After the sebaceous gland is stimulated by androgens, it produces more sebum. The oily sebum accumulate in the follicle, and travels up the hair shaft to the surface of the skin. As it travels up the hair shaft it also mixes with normal skin bacteria and dead skin cells that have been shed from the lining of the follicle.

The greater the sebum production, the greater the likelihood that the hair follicle will become clogged and result in comedones.

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Two factors that make acne more prevalent with pregnancy are the hormone, progesterone, and changes in hydration. Progesterone is the hormone that makes the bed of implatantion healthy for the fertilized egg. The ovary makes it, but after the first trimester it is usually the placenta that makes it. Besides making implantation stable, it also relaxes smooth muscle, which prevents premature labor, but also causes constipation. It loosens up the joints, especially the pubic joint which makes more room for the baby to fit through on the way out during labor.

But because progesterone is more androgenic (male hormone-like) than estrogen, it also causes the secretions of your skin glands to increase, which will lead to more acne.

Hydration is tough to keep up with when you're pregnant. But drinking about 6 to 8 glasses of water a day will not only dilute out secretions to improve acne, but will also contribute to the relaxation of the uterus and even help with the constipation. Hydration is not an acne cure, but it will help.

Skin creams that contain erythromycin and other antibiotics are safe if cleared by your obstetrician. Dermatologists are usually quite sensitive to and knowledgeable of pregnancy, and they will work with your doctor when prescribing such creams. Tetracycline pills, a standard treatment for acne, is absolutely forbidden during pregnancy, because it can permanently discolor your unborn baby's teeth or even theoretically cause bone deformities.
 

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