Salicylic acid during pregnancy: what sources say

Acne often changes during pregnancy, and many people already have a salicylic acid wash or gel in the bathroom. The sources agree on the main answer: low-strength salicylic acid on the skin is generally considered safe for a limited time, and you should ask your obstetrician or dermatologist before you use it. This guide sets out what each source says, why the advice is careful, and what to know about strength, peels, large areas and breastfeeding. Your doctor is the right person to decide what fits your pregnancy.

For the ingredient in general, see the hub guide, what salicylic acid does for your skin.

What the American Academy of Dermatology says

The American Academy of Dermatology (AAD) has a page on acne treatment during pregnancy. Its entry on salicylic acid reads: "Often found in acne treatment you can buy without a prescription, salicylic acid is generally considered safe when used for a limited time. For this reason, you should talk with your obstetrician or dermatologist before using it during your pregnancy."

The same page explains why every entry is careful: "Researchers don't give pregnant women medications, so there are no studies to tell us what happens when pregnant women use a treatment." What is known comes from animal studies and from women who used a treatment while pregnant.

A second AAD page, on skin care in pregnancy, last updated on 26 June 2025, lists ingredients "to use sparingly." Two dermatologists quoted there say to discuss these with a dermatologist and to limit how often you use them. The list includes "Salicylic acid at high doses (greater than 2%), an acne-fighting and exfoliating ingredient," along with benzoyl peroxide.

The AAD's adult acne page adds: "If you're pregnant or trying to get pregnant, consult a dermatologist before treating acne on your own."

What MedlinePlus says

MedlinePlus, the drug information service of the U.S. National Library of Medicine, says: "tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using topical salicylic acid, call your doctor."

What the reviews say about absorption

The question in pregnancy is how much salicylic acid gets from the skin into the body. A 2011 Motherisk review in Canadian Family Physician gives the absorption of salicylic acid through normal skin as "Undetectable from up to 25%," depending on the product base, its pH, its strength and how much is applied. It adds that "Levels might be higher when applied to damaged skin."

The same review says no studies have been done on salicylic acid used on the skin in pregnancy. Because only a small proportion is absorbed through the skin, it concludes that salicylic acid on the skin "is unlikely to pose any risk to a developing baby." It also points to large studies of low-dose aspirin in pregnancy that found no rise in major birth defects, preterm birth or low birth weight.

A 2017 review in the International Journal of Women's Dermatology says salicylic acid "is deemed safe when used within a limited scope for short periods of time," and that it has rarely caused problems in the body when applied to large areas of damaged skin.

A 2003 review in the American Journal of Clinical Dermatology is more cautious. It says caution is advised in pregnancy "because relevant studies are lacking," and that "Animal data support avoidance of many topical agents, particularly known teratogens such as retinoids and salicylic acid, in pregnant women." A teratogen is something that can cause birth defects. The same review says there are no known cases of salicylate poisoning from salicylic acid acne products.

Why the sources differ

The sources agree on the facts and differ in how cautious they are. No one has studied salicylic acid on the skin in pregnant women. The amount absorbed through normal skin is small and depends on the product. Animal studies raised concern, and salicylic acid is closely related to aspirin. From those facts, the AAD concludes "generally considered safe when used for a limited time," with a talk with your doctor first, and the 2003 review favors avoiding it. Your doctor can weigh your own health and history, which none of these sources can.

Things that raise the amount absorbed

Several factors increase how much salicylic acid enters the body. Each is a reason to keep use small in pregnancy and to ask first:

• Higher strength. Over-the-counter acne products hold 0.5 to 2 percent under FDA rules. The AAD's pregnancy page names strengths above 2 percent as the ones to limit.
• Large areas. MedlinePlus says not to apply topical salicylic acid to large areas of the body unless your doctor says to. A body wash, a scalp shampoo and a face product together cover much more skin than one face gel.
• Covering the skin. MedlinePlus says not to cover treated skin with a bandage or dressing unless your doctor says to. A 2015 review says covering the skin raises absorption.
• Damaged skin. MedlinePlus says not to apply it to broken, red, swollen, irritated or infected skin, and the Motherisk review says levels may be higher on damaged skin.

Peels

A salicylic acid peel is a different product. It uses 20 or 30 percent salicylic acid, applied in a clinic. A 2015 review in Clinical, Cosmetic and Investigational Dermatology says: "Use of SA peels is not recommended during pregnancy because the structure of SA is closely related to that of aspirin." Wait until after pregnancy for a salicylic acid peel.

If you used it before you knew

Many people use a salicylic acid wash before they know they are pregnant. MedlinePlus says to call your doctor if you become pregnant while using topical salicylic acid. Tell your doctor which product you used, its strength, and how often, so they can advise you.

Other acne options in pregnancy

The AAD's pregnancy page says azelaic acid "is thought to be safe to use during pregnancy" and that for benzoyl peroxide "experts say it's safe to use in limited amounts," with a talk with your doctor first. A 2016 review in the Journal of the American Board of Family Medicine says "Topical azelaic acid or benzoyl peroxide can be recommended as baseline therapy." The AAD says most experts recommend stopping adapalene and tretinoin during pregnancy.

Skinli's photo plan uses adapalene, so it does not fit pregnancy. The guide retinoids during pregnancy and breastfeeding explains what the sources say about adapalene and other retinoids.

Breastfeeding

LactMed, the database on medicines and breastfeeding from the U.S. National Institutes of Health, says: "No information is available on the clinical use of salicylic acid on the skin during breastfeeding. Because it is unlikely to be appreciably absorbed or appear in breastmilk, it is considered safe to use during breastfeeding." It adds: "Avoid application to areas of the body that might come in direct contact with the infant's skin or where the drug might be ingested by the infant via licking."

The 2003 review is more cautious here too, advising against salicylates during breastfeeding because aspirin carries a risk of bleeding problems in nursing babies. MedlinePlus says to tell your doctor if you are breastfeeding. Keep salicylic acid off the chest, and ask your doctor.

A simple routine in pregnancy

The AAD's pregnancy skin care page says "the best pregnancy skin care routine is a simple one," and gives three steps from a dermatologist:

1. Cleanse your skin up to twice a day and after sweating.
2. Moisturize regularly with a moisturizer made for your skin type.
3. Protect your skin from the sun with shade, sun-protective clothing, and a broad-spectrum, water-resistant sunscreen of SPF 30 or higher. The page suggests a mineral sunscreen with zinc oxide, titanium dioxide or both during pregnancy to avoid irritation.

The same page suggests products free of fragrance and harsh chemicals such as alcohols and sulfates.

Questions to take to your appointment

• Which acne product, if any, fits my pregnancy?
• Is a salicylic acid face wash at my current strength acceptable, and how often?
• Should I stop the adapalene or other retinoid I was using?
• What should I use if my acne gets worse or becomes painful?
• Which products are fine while I breastfeed?

If your doctor agrees to a product, try it first on a small area, as described in how to patch test a new skincare product. Bring the product boxes or photos of the labels, so your doctor can see the active ingredients and their strengths.

When to see a doctor

See your obstetrician or a dermatologist before you start any acne treatment in pregnancy, as the AAD advises. Also see a doctor for deep, painful acne, acne that leaves scars, or any skin change during pregnancy that worries you.