El acné vulgar que se presenta durante el embarazo o la lactancia requiere un enfoque terapéutico modificado. La prioridad clínica es controlar la afección de manera efectiva evitando agentes que representen un riesgo significativo para el feto o el lactante.
En pacientes embarazadas o en período de lactancia, el espectro de tratamientos aceptables se reduce considerablemente. La exposición sistémica a agentes tópicos — incluso en niveles bajos — y el potencial de daño al feto en desarrollo o al lactante son factores centrales en la selección del agente. Ciertas terapias para el acné de uso frecuente no son apropiadas en esta población.
DOI: 10.1016/j.jaad.2023.12.017
In patients who are pregnant, the risk of fetal harm from topical azelaic acid, BP, erythromycin, and clindamycin are not expected based on limited expected systemic absorption.
In patients who are pregnant or lactating, tetracycline-class antibiotics should be avoided due to potential for permanent teeth discoloration and bone growth inhibition in the fetus or nursing infant.
No human studies have established causal relationships between the use of topical retinoids with birth defects; nevertheless, topical therapies other than topical retinoids are preferred during pregnancy.
Salicylic acid can be used in pregnancy if the area of exposure and duration of therapy is limited; use for large areas or under occlusion are not recommended due to the potential for systemic absorption.
Topical minocycline is not recommended during pregnancy or lactation.
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