It’s that time. You’re carrying another human, there is an almost mystical aura permeating through your skin, but in between episodes of reflux – you ponder why wrinkles can’t be relaxed during pregnancy (you probably don’t, but we’ll tell you anyway).
I think the first thing we need to do is clear up the medical guidance on this this topic. The botulinum toxin used in wrinkle relaxing injections has a wide range of applications. Not only can it reduce fine lines and wrinkles, it can also be used to prevent bladder spasms for example (I’ve personally injected the bladder of patients during my days working in Urology. You need to give x10-30 the strength compared to cosmetic procedures on the face #funfact).
Anti-wrinkle injections are contraindicated if:
- You are currently pregnant (doesn’t matter how many weeks gone you are)
- You are trying to conceive
- You are currently breast feeding
But why is it not safe to have anti-wrinkle injections during pregnancy?
The truth of the matter is no one has conducted a robust clinical trial evaluating the safety profile of having anti-wrinkle injections during pregnancy. We know that it is a neurotoxin and when you have a little one growing inside of you, in theory there is a risk for neuro-developmental issues by the toxin traveling through your blood vessels to your baby. Having said this, the doses used for facial aesthetic purposes are often very low.
There was an interesting study published in the Journal of Neurology, Neurosurgery & Psychiatry in which questionnaires were sent to over a thousand doctors who use botulinum toxin injections in their daily practice (1). The questionnaire specifically asked the question on whether any of the doctors had knowingly or unknowingly administered the toxin to a woman who was pregnant or whom they later found out to be pregnant. And most importantly, what was the outcome? Of the 396 doctors that responded, sixteen of their patients were pregnant when they had treatment (most in the first trimester). One patient with a history of miscarriages, unfortunately, had a miscarriage; one had a voluntary termination of pregnancy, whilst the remaining fourteen pregnancies were completely normal and went to full term with no fetal abnormalities.
There are numerous other studies/cases which follow a similar narrative with women having normal pregnancies (2) but as with the study above, the number of patients are always far too small to draw a sound conclusion about the safety profile of anti-wrinkle injections during pregnancy. The truth is we probably won’t ever have a robust clinical trial because it would be unethical to conduct one. And so, it’s always better to err on the side of caution when we don’t have the answer.
What is our perspective?
Our perspective will always be aligned with the medical guidance. Avoid anti-wrinkle injections if you are pregnant, trying to become pregnant or currently breastfeeding. Once you have stopped breastfeeding, it is perfectly safe for you to have wrinkle-relaxing injections for cosmetic procedures. If you do have any further questions, please ensure that you consult a medically trained aesthetic practitioner.
What happens if you find out you’re pregnant after having anti-wrinkle injections?
Sometimes, you might be hit with a surprise where you have just had treatment and a few weeks later found out you are pregnant. If this happens, proceed with your pregnancy, do not have any more anti-wrinkle tweakments until your baby is born & you stop breast feeding.
Remember, avoid anti-wrinkle injections during pregnancy. But if you find out you’re pregnant after treatment, continue as normal but just no more tweakments until you stop breastfeeding.
1) Morgan JC, Iyer SS, Moser ET, Singer C, Sethi KD. BTX A during pregnancy: a survey of treating physicians. J Neurol Neurosurg Psychiatry. 2006;77(1):117-119. doi:10.1136/jnnp.2005.063792
2) de Oliveira Monteiro E. BTX and pregnancy. Skinmed. 2006;5(6):308. doi:10.1111/j.1540-9740.2006.05584.x