Can you get Botox while pregnant?
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Created with Carolyn Kay, MD, Certified By American Board Of Obstetrics And Gynecology
There are no reported cases of pregnancy-related complications from Botox but there is not a lot of data on the safety of Botox in pregnant women to begin with. The FDA has labeled it as a category C drug, indicating that it requires sufficient research on humans to assess all potential risks. Given the uncertainty surrounding how this neuromodulator can affect the fetus, most medical professionals recommend avoiding it during pregnancy.
Most women wonder if they should put parts of their beauty routine on pause when pregnant or planning to get pregnant, and Botox shots are high on the list for discussion. Injection therapy helps reduce the appearance of wrinkles and fine lines on the face, so many use it to enhance their natural beauty and feel more confident. Additionally, it is used to treat several medical conditions.
As an immensely popular procedure used worldwide for medical and cosmetic purposes, the Botox question is commonly asked by women considering getting pregnant and nursing and is often debated among reproductive endocrinologists and ob-gyns. In this post, we’ll discuss whether it is safe to get Botox while pregnant and explore what alternatives pregnant women can use.
General safety of Botox
Botox is the brand name of a product that contains a highly purified neurotoxin protein extracted from the bacterium Clostridium botulinum. When injected in minimal amounts, it temporarily paralyzes muscles and causes them to relax. This helps remove creases, smoothes out texture irregularities, results in a refreshed complexion, and promotes overall skin health. It has become extremely popular, because patients can enjoy the results within a few days, and the toxin remains active in the target area for four to six months before it is metabolized by the body.
In the 1970s, its use was originally approved by the Food and Drug Administration (FDA) to treat uncontrolled eye blinking. Further research shows that Botox injections are safe for most people and can be used medically and cosmetically; however, a positive pregnancy test may make you reconsider.
Botox and pregnancy
Can you get Botox while pregnant? The results of animal research give some reason to be optimistic about Botox safety when pregnant. Injected into pregnant mice, this toxin didn’t cross the placental barrier, because of its large molecule, and didn’t affect fertility. This suggests that, when injected into facial muscles for cosmetic purposes in pregnant women, it would not circulate throughout the body and reach a baby. However, animals are not the same as people.
The FDA has placed Botox in pregnancy category C, meaning there are not enough clinical studies to assess its risks and benefits, given women’s unwillingness to participate in a potentially harmful study. More investigation is required to make a solid recommendation and guarantee it is absolutely safe while pregnant or breastfeeding.
Potential risks of Botox during pregnancy
Generally, this cosmetic treatment is considered safe and does not appear to impact fertility. There are no published studies showing increased chances for birth defects or miscarriages. Still, some doctors recommend avoiding Botox during pregnancy. Theoretically, if this toxin is injected in an inappropriate dose and spreads beyond the original site of injection, it may cause botulism, which leads to poor muscle development, spasms, and poor breathing. However, the risk of developing botulism from such injections is extremely low.
Other possible side effects caused by Botox may include:
- Infection
- Allergic reactions
- Hypersensitivity reactions
- Headaches
- Flu-like symptoms
- Blurred vision
- Difficulty forming words
- Loss of bladder control
These side effects are uncommon and occur at rates similar to those seen in the general population without treatment. Importantly, they do not affect the baby.
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What if you use Botox for medical rather than cosmetic purposes?
Aside from reducing facial wrinkles and creases, Botox has evolved into a treatment for a wide range of medical conditions, including:
- excessive underarm sweating (hyperhidrosis)
- muscle spasms
- chronic migraines
- overactive bladder/incontinence
- eye problems
- gastrointestinal tract malfunctions
- uncontrolled muscle contractions
The FDA allows the use of Botox for certain medical conditions during pregnancy. However, it is ultimately up to your doctor to evaluate your specific situation and determine whether the benefits of Botox outweigh the risks for you and your baby.
In many cases, your doctor may be able to recommend safer variants or better-studied treatment options.
When can you resume Botox injections?
Theoretically, you may safely restart getting Botox after weaning your baby and discuss the appropriate timing with your doctor based on your health conditions. Animal studies show that botulinum toxin is highly unlikely to appear in breast milk and harm a breastfed baby; however, further investigation is required on the topic. Healthcare professionals need more data to support this claim and recommend that women abstain from cosmetic injection therapy just after they’ve delivered a baby.
