Can I Get Botox While Pregnant?

Woman getting Botox injection.

Adam Gault/SPL / Getty Images

Whether you’re a superfan of getting Botox, considering it, or simply intrigued by all the hype you’ve heard, hit the brakes if you’re pregnant or planning on becoming pregnant. Botox has become a hot topic of conversation in the 21st Century—a simple Google search brings up more than 43 million results—but, unfortunately, it falls into the category of luxuries you have to put on hold while pregnant.

Rather than just tell you that Botox is a pregnancy no-no and move on, we’ve tapped a couple of pros to explain why this is so, for how long, and what you can use in the meantime to help smooth out fine lines and wrinkles. Keep reading to learn all about Botox and pregnancy, as well as how you can keep your skin looking fresh and youthful until your baby arrives.

What Is Botox?

Botox is an aesthetic treatment for fine lines and wrinkles. And according to the American Board of Cosmetic Surgery, it’s the most popular cosmetic treatment in the U.S overall. It’s something called a neurotoxin, made from the Clostridium botulinum-derived botulinum toxin, which temporarily restricts muscle movement when it’s injected into them. Currently, it’s FDA-approved for injection into crow’s feet, forehead lines, and frown lines.

Despite there being a common misconception that all aesthetic neurotoxins are Botox, Botox is actually the brand name. There are multiple other neurotoxins that are injected to smooth out fine lines and wrinkles in the same manner. They include Dysport, Jeauveau, and Xeomin.

“[Botox] interferes with [the nerves] that normally enable muscle movement,” says Blair Murphy-Rose, MD, FAAD, a board-certified cosmetic and medical dermatologist at the Laser & Skin Surgery Center of New York in NYC and the Hamptons. “By interfering, that movement is reduced and the skin overlying those muscles folds less (or not at all), thereby preventing and reversing wrinkles.” 

The History of Botox

Interestingly enough, Botox was initially used primarily for medical conditions. Fun facts: In the 1970s, Botox’s active ingredient, botulinum toxin, debuted as a groundbreaking treatment for people with crossed eyes (a.k.a. strabismus).


It then evolved into a treatment for a surprisingly wide range of issues such as a painful, involuntary neck muscle contraction disorder called cervical dystonia, excessive sweating (or axillary hyperhidrosis), chronic migraines, incontinence, and more. Likewise, issues with muscle tone and stiffness, known as spasticity, can be treated with Botox too.

Is It Safe to Use Botox During Pregnancy?

Pregnancy has a way of changing your priorities. From the moment you find out that you’re pregnant, it’s no longer all about your desires. You have to consider what’s best for your baby. Just as raw sushi and a good sweat in a sauna at your favorite spa are a no-go during pregnancy, so, too, is Botox.

Jennifer Levine, MD, PLLC, a double board-certified plastic surgeon in NYC explains, “Botulinum toxin falls into a pregnancy category called ‘X,’ which means it is not safe to use during pregnancy.”

A drug is labeled by the FDA as such when fetal abnormalities have been seen in human and animal studies, and/or there’s been evidence of risk to an unborn child. A treatment gets this designation when the risks involved clearly override any potential benefits.

Every pregnancy is different. Be sure to consult with a healthcare provider about your circumstances if you have any questions about using Botox while pregnant.

Of course, as with any medication, there are risks associated with Botox—baby on the way or not. These can range from mild inconveniences like dry mouth, pain where you got poked, fatigue, or headache to more severe symptoms such as vision disturbances or even life-threatening allergic reactions.

So, even if you’re not pregnant, be sure to check with your provider before hopping on the Botox bandwagon, and make sure you review all of the potential risks.

Why You Should Not Use Botox While Pregnant

In short, given that the risks outweigh its benefits, it’s best to play it safe and save the wrinkle-fighting, skin-smoothing benefits of Botox for a time when your baby is out of harm’s way. You may love mountain-climbing—and we applaud your ambition!—but we’d wager you wouldn’t want to put your infant in any danger by taking them along for a prenatal ride.

Risks of Using Botox While Pregnant

Despite the big, scary “X” category rating given to Botox by the FDA, the effect of Botox on fetuses is still shrouded in a bit of mystery beyond a handful of studies.

Dr. Murphy-Rose explains, “The effects of botulinum toxin A (btxA) administration during human pregnancy are largely unknown . . . Because there is insufficient data to be certain, most dermatologists recommend avoiding Botox injections while pregnant.” Since there’s no guarantee that it’s safe to use Botox while pregnant or breastfeeding, it’s best to be on the safe side and not take the risk.

Some research on pregnant rabbits has pointed to risks such as fetal malformations and abortions. Same with premature birth, low birth-weight, and bone development in rats. And since Botox is a cosmetic procedure, not a medically necessary one, it is generally advised that pregnant people should take a hard, albeit temporary, pass.

