If you’re devoted to your skin care routine, you probably already know that pregnancy can require to make some changes to your regimen, at least until you give birth. All you anti-aging fans who are not strangers to injectables might also be wondering if it’s safe to get Botox while pregnant. Whether you get Botox for cosmetic reasons or medical ones — turns out it’s pretty helpful in getting rid of migraines and TMJ — pregnancy might derail your usual injection schedule, at least until your baby arrives.
Can you get Botox while pregnant?
Experts agree that in most cases, you shouldn’t get Botox while you’re expecting. “The answer is, nobody knows,” says Dr. Julie Ann Woodward, M.D., oculofacial plastic surgeon at Duke Eye Center. “Botox is considered Schedule C, which means it has zero testing [in humans] during pregnancy. I don’t recommend it. If someone comes in and says they’re pregnant, I will not treat them.”
The U.S. Food and Drug Administration (FDA) classifies medications into categories of safety during pregnancy. Category C (or schedule C) drugs have been shown to cause adverse effects in animal fetal studies, but could still be given to pregnant women if the benefit outweighs the risk. That means if you get Botox for cosmetic reasons, your doctor will probably tell you to wait until you deliver to get more. But if you’re wondering if you can get Botox for migraines, TMJ, or other medical reasons while pregnant, that’s worth a conversation with your team including your OB-GYN or midwife and whoever prescribed the Botox.
“There are no studies that say that yes, Botox is safe in pregnancy. There is some literature that says that if you’re getting Botox for medical reasons, like women that have migraine headaches, that might be OK, because we don’t want a woman to suffer during pregnancy,” says Dr. Marilyn Fudge, M.D., board-certified OB-GYN at Bayfront Health. “But you have to look at it as whether the benefit outweighs any potential risk to the baby.”
“It’s a, ‘We’d rather not, but if you need it for medical reasons, talk to your doctor’ sort of thing,” says Woodward.
She added that while there’s simply not enough evidence about whether Botox is safe or unsafe, she definitely advises patients to steer clear of it in their first trimester. This is when most teratogenic effects — fetal abnormalities caused by a medication or something you ingest — take place.
Can you get Botox while breastfeeding?
These doctors agree that there’s not enough research about how much of the Botox medication enters your breast milk, and what effects that could have on a baby, to say whether it’s safe or unsafe.
“The guidance for breastfeeding has a lot to do with how much of that medication actually can show up in the breast milk,” says Fudge. “If you do get it, it’s a good idea to pump and dump the milk. There would need to be guidelines on what specific amount of time you should do that for. I would just recommend that they talk to their pediatrician and see what the pediatrician has to say.”
“I think most people say it’s OK to get injected if you pump and toss your milk for 24 hours,” Woodward says. “That’s what a lot of people will suggest and what I did when I had my three children.”
Fudge said pregnancy can cause changes to your skin, like melasma and sun sensitivity. If you want to take care of your skin safely, you can still get facials (without retinol products, she advises), and do exfoliating and moisturizing treatments to your heart’s content.
Dr. Julie Ann Woodward, M.D., oculofacial plastic surgeon at Duke Eye Center
Dr. Marilyn Fudge, M.D., board-certified OB-GYN at Bayfront Health