Skincare in the First Trimester: You Used Retinol Before You Knew. Now What?

By DermLens AI · 11 October 2026 · 6 min read

A positive test, then a spike of panic: I used retinol last week. I had that acne serum on this morning. If that is you, take a breath. This article sets out what the research says, what the standard advice is, and a simple routine for the weeks ahead.

If you used a topical retinoid before you knew

Two systematic reviews have examined first-trimester use of creams and serums containing retinoids:

• A 2015 meta-analysis of 654 exposed and 1,375 unexposed pregnancies did not detect significant increases in major congenital malformations (odds ratio 1.22, 95% confidence interval 0.65–2.29) or spontaneous abortions (odds ratio 1.02, 95% confidence interval 0.64–1.63).
• A 2026 meta-analysis of eight studies and over 3.6 million pregnancies found no significant association with major malformations (risk ratio 0.83, 95% confidence interval 0.64–1.07) or spontaneous abortion (risk ratio 0.99, 95% confidence interval 0.68–1.43). Its authors describe this as supporting the relative safety of topical retinoids in early pregnancy, but say the results were driven mainly by a single large registry study.

So accidental early exposure looks reassuring. It is still sensible to stop the product now, because the standard advice is to avoid retinoids in pregnancy as a precaution, and to mention it to your midwife at your booking appointment so it is on record.

The important exception: tablets

Oral isotretinoin (Roaccutane) is a different matter. The MHRA calls it a powerful teratogen, associated with a high frequency of severe birth defects when a baby is exposed in the womb. If you take it, or have recently, speak to your doctor straight away, and do not wait for your booking appointment.

Check your supplements too

The NHS says not to take supplements containing vitamin A (retinol) or cod liver oil during pregnancy. Check your multivitamin and any hair, skin or nail supplement. See what to check on the label.

A simple first-trimester routine

• Gentle cleanser and a good moisturiser. Skin often becomes more sensitive, so keep it simple.
• Sunscreen every morning, starting now. A 2024 review of melasma prevention in pregnancy emphasises using sunscreen from the first trimester. See our melasma guide.
• For breakouts or redness: see our pregnancy-safe skincare guide, which covers ingredients such as azelaic acid and what to avoid, and our azelaic acid guide. Ask your pharmacist or midwife before starting anything new.
• Introduce one new product at a time, so you know what is causing any reaction.

Hair dye and haircare

The NHS says most research shows it is safe to dye your hair while pregnant. See our hair dye guide.

The bottom line

If you used a topical retinoid before you knew, the best evidence so far is reassuring. Stop it now, mention it to your midwife, get on top of sunscreen, and keep the rest of your routine simple. If tablets were involved, call your doctor.

Frequently Asked Questions

Sources

1. Kaplan YC, et al. Pregnancy outcomes following first-trimester exposure to topical retinoids: a systematic review and meta-analysis. Br J Dermatol, 2015. doi:10.1111/bjd.14053
2. Alali AB, et al. Topical retinoids and risk of major congenital malformations and spontaneous abortion: a systematic review and meta-analysis. Front Drug Saf Regul, 2026. doi:10.3389/fdsfr.2026.1864872
3. MHRA. Isotretinoin (Roaccutane): reminder of important risks and precautions. Drug Safety Update, August 2020 (since superseded by later MHRA advice; current guidance is on GOV.UK). gov.uk
4. NHS. Pregnancy vitamins and supplements. Page last reviewed 3 June 2026. nhs.uk
5. Zhao L, et al. Prevention of Melasma During Pregnancy: Risk Factors and Photoprotection-Focused Strategies. Clin Cosmet Investig Dermatol, 2024. doi:10.2147/CCID.S488663

This article is general information, not medical advice. If you have a skin or scalp condition, or you are pregnant, breastfeeding or taking medication, speak to a doctor, pharmacist or dermatologist before changing your routine.