When to Stop Topical Retinol Before Pregnancy

If you are trying to conceive, most dermatologists and medical organizations recommend stopping topical retinol at least one month before pregnancy. This precaution is based on safety guidelines for vitamin A derivatives, particularly oral isotretinoin, which must be discontinued at least one month before conception due to its teratogenic effects. While topical retinoids are absorbed in significantly lower amounts than oral forms, the exact threshold of safety is not well established.

To minimize any risk of early fetal exposure, the safest approach is to stop using retinol as soon as you start trying to conceive or discontinue it when you stop using birth control. Some medical professionals recommend discontinuing retinol several months in advance to allow any residual vitamin A to fully clear from your system before pregnancy.

1. American College of Obstetricians and Gynecologists (ACOG) The ACOG advises against the use of retinoids during pregnancy due to the potential risks of birth defects. While the absorption rate of topical retinol is lower than oral forms, they recommend erring on the side of caution and discontinuing use before conception.
2. European Medicines Agency (EMA) & UK Medicines and Healthcare Products Regulatory Agency (MHRA) The EMA and MHRA have issued clear warnings that topical retinoids should not be used by women who are pregnant or planning pregnancy. These organizations state that there is insufficient data to determine a completely safe exposure level, leading to a recommendation to avoid use entirely.
3. Dermatologists' Recommendations Most dermatologists follow a conservative approach, recommending stopping retinol use at least one month before pregnancy. Some prefer an even longer discontinuation period to ensure that no retinol remains in the body, especially since early pregnancy exposure is the most concerning.

Retinol is a form of vitamin A, and excessive amounts of vitamin A during pregnancy can lead to fetal development complications. The main concerns surrounding retinol and pregnancy include:

1. Teratogenic Effects: High doses of vitamin A are known to cause congenital disabilities, particularly when exposure occurs during the first trimester.
2. Early Pregnancy Exposure: Many women do not realize they are pregnant until after several weeks, during which time the baby’s organs are forming. If retinol is used during this critical window, it may contribute to developmental abnormalities.
3. Absorption and Storage: Although topical retinoids are absorbed at lower levels than oral retinoids, vitamin A is fat-soluble and can accumulate in the body over time. This is why medical professionals recommend stopping retinol before pregnancy rather than waiting until a confirmed pregnancy.

The current consensus is that retinol should be completely avoided during pregnancy. There is no established “safe” amount of topical retinoid exposure for a developing baby. Because pregnancy safety studies on retinoids are limited, most experts agree that avoiding retinol while pregnant is the best approach.

Additionally, retinol while breastfeeding is also discouraged, as small amounts may pass into breast milk. Although the risk to a nursing infant is lower than in pregnancy, some doctors advise waiting until after breastfeeding to resume retinol use.

To ensure a safe pregnancy, stop using topical retinol at least one month before trying to conceive. Many experts recommend stopping even earlier, especially if you are actively planning a pregnancy. Given the potential risks of retinol when pregnant, the safest course of action is to eliminate topical retinoids from your skincare routine before conception occurs.

If you have concerns about your skincare regimen and pregnancy safety, consult with your dermatologist or obstetrician for personalized guidance. By planning ahead and discontinuing retinol use early, you can ensure the healthiest possible environment for your pregnancy.