Botox with Breastfeeding or Pregnancy
Medically Reviewed by Arash Akhavan, MD, FAAD
Botox is one of the most popular non-surgical cosmetic procedures in the world- and for good reason. It’s quick, effective, and provides consistently satisfying results with minimal downtime. Many of our patients have been receiving Botox for years and love how refreshed and youthful it makes them feel.
That’s why one of the most common questions we get from long-time Botox patients who become pregnant or begin breastfeeding is whether it’s safe to continue their treatments. They miss the rejuvenating effects of Botox and want to know whether they can safely resume their routine during this important stage of life.
So, is Botox safe during pregnancy or breastfeeding?
Botox and Pregnancy
When it comes to pregnancy, the recommendation is clear: Botox should be avoided.
While Botox (botulinum toxin type A) works locally where it is injected and doesn’t typically circulate systemically in significant amounts, we still don’t have enough high-quality data to confirm that it’s completely safe during pregnancy. Out of an abundance of caution, and because fetal development is a highly sensitive and critical period, Botox is classified as a Category C drug by the FDA for use in pregnancy. This means that risk to the fetus cannot be ruled out.
There have been a few isolated case reports where Botox was administered unknowingly in early pregnancy without adverse effects, but these are not enough to establish safety. Because Botox is a non-essential, elective treatment, the general consensus across the medical community- including among dermatologists, obstetricians, and neurologists- is that it should be postponed until after delivery.
Our advice to patients is always the same: Wait until after pregnancy to resume your Botox treatments. It’s simply not worth the theoretical risk, and your safety, as well as your baby's, always comes first.
Botox and Breastfeeding
When it comes to Botox during breastfeeding, the conversation becomes more nuanced.
According to the LactMed database maintained by the U.S. National Institutes of Health, there is currently no published data on the excretion of botulinum toxin into human breast milk. However, due to the large size of the botulinum toxin molecule and the way Botox is administered (in small amounts locally into muscle), it is considered highly unlikely to transfer into breast milk in any clinically significant amount.
Additionally, Botox is poorly absorbed through the gastrointestinal tract, meaning that even if tiny amounts did make their way into breast milk, they would likely be broken down and rendered inactive when ingested by the infant.
That said, because Botox is a cosmetic and non-vital treatment, the most cautious approach- especially for new mothers who want absolute peace of mind- is to wait until breastfeeding has ended before resuming treatment. This conservative approach helps avoid any theoretical risks, even in the absence of evidence showing harm.
For patients who do choose to proceed with Botox while breastfeeding, we are happy to discuss in person and perform the treatment with the same highest level of care we give to every patient.
Arash Akhavan, MD is founder and owner of The Dermatology and Laser Group, one of the top centers for cosmetic procedures in New York City for over a decade. Arash Akhavan, MD, FAAD is a Board Certified Dermatologist and an Associate Professor at The Mount Sinai School of Medicine. Dr. Akhavan is a Castle Connolly Top Doc, New York Magazine Best Doctor, and Super Doctor featured in The New York Times. Dr. Akhavan is a key opinion leader that has been featured on hundreds of media publications including The New York Times, Allure, Marie Claire, Women’s Health, Cosmopolitan, ABC News, Fox News, Fox 5, NY1, WPIX, and more. He has been featured on nationally syndicated television programs such as The Doctors.
Dr. Akhavan serves as an educator and lecturer for multiple aesthetic device and injectable companies. This allows his office access to newer technologies at an earlier date than other offices, as well as a higher level of expertise in the use of these devices. This, in turn, translates to more effective and safer treatments for our patients.
By Arash Akhavan, MD, FAAD | | Categories: Surgical Dermatology