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Dermatology and pregnancy: no retinoids,
not even topical

Oral retinoids, used in particular against acne, must absolutely be avoided during pregnancy as they can cause foetal malformation. As a precaution, it is wise to steer clear of topical retinoids too.

Retinoids, including isotretinoine, are derived from vitamin A. They are mainly used in dermatology, especially for the treatment of acne and psoriasis. Retinoids are teratogenic (i.e. they cause birth defects). A quarter of the fœtuses exposed in utero to orally administered isotretinoin are born with defects, which can be serious: craniofacial (missing ear, etc.), cardiac, or of the nervous system (malformations, intelligence deficit). Oral retinoids must not be taken during pregnancy. Their use must be closely supervised and the patient must use reliable contraception. Isolated cases of malformations have been notified concerning women using topically applied retinoids. Studies involving a large number of women have left a margin of doubt and cannot rule out a possible risk. It is wiser not to prescribe either oral or topical retinoids for women who are pregnant or likely to become pregnant (no contraception). Acne is generally benign, and does not justify such a huge teratogenic risk.

©Prescrire February 2005

Source: "Éviter les rétinoïdes en application cutanée pendant la grossesse (suite)" Rev Prescrire 2005 ; 25 (258) : 106-108.

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