Besides, pregnant women’s bodies undergo significant changes. Some women may experience weight gain in the face and lips during pregnancy, and the face may still hold on to water for some time after birth. This gives the face some fullness and smoothes skin irregularities, masking fine lines and wrinkles. We recommend waiting until these effects subside post-pregnancy, as Botox therapy may not provide the expected outcome.
In the meantime, you can consider alternative aesthetic procedures deemed proven to be safer for you and your newborn.
Alternatives to Botox for pregnant women
While injections with Botox and other neuromodulators are off the table for a while, you can look to other safe solutions to keep the skin of your face in top shape. With pregnant and nursing women, dermatologists turn to non-invasive skin care alternatives, such as:
- Cleansing facials to minimize the appearance of fine lines and amp up your glow;
- Chemical peels (like glycolic and lactic acid) to help exfoliate the skin and improve its overall tone and texture;
- Dermaplaning—a pregnancy-safe treatment that uses a surgical blade to remove dead skin, leaving our derma noticeably smoother and softer;
- Topical products containing hyaluronic acid, peptides, vitamin E, and vitamin C that help plump and nourish your skin, brighten and moisturize it, protect it from free radicals, reduce mild pigmentation, and boost collagen production;
- Massages, face yoga, and facial acupuncture to improve blood flow, resulting in smoother skin.
You should contact a professional dermatologist to advise you on risk-free treatment for your specific needs. However, there are also many tips you can follow on your own to keep your skin healthy on a daily basis.
Consider drinking enough water to keep your derma hydrated, and moisturize your face during the day. Try to protect your skin from the sun, have a good night’s sleep, eat healthy food, and be physically active. These lifestyle practices will help you to keep your skin looking young.
The bottom line
Even though Botox is considered safe for medical and cosmetic purposes, continuing treatment during pregnancy is somewhat of a gray area. As a precautionary measure, it is better to postpone your next round of beauty injections and discuss safer cosmetic alternatives with a medical professional. You may find that you don’t even need this procedure during pregnancy, because facial swelling will add a bit of fullness to your face, making wrinkles less noticeable. Besides, various skin changes typically occurring during pregnancy may resolve within three to six months after you give birth.
References
- Cohen, Joel L., and Nicolò Scuderi. “Safety and Patient Satisfaction of Abobotulinumtoxin A for Aesthetic Use: A Systematic Review.” Aesthetic Surgery Journal, vol. 37, no. suppl_1, Apr. 2017, pp. S32–44. https://doi.org/10.1093/asj/sjx010.
- Morgan, John C., et al. “Botulinum Toxin During Pregnancy: A Survey of Treating Physicians.” Journal of Neurology, Neurosurgery and Psychiatry, vol. 77, no. 1, Jan. 2006, pp. 117–19. https://doi.org/10.1136/jnnp.2005.063792.
- FDA Pregnancy Categories – CHEMM. chemm.hhs.gov/pregnancycategories.htm.
- Wu, Lin, and Min Tang. “Application of Botulinum Toxin in Pregnancy and Its Impact on Female Reproductive Health.” Expert Opinion on Drug Safety, vol. 19, no. 1, Dec. 2019, pp. 83–91. https://doi.org/10.1080/14740338.2020.1707803.
- Botox Medication Guide | FDA. www.fda.gov/media/77359.
- Brin, Mitchell F., et al. “Pregnancy Outcomes Following Exposure to onabotulinumtoxin A.” Pharmacoepidemiology and Drug Safety, vol. 25, no. 2, Dec. 2015, pp. 179–87. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063122/pdf/PDS-25-179.pdf.
- Tang-Liu, Diane, et al. “Intramuscular Injection of 125I-botulinum Neurotoxin-complex Versus 125I-botulinum-free Neurotoxin: Time Course of Tissue Distribution.” Toxicon, vol. 42, no. 5, Oct. 2003, pp. 461–69. https://doi.org/10.1016/s0041-0101(03)00196-x.
- “A Review of the Safety of Cosmetic Procedures During Pregnancy and Lactation.” International Journal of Women’s Dermatology, vol. 3, no. 1, Mar. 2017, pp. 6–10. https://doi.org/10.1016/j.ijwd.2017.01.005.
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