Postpartum is a period encompassed by significant changes, such as the arrival of a new baby, creating a new routine, and for many, unwelcome changes to the skin.¹ Despite acne typically being related to our teenage years, hormonal shifts during pregnancy can unpredictably affect the skin postpartum. Postpartum acne can be distressing, but with this article, and the right knowledge and strategies, it can be effectively managed and treated. 

Introduction: what is postpartum acne?

Postpartum acne can be defined as a chronic dermatologic condition that affects people after pregnancy and during lactation notably due to the hormonal fluctuations experienced during this period.² Notably the elevated levels of progesterone experienced towards the end of pregnancy have been known to be implicated in increased sebum production, causing pores to become clogged and resulting in acne breakouts.

Management of postpartum acne

Managing postpartum acne requires a diverse approach that involves addressing hormonal imbalances, lifestyle factors, and skincare routines. By adopting targeted strategies, you can effectively manage and alleviate the symptoms of postpartum acne.

Lifestyle modifications

Before opting for invasive treatments or medications, first consider making lifestyle modifications to address postpartum acne effectively and holistically.^3,4

Dietary modifications, hydration and supplementation

Incorporating nutrient-rich foods such as fruits, vegetables, lean proteins, and omega-3 fatty acids, while minimising processed foods, sugary snacks, and dairy products can exacerbate acne. Additionally, prioritizing hydration and nutrition to nourish the skin from within. Drinking around two litres daily can maintain skin hydration and support detoxification processes. Consider supplementing with vitamins and minerals that are essential for skin health and repair, such as vitamin A, vitamin C, vitamin E, and zinc.

Stress reduction techniques

Using stress reduction techniques can help alleviate the psychological and physiological stressors associated with postpartum. Practice mindfulness, meditation, yoga, deep breathing exercises, or other relaxation techniques to promote emotional well-being and reduce cortisol levels.

Exercise

Exercise has proven benefits in skin health as it promotes blood circulation, delivering oxygen and essential nutrients to the skin cells. Exercise also has shown an impact on sleep quality, immune function, and regulation of hormones. Furthermore, the sweat produced in exercise can help unclog pores, reduce sebum build-up, and prevent acne breakouts.

Establishing a consistent skincare routine

Finding and adhering to a regular skincare routine tailored to your skincare type and concerns can promote skin health, minimize inflammation, and prevent acne flare-ups. There are a lot of products on the market that are targeted toward acne-prone skin however studies have demonstrated that a simple routine comprised of a cleanser and a moisturiser can vastly help the skin.⁵

Why is cleansing important in postpartum acne?

The fluctuating hormones during postpartum can cause the body to produce excess oil which clogs the pores with dirt and dead skin cells. Cleansing helps remove these build-ups, preventing pore blockages and reducing the likelihood of acne breakouts. Here is what to look for when trying out new cleansers:

1. pH

For people with acne, normal soaps have a high pH and can be considerably irritable to the skin. Additionally, antibacterial face washes may have a positive effect on mild acne but might also irritate more sensitive skin. The key is finding the right balance between the two. Soap-free cleansing products have a similar pH to the skin (5.5) and are more suitable for people with acne.⁶

2. Mild surfactants

Products with mild surfactants like Zinc Coceth sulphate can effectively remove dirt, oil, and impurities from the skin’s surface. They have low irritation potential and enable the cleanser to retain its effectiveness at a low pH.⁵

3. Anti-inflammatory products

Zinc Gluconate and Dipotassium glycyrrhizate have anti-inflammatory properties that have been linked to the inhibition of superoxide formation and the breaking down of cortisol (stress hormone) in the skin.⁵

4. Humectants

Humectants are important because they help maintain and improve skin hydration. By promoting water retention in the different layers of the skin, humectants can counteract dryness from cleansing agents, irritation, and inflammation. Additionally, by ensuring the skin is hydrated, it allows more topical acne treatments to penetrate more effectively. Ingredients such as hyaluronic acid and glycerine are non-comedogenic (they do not clog pores), have inflammatory healing properties, provide lightweight hydration, and enhance penetration.⁵

Why is moisturising important in postpartum acne management?

Proper hydration is essential in maintaining skin health and function. Moisture can be lost in the skin due to poor diet and hydration and fluctuating hormones due to postpartum and breastfeeding. A healthy skin barrier can protect against irritants, bacteria, and other harmful substances from penetrating the skin and leading to acne. Additionally, when the skin is well-hydrated and moisturise, it can help regulate the skin’s natural oil production by preventing dehydration. It does this by signalling to the sebaceous glands to produce less oil, reducing the risk of pore blockages and acne.⁵

Here is what to look for when trying out new moisturisers:

Non-comedogenic ingredients

Choosing moisturisers that will not clog the pores or aggravate acne breakouts are essential. Opting for products labelled as ‘oil-free’ or lightweight formulas can help avoid adding excess oil to the skin. Gel-based, water-based, or oil-in-water emulsions are often suitable choices for postpartum acne.⁶

Humectant ingredients

Like in cleansers, these ingredients are essential in attracting and retaining moisture in the skin without feeling heavy or greasy.

