A pregnancy skincare routine: what to use morning and evening
Pregnancy changes your skin in ways that are hard to predict, and the advice online tends to focus almost entirely on what to avoid. That is useful, but it leaves a gap: what should you actually be putting on your face each morning and evening? This article gives you a straightforward, step-by-step routine using ingredients that are safe and effective throughout pregnancy, with specific guidance for the three most common concerns: acne, pigmentation and dryness. If you want the full breakdown of which ingredients to avoid and why, see our companion article on pregnancy-safe skincare ingredients.
How pregnancy changes your skin
Hormonal surges in oestrogen, progesterone and melanocyte-stimulating hormone drive most of the visible skin changes you will notice. The effects vary enormously from person to person and can shift in each trimester. Some people experience the "glow" that is often talked about, caused by increased blood volume bringing more circulation to the surface of the skin. Others deal with the opposite: breakouts, dark patches, increased dryness or new sensitivities to products that used to feel fine.
Melasma, sometimes called the "mask of pregnancy", appears as darker patches on the cheeks, forehead and upper lip and affects up to 70% of pregnant people to some degree. It is driven by the same hormonal increase in melanin production and is significantly worsened by UV exposure. Acne, particularly in the first trimester, is also common due to the rapid hormonal shift. Dryness and itchiness on the bump and elsewhere increase as the skin stretches and the body redirects resources. All of these responses are normal. They do not mean something is wrong, and most resolve after birth.
Your morning routine
A morning routine has one job above all others in pregnancy: protect. Here is what that looks like, step by step.
- Gentle cleanser. Choose a fragrance-free, pH-balanced formula that does not strip the skin. Foaming cleansers that leave your face feeling tight are doing more harm than good. A cream or gel cleanser with no sulphates or heavy fragrance is ideal.
- Vitamin C serum. Vitamin C is an antioxidant that protects against the free-radical damage caused by UV exposure and pollution, and it also helps brighten uneven skin tone over time. It is generally well-tolerated in pregnancy and is one of the best tools you have for early pigmentation. Look for a stable form: L-ascorbic acid, ascorbyl glucoside or sodium ascorbyl phosphate all work well.
- Moisturiser. A ceramide-based or hyaluronic acid moisturiser keeps your skin barrier intact and locks in hydration. This step matters more in pregnancy, when hormonal changes and the physical demands of growing a baby can leave skin drier than usual.
- Mineral SPF. This is the single most important step in your morning routine, full stop. Choose a mineral sunscreen with zinc oxide or titanium dioxide at SPF 30 or higher. Apply it every day, including in winter and on overcast days. Melasma worsens dramatically with UV exposure, and consistent daily sun protection is far more effective at managing it than any treatment applied after the fact.
Your evening routine
The evening is your opportunity to treat and repair. Keep it simple: a two or three step routine works better than a complicated eight-step one with products that might clash.
- Cleanser or double cleanse. If you have been wearing SPF or makeup, start with an oil cleanser to dissolve it, followed by a gentle water-based cleanser. If you have not worn SPF or makeup, one gentle cleanser is enough. Do not cleanse more than twice a day: over-cleansing strips the barrier and tends to make both dryness and acne worse.
- Treatment step: azelaic acid or niacinamide. Both of these are safe in pregnancy and do real work. Azelaic acid (available at 10% over the counter, or higher by prescription) addresses acne and pigmentation simultaneously, making it particularly useful in pregnancy. Niacinamide calms redness, regulates oil production, supports the skin barrier and helps with uneven tone. You do not need both every night: choose one or alternate.
- Moisturiser. A ceramide or peptide-based night moisturiser seals everything in and supports skin repair overnight. You do not need a separate "anti-ageing" night cream: a good moisturiser with ceramides does the same job without the unnecessary extras.
- Eye cream if needed. Not essential for everyone, but if you find the skin around your eyes is particularly dry or sensitive, a gentle fragrance-free eye cream is fine. Check that it does not contain retinol, which is common in eye cream formulas and should be avoided during pregnancy.
Dealing with pregnancy acne
The hormonal surge in the first trimester can trigger acne even in people who have not had it since their teens, and it can be frustrating when many of the usual treatments are off the list. The good news is that there are effective options that are safe to use.
Gentle cleansing twice a day is the foundation. Over-cleansing or using harsh scrubs makes acne worse, not better, by stripping the skin barrier and triggering more oil production. Beyond that, azelaic acid is the most versatile pregnancy-safe acne treatment: it reduces the bacteria that cause breakouts, calms inflammation and tackles any resulting pigmentation at the same time. Benzoyl peroxide at 2.5% to 5%, applied to specific spots rather than used all over the face, is generally considered low risk. Topical clindamycin (an antibiotic) is another option your GP can prescribe if over-the-counter products are not enough.
