Table 2. Treatment Algorithm for Acne in Pregnancy
Type of AcneTreatmentFDA Pregnancy Drug ClassEvidence Rating
Noninflammatory
    ComedonalAzelaic acidBLikely to be beneficial
Inflammatory
    Mild to moderateAzelaic acid +BLikely to be beneficial
Benzoyl peroxide orCBeneficial
Topical erythromycin orBBeneficial
Topical clindamycin +BBeneficial
Benzoyl peroxideCBeneficial
    Moderate to severeOral erythromycin orBLikely to be beneficial
Oral cephalexin +B*
Benzoyl peroxide with or withoutCBeneficial
Azelaic acid orBLikely to be beneficial
Intralesional steroid injectionsC*
    FulminantOral erythromycin +BLikely to be beneficial
Benzoyl peroxide +CBeneficial
Azelaic acid +BLikely to be beneficial
Oral prednisone(short-term)C*
  • Data from Ref. 37.

  • * Evidence of a drug's benefit is not discussed in Ref. 37.