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Its hard to say exactly because everyone and every pregnancy are different but its most likey to begin and be at its worst the first trimester. This is due to the inbalance and increase of progesterone. Your skin is going through an overproduction of oil. This in turn clogs your pores and creates bacteria to build up. If lucky, it will decrease or go away after the first trimester due to the estrogen increase. People with acne already will either get worse OR will clear up when pregnant, and then on the other hand, people who never have acne are very likely to get it! Here are some tips to help reduce acne: 1. DRINK TONS OF WATER....8 glasses a day, up to half gallon 2. Take your prenatal vitamins daily, VERY important for you and the BABY 3. Wash your face twice a day only. Use oil and soap free wash (ie: Cetaphil is best choice), oil free and alchohol free toner, oil free moisturizer. The use of a clay based mask is great too during bad break out periods!(Clinique makes 2 great ones!!) Use sunscreen, oil free. ALL makeup should also be oil free. I use the ACNE SOLUTIONS line by Clinique and love it! It does however contain benzol peroxide 2.5% and salysic acid at low doses of 1-2%, all OTC products though. My OB and derm all say its safe and its nonmedical. It will just depend on YOUR DR/OB if they say its ok to use...some say yes, some say no. There is no research done on salysic acid, however there has been some on done on benzol peroxide and deemed safe for pregnancy FYI. DO NOT use ANY perscriptions like Differin gel, Retin A, Accutane, etc...these can HARM your BABY. 4. Eat healthy. Lots of veggies and fruits. Avoid garlic, spices,sugar and fried foods. 5. Get 7-8 hrs of sleep every night 6. Exercise daily or 3x week to improve circulation. CONGRATS on your pregnancy and hopefully you can live with the acne a bit, just think of the life youre creating and it will all be worth it in the end:)