Treatment of acne in pregnant women is inconsistent. International Journal of Women’s Dermatology.
In addition, studies have shown that treatment for this condition does not always follow evidence-based guidelines. Based on their study, the study authors stress the importance of doctors caring for women and pregnant women “getting to know themselves better. [American Board of Family Medicine] Guidelines for acne treatment during pregnancy.
Common treatments for acne are known to be unsafe for pregnant women, but alternative treatments exist that are safe to use. Yes, the authors point out.
Inflammatory disease is also common during pregnancy, and “many first-line acne treatments are teratogenic, complicating the management of this condition,” the researchers said. may alter the normal intrauterine development and bodily functions of
To better understand acne management in pregnant patients, researchers evaluated real-world data from the Northwestern Medicine Enterprise Data Warehouse.
This dataset contains information from over 40 clinics and 100 healthcare providers in the Chicago metropolitan area. A total of 4050 analyzed patient encounters diagnosed with acne vulgaris were identified, while 115 visits occurred in pregnancy-related encounters. Of the 115 patients included, 66 were trying to conceive within the next year, 37 were pregnant, and 12 were lactating.
- Azelaic acid 15% gel and clindamycin 1% gel, solution or lotion were the most commonly prescribed treatments in 83.3% and 69.7% of patients desiring pregnancy and 75.7% and 75.7% of pregnant patients. 56.8% prescribed these drugs.
- Only 13.5% of currently pregnant patients were prescribed category C prescriptions (benzoyl peroxide, tretinoin, adapalene, dapsone, spironolactone, trimethoprim-sulfamethoxazole), providing safe treatment for acne during pregnancy. suggesting.
- Among non-pregnancy-related encounters, prescribing rates for azelaic acid (4.5%) and clindamycin (54.0%) were lower, and recommendations for other pregnancy C drugs (retinoids, spironolactone, dapsone) were higher than for pregnancy-related encounters. was also expensive.
“These findings suggest significant adjustments in acne treatment regimens for safety during and during pregnancy, as well as providers’ awareness of the teratogenic effects of acne medications,” the authors said. I am writing.
However, guidelines from the National Board of Family Medicine recommend avoiding antibiotic monotherapy in pregnant patients with acne and instead recommending the use of benzoyl peroxide as a first-line treatment to avoid antibiotic resistance. I’m here.
Of the 37 pregnant patients included in the study, 16% were prescribed antibiotic monotherapy, a higher rate than the 7% in the nonpregnant population.
Benzoyl peroxide 2.5%-10% was also recommended at lower rates in the pregnant group compared to the non-pregnant group.
“The high rate of antibiotic monotherapy and the low rate of benzoyl peroxide prescribed to pregnant patients reflect the limitations of ideal acne treatment and highlight potential areas for improvement. It may be embossed,” the author wrote.
A relatively small sample size indicates a study limitation: trends and generalizations can be inferred from the data set, but researchers warn that the sample size is too small to determine statistical significance. Also, the data only reflected a single healthcare system.
Data indicate that acne treatment regimens in pregnant patients are adjusted to account for the possible adverse effects of some drugs on fetal growth, but the American Academy of Dermatology has We have identified acne treatment in women in the middle as a research gap, leaving room for research improvement,” the authors wrote.
“It is imperative that health care providers pay attention to the class of medications during pregnancy and become familiar with the recommended guidelines for optimal patient management,” they concluded.
Garg SP, Alvi S, Kundu RV. Analysis of treatment trends in acne vulgaris during pregnancy: a retrospective study. Int J Women’s Dermatol. Published online March 9, 2023. doi:10.1097/JW9.0000000000000076