Other Acne Medications and Their Risks
Benzoyl peroxide is used as a topical acne medication. It exerts an antibacterial effect and causes skin peeling. Approximately 5% of topically applied benzoyl peroxide is absorbed through the skin. There are no available studies regarding exposure to benzoyl peroxide during human pregnancy. Further investigation is required to accurately determine the risk of reproductive or lactation effect in humans.
Tetracycline is an antimicrobial and has been found to cross the placenta. Tetracycline use during the second and third trimester has been found to cause staining of the teeth of the child and up to a 40% depression of bone growth. The Collaborative Perinatal Project has identified several case reports of abnormalities in human pregnancies with exposure to tetracycline. However, no significant risk for a major birth defect was found. An association between tetracycline use and minor malformations has been suggested; however, due to the small number of cases, further investigation is required to accurately determine the risk of tetracycline use during human pregnancy. Based on the above information, it is recommended that tetracycline not be used during pregnancy.
A topical agent in which the active ingredient is erythromycin is a relatively safe choice. Erythromycin is a macrolide antibiotic which is found to cross the placenta, but in concentrations too low to treat fetal infection. The Collaborative Perinatal Project followed 79 pregnancies with first trimester exposure to erythromycin, as well as identified 230 exposures to erythromycin at any time during pregnancy, and did not find any association with erythromycin use and congenital major or minor birth defects. Erythromycin has been used successfully in the treatment of several maternal infections during pregnancy, such as chlamydia and mycoplasma. The above information was based on oral administration of erythromycin.