Which cosmetic active ingredients are not recommended for pregnant and nursing people?

The retinoids are synthetic forms of vitamin A. They address fine lines, acne, and brown spots by promoting exfoliation of dead cells and stimulating collagen production. Retinoids are available over the counter (retinol, retinaldehyde, retinal, retinyl palmitate) and by prescription (adapalene, tretinoin, tazarotene, isotretinoin, retinoic acid). However, oral retinoids such as isotretinoin and first-generation topical agents such as tretinoin and tazarotene may pose concerns during pregnancy and breastfeeding. They can affect the embryo and developing fetus, causing miscarriage, preterm birth, and various congenital malformations.

Classified as potent teratogens, infants may develop of fetal retinol syndrome beyond day 15 after conception, causing a range of congenital mental and physical malformations. Manifestations may include delayed neurological development, anomalies of the craniofacial region, central nervous system, cardiovascular system, renal system, thymus function, parathyroid glands, skeletal malformations, and other physical signs. The extent and severity of associated anomalies vary depending on timing of exposure during pregnancy.

However, no studies have evaluated the risks of topical retinol, a retinoid found in over-the-counter products. Although systemic absorption remains minimal and the compound undergoes rapid metabolism, we recommend caution and removing them from your skincare routine.