What If You Have Botox, Then Got Pregnant?

Try as we may, we can’t always plan for all of life’s little surprises. What if you’ve already gotten Botox, then find out you're pregnant? Your first thought might be one of dread—and understandably so. 

Fortunately, Dr. Levine has some calming assurance for just such a worrying situation: “There have been studies on pregnant women who had Botox injected when they did not realize they were pregnant yet, and no untoward effects have been reported.”

She goes on to explain, “Botox has very little bioavailability in the bloodstream, so it is unlikely to cause a problem, but I would not recommend injecting Botox into pregnant women.”

So, if you happen to have fallen into this situation, go ahead, and take a deep breath. From what science has seen so far, your unborn baby will likely be unaffected. Still, be sure to talk to your healthcare provider about it just in case.

When Can I Resume Using Botox? 

Once your little one has arrived, you may be anxiously awaiting your next (or first) Botox appointment. If you’re breastfeeding, however, you may want to give it a bit more time. According to the FDA, it’s unknown if Botox affects breastmilk. Dr. Levine concurs: “Botox is safe to use once you are no longer pregnant or breastfeeding.”

And actually, either way, if you’re breastfeeding or not, it’s always best to check with your provider before resuming Botox.

Pregnancy-Safe Alternatives 

Just because you can’t get Botox while you’re pregnant or breastfeeding, that doesn’t mean you have to throw your anti-aging regimen out the window. There are safe alternatives you can use to help keep your skin looking its best.

Though they’re not medical aesthetic treatments like Botox, there are some skincare ingredients that have anti-aging benefits that you can use while pregnant. Consider some of the following pregnancy-safe alternatives to Botox, then feel free to book your facial or bask in some self-care at home.

Glycolic Acid

Glycolic acid is known as the most effective alpha-hydroxy exfoliant, leading to it becoming lauded for its skin-renewing abilities. In addition to helping to smooth lines, it can also help improve tone and texture, treat sun damage, and plump the skin.

Dr. Murphy-Rose isn’t shy about it being her favorite skincare ingredient to replace Botox. “The best pregnancy-safe alternative is glycolic acid,” she says. “While glycolic acid is known to be safe during pregnancy, it is not nearly as effective for reduction of wrinkles as Botox.”

Yet, she explains, “Glycolic acid is believed to stimulate collagen production, which can help over time with fine lines.”

Hyaluronic Acid

Dr. Levine mentions that the key to treating and preventing fine lines and wrinkles is to keep your skin hydrated and moisturized—which you should try and do regardless.

One ingredient that shines in this sense is hyaluronic acid, a water-loving molecule that occurs naturally in the body, which is capable of holding 1,000 times its weight in water. It attracts and retains water, and is also generally well-tolerated by all skin types, including sensitive skin. You can find it in many skincare products, ranging from serums to creams.

Hyaluronic acid has different molecular sizes. Larger molecules can’t penetrate the skin, but they do an excellent job of sealing in moisture on the skin’s surface. Smaller molecules, on the other hand, are easily absorbed into the skin.

Luxe brands like Kiehl’s Vital Skin-Strengthening Hyaluronic Acid Super Serum ($39) contain small hyaluronic acid molecules, for instance, as do drugstore brands such as Valjean Labs Facial Serum, Hydrate | Hyaluronic Acid + Vitamin B5 ($13).

Argireline

Argireline, a skincare ingredient, acts similarly to Botox in that it interferes with the neurotransmitters responsible for muscle movement. “Some Botox alternatives are topical neurotransmitter inhibitor peptides that reduce muscle activity (though to a much lesser extent than Botox),” Dr. Murphy-Rose says.

“Peptides like Argireline (acetyl-hexapeptide-3 or acetyl-hexapeptide-8) aim to have gentle, Botox-like anti-wrinkle effects without an injection, and some are backed by encouraging clinical trials demonstrating efficacy.” It smooths out fine lines in a way similar to Botox, though not nearly as much. But it’s still an effective option.

Ten percent topical Argireline, for instance, has been shown to reduce wrinkles by 30 percent. These results also confirm that it’s a safe alternative to Botox. In fact, in some studies, it’s been shown to be up to 48 percent effective with twice daily continued use.

A Word From Verywell

While Botox injections are an effective way to smooth out unwanted fine lines and wrinkles, it should go without saying by now that Botox and pregnancy should not mix.

While it’s best to keep your unborn baby safe, you shouldn’t have to give in to fine lines and wrinkles completely. There are alternatives, such as those mentioned above.

You can also speak with your healthcare provider or dermatologist about other options that may be right for you while pregnant or breastfeeding.

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10 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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