Safety in Lactation: Acne and rosacea

Laura Kearney, Regional Principal Medicines Information Pharmacist, Midlands and East Medicines Advice Service (Midlands site) & UK Drugs in Lactation Advisory ServicePublished

Topical preparations for acne are considered to pose a negligible risk to a breastfeeding infant as long as precautions are taken to avoid contact of the breastfeeding infant with treated areas. There is no published evidence on the safe use of these topical preparations in breastfeeding.
Oral isotretinoin is highly teratogenic and must be used in the mother only in accordance with strict contraception guidance. Topical acne preparations are preferred if possible while breastfeeding. Topical isotretinoin and tretinoin have minimal systemic absorption by the mother, although use with contraception guidance is advised.
It is advisable to remove all topical products from the breast before feeding, and to avoid all use of isotretinoin and tretinoin preparations on the nipple and areola.