Welcome to “Managing Acne Safely: Treatment Options for Breastfeeding Women”. This guide is designed to provide you with the latest information and safe, effective strategies for managing acne while breastfeeding. We understand the unique challenges faced by breastfeeding mothers who are also dealing with acne. In this guide, we will explore a variety of treatment options, both topical and systemic.
Topical Acne Treatment options for Breastfeeding Women
- Benzoyl peroxide
- Azelaic acid
- Salicylic or glycolic acids
- Topical clindamycin + BPO
- Topical sodium sulfacetamide ± sulfur
- Topical retinoids
- Low risk (limit tazarotene to < 20% BSA)
- Topical metronidazole + BPO
Systemic Antibiotics For Breastfeeding Women
- Oral amoxicillin
- Spironolactone
- Spironolactone looks to be safe to take during lactation. [Ref]
- Oral cephalexin
- Oral azithromycin
- Oral erythromycins
- It is important to observe the infant for signs of irritability and potential impacts on gastrointestinal flora, such as diaper rash, thrush, and diarrhea.
- Possibility of hypertrophic pyloric stenosis in infants when erythromycin is used by the mother during the first two weeks of breastfeeding (very rare).
- Trimethoprim/sulfamethoxazole
- Better avoided with less than 2 months infants.
- Avoid if the baby has hyperbilirubinemia or G6PD deficiency
- Avoid in premature neonates.
Contraindicated Drugs during breastfeeding
Topical drugs
- Topical Dapsone.
- The manufacturer advises against its use during breastfeeding.
Systemic drugs
- Isotretinoin
- Oral metronidazole:
- Discontinue breastfeeding for 12–24 h after single-dose therapy.
Isotretinoin is not recommended for use during breastfeeding.While there hasn’t been direct research on its effects on breastfeeding infants due to ethical constraints [Ref], the chemical properties of isotretinoin suggest that it can cross into breast milk and potentially harm the infant.
There have been reports of breast reactions in patients taking isotretinoin, such as an increase in breast size in men (gynecomastia) [Ref] and spontaneous flow of milk from the breast in a man or non-breastfeeding woman (galactorrhea). These reactions suggest that isotretinoin may indeed cross into breast milk.
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