Botox is a big no-no if you’re pregnant or planning to become pregnant. Let’s get into why and for how long Botox isn’t allowed and what alternatives there are. 


By OBGYN and reproductive health specialist Dr. Mare Mbaye

Whether you already get Botox on the regular, are planning to get it for the first time, or are just intrigued by what you’ve seen and heard about it, it’s unfortunately a big no-no if you’re pregnant or planning to become pregnant.

Instead of just telling you NO, let’s get into why and for how long Botox isn’t allowed and what alternatives there are. Keep reading to learn all about Botox and pregnancy!

What is Botox?

Botox is an aesthetic treatment for fine lines and wrinkles. It’s the most popular cosmetic treatment in the US, according to the American Board of Cosmetic Surgery. Botox itself is a neurotoxin made from the Clostridium botulinum-derived botulinum toxin. When injected into muscle, this toxin temporarily restricts muscle movement. This reduced movement causes the overlying skin of those muscles to fold less (or not at all) so that wrinkles are prevented and reversed. Botox is FDA-approved for injection into crow’s feet, forehead lines, and frown lines.

Of note, there is a common misconception that all aesthetic neurotoxins are Botox, but Botox is just the brand name. There are multiple other brands that work the same way, including Dysport, Jeauveau, and Xeomin. 

Risks and benefits of Botox

Even if you’re not pregnant or trying to conceive (TTC), there are still risks associated with Botox. Mild redness, swelling at the injection site, and bruising are the most common side effects. Other side effects include headache, fatigue, dry mouth, or more severe symptoms like vision changes or life-threatening allergic reactions.

The wrinkle reducing effects of botulinum toxin products are just one benefit. Some neurotoxins can also be used to treat conditions relating to nerve and muscle activity, like chronic migraines, urinary incontinence (leaky bladder), excessive sweating, or vertical neck bands. Botulinum type A injections can interrupt the nerve impulses that activate the sweat glands, which in turn reduces excessive sweating of the armpits, hands, or feet. Botulinum toxins can also soften prominent vertical bands on the neck by relaxing the responsible muscles, giving the neck a smoother, softer appearance.

So…can I use Botox while TTC or during pregnancy?

While there’s technically no conclusive answer to this question, the short answer is no. Until the research shows otherwise, most experts recommend stopping Botox once you are actively trying to get pregnant until after your baby is born

What about Botox while breastfeeding? Sadly, it’s still a no. Researchers haven’t studied the effects of Botox on breast milk so it’s not known with certainty if it passes into breast milk. The risk is likely very small, but since we already know the botulinum toxin can spread beyond a treatment area, why take the risk of it passing to your baby through your breast milk?

Risks of Botox while pregnant and breastfeeding

There are a few reasons for the medical community's caution with Botox during pregnancy. First, Botox has an FDA warning alerting users to the risk that the botulinum toxin can spread beyond the treatment area and affect other parts of the body with the same movement-inhibiting effects that help with wrinkles.

In animal studies, rodents injected with Botox had babies that were born early, didn’t develop properly, or even died. We can't be sure that the same would happen in human babies since the research just hasn’t been done, but without any evidence proving otherwise, doctors will continue to advise against Botox in pregnancy.

Now, what if you used Botox before finding out you were pregnant? What are the chances the Botox crossed to the baby? Thankfully, the same animal studies have found no evidence of the toxin from Botox injections passing through the placental wall to harm the developing fetus.

This means that if you’ve had Botox treatment recently before becoming pregnant or before realizing you were pregnant, there’s no need to panic! The small doses of botulinum toxin that are used in a single treatment session are unlikely to make it near your baby. Just don't plan on any more Botox treatments until you’re done with breastfeeding.

The good news is that many women who usually get Botox don’t feel like they need it while they're pregnant. As you retain more water in pregnancy, some fine lines and wrinkles may get filled out. And there are fortunately other ways to keep your skin looking young and healthy.


Pregnancy-safe alternatives to Botox

Even without your trusty Botox, there are other ways to maintain a pregnancy-safe anti-aging regimen. These alternatives are not equivalent to Botox (otherwise, why would anyone pay for Botox?), but they have anti-aging benefits that are safe for you and your baby during pregnancy and breastfeeding. Consider incorporating some of the following pregnancy-safe skincare ingredients into your regimen.

Glycolic acid

Glycolic acid is known as the most effective alpha-hydroxy acid (AHA) exfoliant. In addition to helping to smooth lines, it can also help improve tone and texture, treat sun damage, and plump the skin. Glycolic acid is believed to stimulate collagen production in the skin. While it’s not nearly as effective for reducing wrinkles as Botox, it can help to reduce fine lines over time. 

Hyaluronic Acid

One of the main tenets of skincare has always been hydrate, hydrate, hydrate! This key step doesn’t change in pregnancy, and it can help treat and prevent fine lines and wrinkles from developing in the first place. 

Hyaluronic acid (HA) is your best friend when it comes to keeping skin hydrated and moisturized. HA is a water-attracting molecule that is produced naturally in the body, and it can hold 1,000 times its weight in water. It’s also generally well-tolerated by all skin types, even people with sensitive skin. HA can be found in many skincare products, from serums to lotions to creams. 

An important note with HA: there are different molecular sizes which make certain products better for certain things. Smaller molecules have no trouble getting into the skin so they are great as hydrators and moisturizers on their own. Larger molecules can’t pass through the skin so they are better for sealing in moisture. 


Argireline is another pregnancy-safe Botox alternative. It interferes with the neurotransmitters responsible for muscle movement, thereby smoothing out fine lines and wrinkles. It works similarly to Botox, though it’s of course less effective. 

Clinical trials have been promising, with one study showing that 10 percent topical Argireline reduced wrinkles by 30 percent while another showed that with twice daily use, it could be up to 48 percent effective.

Facials and facial acupuncture

Another alternative, if it’s within your budget, is to simply pay an aesthetician and get yourself a facial. Facials are a great way to rejuvenate your skin and facial acupuncture has also recently been used as an alternative to Botox, though the research is still early. 

Go on now, you deserve it. Just make sure your aesthetician or acupuncturist knows that you’re TTC, pregnant, or breastfeeding. They will adjust the skincare ingredients they use and hopefully provide you with some suggestions to take home with you.

And don’t forget about lifestyle practices that help you keep your skin looking healthy (while also keeping you and your baby healthy):

  • Drink plenty of water every day.

  • Eat a healthy mix of foods, including lean proteins, nuts, and lots of vegetables and fruit.

  • Try to be physically active every day. Go out for walks with your baby and get other exercise when you can.

  • Protect your skin from the sun.

  • Get plenty of sleep. This one is tough after you’re home with a new baby. Try to nap when you can and especially when the baby is sleeping. Take turns with your partner getting up at night. Hire a sitter to give yourself a break. Get out of the house and hang out with your friends, family, or whatever support system you have.

Talk with your doctor

While you’ll have to put a hold on those Botox appointments for a while, there are thankfully plenty of pregnancy-safe alternatives to try to include into your skincare regimen. You can keep your baby safe AND still keep your skin looking beautiful.

And when in doubt, always speak with your healthcare provider or dermatologist about other options that may be right for you while TTC, pregnant, or breastfeeding. The questions answered here are a great place to start when you speak to your doctor.

If you’re someone who uses Botox for reasons other than a cosmetic one–like for migraines, muscle spasms, or bladder leaks–stopping Botox will involve a bigger conversation with your healthcare provider. They will help guide your decision making about alternative options that can safely treat your condition while you’re pregnant and breastfeeding. 


Featured Image by cottonbro