alternatives: Options for sensitive skin, Medical News Today
• A Dermatologist’s Guide to Safe Skincare During Pregnancy

Recommended

• Pregnancy Skincare for Sensitive Skin: 3 Picks, Retinoids to Avoid
• After 12 Weeks, Bakuchiol Matched Retinol for Sensitive Skin
• Sensitive Skin? Rosehip Oil for Your Face With 7 Day Patch Test