Is Retinol Safe While Pregnant or Breastfeeding? What the Research Actually Says

I get some version of this question constantly, from coworkers, from friends who just found out they're expecting, from my own patients when it comes up in passing. Can I still use my retinol?

I understand the panic behind it. You've built a routine you actually like, and now you're being told to just stop, without much explanation of why.

As a nurse, I want to give you a real answer instead of just "ask your doctor" and leave it there, though I'll still say that too, because I mean it.

Here's what the research actually shows, and why the guidance stays cautious even when the data is fairly reassuring.

What the Research Actually Shows

A large study published in 2025 looked at nationwide health records across Denmark, Iceland, Norway, and Sweden, covering 3.87 million births.

Researchers identified infants with confirmed topical retinoid exposure during the first trimester, when organ development is most sensitive, and compared their outcomes to infants without that exposure.

The results were reassuring. Among exposed infants, 3.3% had a major congenital malformation, compared with 3.0% among those not exposed.

After adjusting for maternal age, country, and birth year, that small difference was not statistically significant. A comparison group exposed to other topical acne treatments showed a similarly unchanged risk.

This is the largest study of its kind on this specific question, and it lines up with smaller studies before it that also failed to find a clear increase in risk from topical retinoid use.

Why Guidance Still Says to Avoid It

If the data is reassuring, you might wonder why every dermatologist and OB still says to stop. I asked myself the same thing before I understood the full picture.

The caution comes from a different retinoid entirely. Oral isotretinoin, the prescription medication for severe acne, is a well-established human teratogen.

Its malformation rate in exposed pregnancies is estimated between 20% and 35%. That risk is real, serious, and not in question.

Topical retinol and tretinoin are structurally related to isotretinoin, but they behave very differently once applied to skin. Topical application results in minimal absorption into the bloodstream, nowhere near the levels reached with an oral medication.

Even so, because the ingredient family carries that association, the standard medical approach is to avoid the entire category during pregnancy. That's simpler and safer than trying to draw a fine line between "probably fine" and "definitely fine."

I understand that reasoning, and as someone who has seen how devastating isotretinoin exposure can be, I don't think it's overly cautious. It's the kind of precaution I'd want in place for myself.

What About Breastfeeding?

The research here is thinner than the pregnancy data, which makes it harder to give a confident answer either way.

What we do know is that topical retinoids have very low systemic absorption, and the amount that could theoretically pass into breast milk is expected to be even smaller.

Some professional guidance now categorizes topical retinoids as compatible with breastfeeding in small amounts, particularly when applied to the face and kept away from the chest, where a baby's skin and mouth make contact. Other guidance still recommends waiting.

Given the mixed picture, I'd treat this as a conversation to have directly with your OB or your baby's pediatrician, especially if you're using anything beyond a small, occasional amount.

What to Use Instead in the Meantime

The good news is that you don't have to leave your skin unsupported during this window. A few gentler options can fill the same slot in your routine without the same caution flags.

Bakuchiol is a plant-derived ingredient that behaves similarly to retinol without being a retinoid itself, and it doesn't carry the same pregnancy caution.

Vitamin C and peptide serums are also generally considered safe choices, since neither works through the same mechanism that makes retinoids a concern.

Our best bakuchiol serums guide covers the plant-based option in more depth, and our best anti-aging serums guide includes several peptide and vitamin C formulas that can round out a gentler routine for this stage of life.

Practical Takeaways

When you're ready to bring retinol back into your routine, our piece on the retinol purge walks through how to restart gradually, since your skin's tolerance may have reset during the break.

Our best retinol serums guide can help you choose a gentle formula for that restart, and our anti-aging serum routine shows where it fits alongside everything else once you're back to a full routine.

I know how frustrating it feels to pause something that was working for you. But this is a short window in a much longer routine, and there are gentle ways to keep caring for your skin while you wait.

This article is for informational purposes only and does not constitute medical advice. Please talk with your OB, midwife, or dermatologist about your specific situation before starting, stopping, or continuing any skincare active during pregnancy or while breastfeeding.

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