Being pregnant is nothing short of miraculous, but it’s also really damn hard. I recently gave birth to my second child, and during both pregnancies, my body didn’t look or feel like my own, my anxiety levels were always elevated, and my skin? It was a disaster. (The pregnancy glow that people rave about? I didn’t experience it.)

During my first pregnancy my face was constantly oily and full of angry cystic breakouts. Then came the perioral dermatitis (a fancy term for inflammation around the chin and mouth). My very stubborn post-inflammatory hyperpigmentation—aka acne scars—from all those hormonal breakouts took forever to go away, too.

I knew I couldn’t be the only person with this experience, which prompted me to chat with dermatologists to find out what really happens to skin during pregnancy and learn how skincare routines should shift while growing a human. Keep in mind that you should always consult with your OB about specific concerns, but the following information can be used as a starter guide to pregnancy skincare. Prepare yourself, because you’re about to learn a lot.

How should my skincare routine change during pregnancy?

Your skin goes through a variety of changes during pregnancy because of hormonal fluctuations. Board-certified dermatologist Marisa Garshick, MD, says this can lead to acne, dryness, sensitivity, and hyperpigmentation. “It is important to adjust your skincare routine to address these concerns while making sure the ingredients you are using are safe during pregnancy,” she explains. “In general, I recommend keeping the routine simple and focusing on gentle cleansing, hydration, skin barrier support, and sun protection.” We’ll get into more details about this routine a little later, but first…

What skincare ingredients aren’t pregnancy safe?

Depending on who you ask, the list of what skincare to avoid while pregnant can either be really long or really short. “It’s a big gray area,” says board-certified dermatologist Heather Rogers, MD. “There’s very little scientific data surrounding skincare ingredients and pregnancy, and the vast majority of recommendations come from inference,” she says. This makes sense considering most pregnant women wouldn’t willingly volunteer to be in a scientific study or clinical trial that comes with any potential risks to their fetus.

This is why topical retinoids—a derivative of vitamin A—are most commonly avoided during pregnancy. Dr. Rogers explains that, through research, we know that taking high doses of vitamin A orally (in the form of Accutane) causes birth defects, so doctors infer that the topical versions must be bad or potentially harmful too.

If you want to be extra cautious, Dr. Garshick also suggests avoiding hydroquinone (which is often used to treat hyperpigmentation), and high concentrations of exfoliating acids (like glycolic and salicylic acids). “Low concentrations of exfoliating acids used on small areas are generally considered low risk, though,” she adds.

Is pregnancy glow a real thing?

Technically, yes, but not all women will experience the “glow” during their pregnancy. Dr. Garshick explains that as blood volume increases during gestation, it can lead to more blood flow in the skin, which gives some people that flushed, radiant appearance. That said, “sometimes hormonal changes lead to increased oil production which may make the skin seem more dewy, but also can contribute to acne and other skin concerns,” she adds.

An easy pregnancy-safe skincare routine

Most skincare is “safe” for pregnant women, so don’t feel like you need to overhaul your existing routine and replace everything with all-natural or organic products (although that’s totally fine if you choose to do so). Ultimately, the safest and best skincare to use during pregnancy contains ingredients that are approved by your OB and tailored to your specific skin type and concerns, which can be narrowed down by a derm or skincare pro if you’re feeling overwhelmed or confused.

Still, if you’d like some guidance, follow this dermatologist-recommended skincare framework during your pregnancy.

1. Use a cleanser

Hormonal fluctuations that occur during pregnancy can lead to more oil production, so you should always begin your routine with washing your face, regardless of whether you’re wearing makeup or not. Dr. Garshick recommends a “gentle, hydrating cleanser that removes dirt and oil without stripping the skin of its natural moisture.” I like the La Roche-Posay Toleriane Purifying Foaming Cleanser.

2. Stick with gentle serums

Serums are typically the most potent products in your skincare routine, so you’ll want to pay attention to the ingredients when choosing which ones to use throughout pregnancy. Dr. Garshick says to look for formulas with hyaluronic acid, niacinamide, and azelaic acid because they can “help address concerns such as dryness, discoloration, and breakouts.”

You can still use vitamin C while pregnant, but maybe swap your current pick for one that also contains niacinamide for extra skin barrier support. The Summer Fridays CC Me Serum is a great addition to your morning routine. In the evening, Dr. Garshick suggests using an azelaic acid serum if you are dealing with acne or hyperpigmentation.

3. Always remember moisturizer

Maintain hydration levels and strengthen your skin barrier with a moisturizer packed with hyaluronic acid, ceramides, or glycerin. You don’t need anything super fancy—the CeraVe Moisturizing Cream contains all three hydrators and is under $20.

4. Sunscreen is still important!

Yes, you still need to wear sunscreen while pregnant. Dr. Garshick recommends using a broad-spectrum SPF 30 or higher every morning. My favorite is the Alastin HydraTint Pro Mineral Broad Spectrum Sunscreen SPF 36.

Meet the experts

Why trust Cosmopolitan?

Lauren Balsamo is the beauty director at Cosmopolitan with over a decade of experience researching, writing, and editing skincare stories. She’s an authority in all skincare categories but an expert when it comes to pregnancy skincare products. She used the products recommended in this article during her two pregnancies.

Mary Honkus is a contributor for Cosmopolitan with eight years of experience researching, writing, and editing beauty stories, including a deep dive on face mists and making a case for hypochlorous acid for skin. She’s an authority in all beauty categories and prides herself on her skin. For this story, she spoke with dermatologists to learn how skin changes during pregnancy.

Mary Honkus is a freelance writer who covers beauty, home, fashion, health, and wellness (just call her a jack of all trades!). She has held staff roles at Real Simple, People, and InStyle, and her bylines can be found in numerous other publications. When she’s not testing the latest and greatest products, she can be found chilling on her Hell’s Kitchen rooftop, checking out NYC’s hottest new restaurants, or recording her podcast Good Trouble NYC. Follow her on Instagram.

Lauren Balsamo is the beauty director at Cosmopolitan where she writes, edits, and produces all types of beauty content—from product reviews to personal essays and trend reports. She has covered beauty for more than a decade at Cosmopolitan. Follow her on Instagram.