Calming and anti-inflammatory ingredients

Moisturisers formulated with soothing agents such as aloe vera, chamomile, or niacinamide can help calm redness, irritation, and inflammation associated with postpartum acne.

Sun protection

The sun can aid in post-inflammatory hyperpigmentation and acne scarring so selecting a moisturiser with SPF protection can shield from harmful UV rays which can not only darken existing hyperpigmentation but also lead to the formation of new pigmented spots and worsen the appearance of acne scars.⁵ 

Treatment for postpartum acne

In many cases, postpartum acne may not respond to the management techniques listed above. Thus, It may be worth considering seeking a doctor or dermatologist's advice about topical treatments that may be useful in treating the skin. However, these treatments must be thoroughly researched and used in line with guidance provided by a medical professional as they are known to be harmful and irritable to the skin.²

Treatment options for postpartum acne

Topical treatments

Products with ingredients such as benzoyl peroxide, salicylic acid, glycolic acid, and topical antibiotics have antibacterial and exfoliating properties that can help unclog pores by removing excess oil and dead skin cells.

Alternatively, natural remedies such as tea tree oil, witch hazel, and aloe vera possess antibacterial and anti-inflammatory properties.⁸

Oral medications

If lifestyle modifications and topical treatments have proven to be ineffective, a doctor may consider prescribing antibiotics or contraceptives. Antibiotics can help reduce inflammation and acne breakouts while contraception can help regulate hormone fluctuations that stimulate excess oil production and contribute to acne formation. 

However, these medications may not be suitable for breastfeeding mothers and often come with potential side effects therefore it is worth discussing it with a healthcare provider.²

Prevention

While it may be challenging to eliminate the impact of lifestyle and stress factors on postpartum acne, certain measures can help minimize the risk and severity of breakouts. By avoiding, pore-clogging and irritating products and avoiding harmful acne removal procedures without the guidance of a professional, individuals can significantly reduce the risk of exacerbating postpartum acne.⁷ Here are some proactive steps to consider:

• Stay away from fragranced and hypoallergenic products
• Avoiding harsh skincare products
• Not picking or squeezing pimples
• Using non-comedogenic makeup products

FAQ’s

How long does postpartum acne usually last?

Postpartum acne is temporary and typically stabilises once hormone levels revert to their pre-pregnancy state. In most cases, this can take a few weeks however individuals may experience a longer duration of several months depending on hormonal fluctuations and lifestyle factors.

How can I prevent acne after pregnancy?

Maintaining a healthy lifestyle, prioritizing sleep, a consistent skincare routine, and reducing stress can help curb acne breakouts. Additionally, using topical treatments, under doctor, supervision can also help with postpartum acne.

What are the best acne products to use while breastfeeding?

The use of topical treatments such as topical antibiotics and exfoliants has proven to be safer and recommended in breastfeeding. Oral antibiotics may be considered at the recommendation of a doctor however many do pose a risk of being present in breastmilk.

What causes postpartum acne?

Hormones are a leading cause of acne however genetics, diet, and hydration can also increase chances of developing acne after childbirth. Additionally, breastfeeding can also be shown to stimulate oil production and potential acne breakouts. 

Summary key points

• Postpartum acne is a common dermatologic condition affecting individuals after pregnancy and during lactation, often triggered by hormonal fluctuations and changes to lifestyle routines
• Lifestyle modifications, such as maintaining a balanced diet, staying hydrated, managing stress, prioritizing sleep, exercising, and establishing a consistent skincare routine, can help mitigate the risk and severity of postpartum acne
• Treatment options for postpartum acne may include topical treatments containing benzoyl peroxide, salicylic acid, or glycolic acid, as well as natural remedies like tea tree oil or witch hazel. In severe cases, oral medications such as antibiotics or contraceptives may be prescribed, but consultation with a healthcare provider is recommended
• Prevention strategies such as avoiding pore-clogging and irritating products, as well as refraining from harmful acne removal procedures without professional guidance, are crucial in preventing exacerbation of postpartum acne

REMEMBER: Managing postpartum acne is a journey, and seeking professional help from a dermatologist or healthcare provider is always an option. If lifestyle modifications and over-the-counter treatments are not effective, or if acne is severe and persistent, consulting with a medical professional can provide personalized treatment recommendations and support. Don't hesitate to reach out for help if postpartum acne is impacting your quality of life or self-esteem. With proper care and guidance, clearer, healthier skin is within reach.