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Aknetherapie in der Schwangerschaft

Acne therapy in pregnancy

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Zusammenfassung

Eine Aknetherapie ist auch in der Schwangerschaft notwendig, um eine Verschlechterung, Narbenbildung, Superinfektion oder psychische Beeinträchtigung der Mutter zu verhindern. Sichere Produkte müssen ausgewählt werden. Tetrazykline, Doxyzyklin, Minozyklin oder Isotretinoin sind nicht einzusetzen. Topisches Benzoylperoxid und topische Azelainsäure sind sichere Therapiemöglichkeiten. Eine systemische Therapie kann bei ausgeprägt schwerer Akne nach den Leitlinien auch in der Schwangerschaft mit Glukokortikoiden ab dem 2. Trimenon in Zusammenarbeit mit dem Gynäkologen und/oder mit Erythromycin (Letzteres nicht in der Stillzeit) durchgeführt werden. Zink kann, falls nötig, oral gegeben werden, jedoch nicht länger als 3 Monate. Ergänzende kosmetologische Maßnahmen sind das manuelle Ausreinigen, Peeling-Maßnahmen wie ein mechanisches Peeling oder ein chemisches Peeling mit Glykol- oder Fruchtsäuren. Dagegen sollten Salicylsäure-, Trichloressigsäure- oder Phenol-Peels in der Schwangerschaft nicht eingesetzt werden. Camouflage kann die psychische Belastung seitens der Haut deutlich reduzieren.

Abstract

Acne should be treated during pregnancy to prevent worsening, scarring, secondary infection or psychological impairment of the mother. Safe products must be chosen. Systemic tetracycline, doxycycline, minocycline or isotretinoin can not be used. Topical benzoyl peroxide or topical azelaic acid are safe therapeutic options. According to the guidelines, systemic corticosteroids or systemic erythromycin (the latter not in lactation) can be employed beginning in the second trimester for severe flares of acne and should be started in cooperation with the patient’s gynecologist. Oral zinc is another option, but not for longer than 3 months. Accessory cosmetic measures may be useful, including mechanical peeling or chemical peeling with glycolic or alpha-hydroxy-acids. In contrast, salicylic acid, trichloracetic acid or phenol peels should not be performed in pregnancy. Camouflage makeup can clearly lower the psychological stress.

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Interessenkonflikt

Die korrespondierende Autorin weist auf folgende Beziehungen hin: Unterstützung zu Symposien, Vorträgen und Aufwandsentschädigungen für Studien und Advisory-Board-Tätigkeiten von Firmen, die Aknepräparate, Peelingsubstanzen und Camouflage-Produkte herstellen.

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  1. Klinik für Dermatologie und Allergologie, Hauttumorzentrum Wiesbaden, Dr. Horst Schmidt Kliniken, Aukammallee 39, 65191, Wiesbaden, Deutschland

    C. Bayerl

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Bayerl, C. Aknetherapie in der Schwangerschaft. Hautarzt 64, 269–273 (2013). https://doi.org/10.1007/s00105-012-2456-2

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