First-trimester pregnancy acne is mostly driven by a surge in progesterone and androgens ramping up oil production fast, while third-trimester breakouts are more often linked to increased blood volume, heat, sweat and a compromised barrier from months of hormonal change. They look similar on your skin, but the underlying cause — and sometimes the best approach — is a little different.
General information, not medical advice — always check with your GP, midwife or pharmacist about your own skin and any product you're unsure of.
First Trimester: The Hormone Surge Breakout
In the first few weeks of pregnancy, progesterone rises sharply and androgens follow, both of which stimulate your oil glands. If you were ever going to be caught off guard by a breakout, this is usually when — often before you've even told anyone you're expecting. Skin can look and feel like the oily, congested skin of puberty, with breakouts concentrated around the chin, jaw and cheeks.
The good news is that a lot of the acids and treatments that worked for you before pregnancy just need pausing, not replacing with nothing. I've written a full breakdown of what's safe for pregnancy breakouts if you want the ingredient-by-ingredient version.
Third Trimester: The Heat-and-Barrier Breakout
By the third trimester, your blood volume has increased substantially and your body is running warmer, which means more sweat and oil sitting on the skin's surface, especially in Australian summer humidity. Your barrier has also usually taken months of hormonal hits by this point, so it's more reactive and slower to recover from congestion. The breakouts here often sit deeper and can feel more like inflamed bumps than the surface-level pimples of early pregnancy.
What's Safe to Use, Whichever Trimester You're In
Niacinamide and azelaic acid are generally considered pregnancy-safe and can help with the appearance of both oil and congestion. Gentle, low-strength salicylic acid in wash-off cleansers is typically fine, but leave-on, high-strength salicylic acid, along with retinoids and oral acne medications, should be avoided in pregnancy without your doctor's guidance. Keep cleansing gentle rather than stripping, and don't skip moisturiser just because your skin is breaking out — under-hydrated skin often produces more oil, not less.
Questions mums ask
Does pregnancy acne mean I'm having a certain gender baby?
No — this is a popular myth with no scientific basis. Breakouts are driven by your individual hormone levels and skin type, not the baby's sex.
Can I use a spot treatment with benzoyl peroxide?
Benzoyl peroxide is generally considered lower-risk than some other acne actives, but it's still worth checking with your GP or pharmacist before using it regularly in pregnancy, especially at higher strengths.
Will pregnancy acne come back after the baby is born?
It can — postpartum hormone shifts and breastfeeding both bring their own acne patterns, which are often a bit different again from what you experienced during pregnancy.
Where to start
Whichever trimester you're navigating, The Pregnancy-Safe Routine ($185) is built around ingredients that are gentle enough for congestion-prone, hormonal skin. If your breakouts sit alongside a stressed, reactive barrier, The Barrier Repair Set ($188) is worth adding in too.
Edwina x
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