Bakuchiol and Pregnancy: What the Science Actually Says About Retinoids and Your Skin

It is one of the most common questions in skincare: can I keep using my night cream during pregnancy?

The short answer, for any product containing retinol, is no. But the longer answer reveals something worth understanding about how different active ingredients work, why they are not interchangeable, and what the distinction between retinol and bakuchiol tells us about the future of corrective skincare.

Why Retinoids Are Avoided During Pregnancy

Retinoids, the family of compounds derived from vitamin A, have been a cornerstone of corrective skincare for decades. Retinol, retinaldehyde, and prescription-strength tretinoin all function by binding to specific nuclear receptors in your skin cells: the retinoic acid receptors, known as RAR-alpha, RAR-beta, and RAR-gamma.

These receptors do not only exist in the skin. They play critical roles in embryonic development, particularly in the formation of the neural tube, heart, and limbs during the first trimester. This is why oral retinoids such as isotretinoin carry strict pregnancy contraindications, and why topical retinoids, including over-the-counter retinol, are avoided as a precaution throughout pregnancy and breastfeeding.

The concern is not theoretical. Oral retinoid exposure during pregnancy is associated with well-documented birth defects. Topical retinoids carry a lower systemic absorption profile, but the standard of care remains clear: avoid all retinoids during pregnancy and while breastfeeding. No concentration is considered proven safe.

What Bakuchiol Is, and What It Is Not

Bakuchiol is a meroterpene extracted from the seeds of Psoralea corylifolia, a plant used in traditional medicine for centuries. In skincare, it gained attention after a 2019 randomised controlled trial (Dhaliwal et al., published in the British Journal of Dermatology) demonstrated comparable improvements in wrinkle depth and pigmentation to retinol over 12 weeks, with significantly better tolerability.

What makes bakuchiol fundamentally different from retinol is its mechanism. Bakuchiol does not bind to retinoic acid receptors. It does not activate RAR-beta or RAR-gamma, the receptors most directly linked to fetal development concerns. Instead, bakuchiol works through an entirely separate biological pathway, acting on prohibitins, a family of mitochondrial proteins involved in cell proliferation, antioxidant defence, and gene regulation.

This is not a minor distinction. It means bakuchiol and retinol arrive at overlapping clinical outcomes through completely different cellular mechanisms.

The Pregnancy Question, Directly

Because bakuchiol does not interact with the retinoid receptor pathway implicated in developmental toxicity, some clinicians consider it a potentially safer alternative during pregnancy. However, "potentially safer" is not the same as "proven safe." Large-scale safety studies of bakuchiol use during human pregnancy do not yet exist. The absence of a known mechanism of harm is encouraging, but it is not the same as confirmed safety data.

Dr Alison Jamieson, Cosmetic Physician and formulator of the Aliangé PM Protocol, takes a conservative position on this: the responsible recommendation is to consult your prescribing doctor or obstetrician before using any active skincare ingredient during pregnancy or while breastfeeding.

This is not an area where skincare brands should be making definitive statements. Your healthcare provider, who understands your full medical history and pregnancy, is the only appropriate source of guidance.

What This Means for the Night Cream

The Aliangé Ultimate A Night Cream contains both micro-encapsulated retinol and bakuchiol at a 4:1 ratio. The bakuchiol serves a dual purpose in this formulation: it provides retinol-equivalent corrective activity through its own pathway, and it stabilises the retinol molecule, preventing photodecomposition and extending its functional half-life.

Because this product contains retinol, it is contraindicated during pregnancy and breastfeeding, regardless of the bakuchiol component. The two ingredients are formulated to work as a system. They are not separable, and the presence of retinol means the standard precaution applies.

If you are pregnant, planning to become pregnant, or breastfeeding, discontinue use of any retinol-containing product and speak with your healthcare provider about appropriate alternatives.

The Bigger Picture: Why Pathway Matters

Understanding the difference between bakuchiol and retinol is not only relevant during pregnancy. It speaks to a broader principle in evidence-based skincare: two ingredients can produce similar visible outcomes while operating through entirely different biological mechanisms.

This is precisely why Dr Alison Jamieson formulates with both. When retinol activates retinoic acid receptors to drive cell turnover, and bakuchiol simultaneously engages prohibitin-mediated pathways to support cellular renewal, the skin receives corrective signals through two independent channels rather than one.

For non-pregnant individuals using the PM Protocol, this dual-pathway approach is the rationale behind the Night Cream's formulation. For those who cannot use retinol, it explains why bakuchiol-only products have gained clinical credibility as alternatives.

What to Do Next

If you are currently pregnant or breastfeeding and looking for guidance on which steps of the Aliangé Protocol remain appropriate, the skin concern quiz can help identify your primary needs. From there, a conversation with your healthcare provider will clarify which actives to pause and which to continue.

The Protocol is designed to be adaptable. Not every step is appropriate at every life stage, and that is by design. A protocol built on clinical logic accounts for the fact that skin needs change, and so should the approach.

Dr Alison Jamieson, MBBS, FRACGP, Dip Derm, is a Cosmetic Physician with over 40 years of clinical experience treating Australian skin. She is the clinical founder and formulator of Aliangé.

This article is for educational purposes only and does not constitute medical advice. Always consult your healthcare provider regarding skincare during pregnancy and breastfeeding.