Which cosmetic active ingredients are not recommended for pregnant and breastfeeding women?

The retinoids are synthetic forms of vitamin A. They are used in skincare for their threefold efficacy on fine lines, acne, and dark spots. They accelerate the exfoliation of dead cells and stimulate 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 molecules such as tretinoin and tazarotene have raised concerns during pregnancy and breastfeeding. They can affect the embryo and developing foetus, causing miscarriage, preterm birth, and congenital malformations.

Classified as potent teratogens, infants may develop the foetal retinol syndrome after the fifteenth day post-conception, which lead to a range of congenital mental and physical malformations. Manifestations may include neurological development delay, craniofacial anomalies, central nervous system defects, cardiovascular anomalies, renal anomalies, thymus dysfunction, parathyroid gland abnormalities, skeletal malformations and/or other physical signs. The scope and severity of anomalies vary depending on the timing of exposure during pregnancy.

However, no studies yet exist on the risks of topical retinol formulations, a type of retinoid widely used in products available without prescription. Although systemic absorption of retinol remains minimal and the compound undergoes rapid metabolism, it is preferable to exercise caution and exclude them from a skin care regimen.