What to avoid: retinoids (tretinoin, adapalene), oral isotretinoin (Roaccutane, which is absolutely contraindicated in pregnancy), and high-concentration leave-on salicylic acid. The American Academy of Dermatology advises seeking medical advice before using any prescription acne treatments while pregnant. If your acne is severe or affecting your mental health, speaking to your GP or a dermatologist is absolutely the right move, not something to push through on your own.
Melasma and pregnancy pigmentation
Up to 70% of pregnant people develop some degree of pigmentation change. The "mask of pregnancy" typically appears as dark patches on the cheeks, forehead and upper lip, and it is directly driven by the hormonal increase in melanin production during pregnancy.
Prevention is more effective than treatment here. Daily mineral SPF is the most important thing you can do, because UV exposure accelerates melasma dramatically. Vitamin C in your morning routine provides antioxidant protection and gradually brightens existing patches. Azelaic acid in the evening helps reduce pigmentation over time. This combination, morning SPF plus vitamin C, evening azelaic acid, is the approach most dermatologists recommend for pregnancy melasma. Hydroquinone, which is often prescribed for melasma outside of pregnancy, should be avoided until after you have finished breastfeeding.
Most melasma fades within a few months after birth. It can take longer if sun exposure continues, which is another reason consistent SPF use matters not just during pregnancy but beyond it.
Stretch marks: what actually helps
No cream or oil has been proven in clinical trials to prevent stretch marks. Genetics plays the biggest role in whether you develop them, how many, and how visible they are. That said, keeping the skin well-hydrated may reduce the itchiness that often accompanies stretching skin, and there is some evidence it may support elasticity slightly, even if it cannot change what your genetics have determined.
Safe options to apply to your bump, thighs, breasts and anywhere skin is stretching include rosehip oil, coconut oil, sweet almond oil and shea butter. All of these are safe during pregnancy. Apply after a bath or shower when skin is warm and more absorbent, which helps the product sink in rather than sit on the surface. The ritual of applying it is also genuinely calming, which is worth something in itself.
When to see a dermatologist during pregnancy
Most skin changes in pregnancy are normal and manageable with the approach above. There are situations where you should see your GP or a dermatologist rather than managing it yourself.
See a doctor if you develop intense itching across your whole body, not just the stretched skin of your bump. This can indicate obstetric cholestasis, a liver condition that requires prompt medical attention, and it is not something to wait and see on. PUPPP (pruritic urticarial papules and plaques of pregnancy) is a very itchy red rash that appears in late pregnancy, most often on the abdomen: it is not dangerous but is uncomfortable enough that medical support is worthwhile. Severe acne that is affecting your mental health deserves a referral rather than continued attempts at self-management. And if you notice a mole or skin lesion that is changing shape, colour or size, do not assume it is pregnancy-related: get it checked.
Frequently asked questions
Can I use my normal moisturiser during pregnancy?
Most regular moisturisers are fine during pregnancy. Check the ingredients list and avoid anything containing retinol, retinoids, or salicylic acid in high concentrations. Fragrance-free ceramide or hyaluronic acid moisturisers work well for most people throughout pregnancy and are worth switching to if your usual formula contains any of those ingredients.
What is the best SPF to use during pregnancy?
Mineral sunscreens using zinc oxide or titanium dioxide are preferred in pregnancy. They sit on top of the skin rather than being absorbed, and there is no evidence of harm to a developing baby. Choose SPF 30 or higher and apply every morning, including in winter and on cloudy days. This is the single most impactful step in managing pregnancy pigmentation.
How do I treat pregnancy acne safely?
Gentle cleansing twice daily, azelaic acid as a treatment step, and benzoyl peroxide 2.5% applied to specific spots are all considered low risk during pregnancy. Avoid retinoids and any oral medications without medical supervision. Your GP can prescribe topical clindamycin or higher-strength azelaic acid if over-the-counter products are not enough.
Does vitamin C serum help with pregnancy pigmentation?
Yes. Vitamin C is an antioxidant that helps brighten skin and gradually reduce the appearance of dark spots. It works particularly well alongside daily mineral SPF and an evening azelaic acid step. Look for a stable form such as ascorbic acid, ascorbyl glucoside or sodium ascorbyl phosphate.
Do any creams actually prevent stretch marks?
No cream or oil has been shown to prevent stretch marks in clinical trials. Genetics is the biggest determining factor. Keeping skin well-hydrated reduces itching and may support elasticity slightly. Oils such as rosehip, coconut and sweet almond, and products containing shea butter, are all safe and many people find them comforting to use.
When should I see a dermatologist during pregnancy?
If you have severe acne, intense all-over itching (which can indicate obstetric cholestasis), PUPPP rash, or concerns about a changing mole or skin lesion, see your GP promptly. They can refer you to a dermatologist and confirm whether what you are experiencing needs medical treatment rather than a skincare adjustment.
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