Pregnancy comes with a lot of excitement and, for some women, significant skin changes. When you're expecting, you can also kiss Botox goodbye until your doctor gives you the green light to resume your treatments, likely after delivery and nursing. That means a few lines and wrinkles may be along for the ride.

Just because Botox and other neuromodulators, which temporarily freeze facial muscle movement for a wrinkle-smoothing effect, may be off the table for a while doesn't mean that you can't look to other safe solutions to keep your skin wrinkle- and line-free and in top shape. From the best topical ingredients to use to treatments to indulge in, these are the options dermatologists turn to for pregnant patients when Botox is out of the question. 

Why You Should Avoid Botox While Pregnant

According to David Kim, MD, there are several treatments and skin care ingredients to avoid when pregnant, and Botox is one of them. "Botulinum toxin is derived from Clostridium Botulinum and softens the muscles," he says. "So if the toxin gets into the fetus, it can cause botulism and lead to muscle weakness, spasms, poor muscle development, and poor breathing."

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Injectables are generally not safe for pregnant women to use. "Botox is a category C drug, meaning that the drug's risks can't be ruled out because, even though no satisfactory studies have been done in pregnant women, animal studies demonstrate a risk to the fetus," Dr. Kim explains.

So, it's better to err on the side of caution and not inject Botox for cosmetic purposes. However, he adds, studies show using Botox to alleviate migraines during pregnancy is safe, with no increased risk of birth defects in children of patients treated for this purpose. "It's about the risk versus the benefit. If a treatment is medically indicated and the benefits outweigh the risks, it's okay to proceed," he says. "However, it's advised not to treat patients during pregnancy with elective aesthetic procedures because the risks outweigh the benefits."

That said, just because you can't indulge in regular Botox treatments doesn't mean you can't keep your skin smooth, wrinkle-free, and youthful-looking while expecting. Marisa Garshick, MD, says that some patients don't even need Botox while expecting because facial swelling can plump the face for added fullness, making wrinkles and lines less noticeable.

Pregnancy-Safe Botox Alternatives

It's a given that cosmetic Botox is a no-no while pregnant, yet these pregnancy-safe alternatives can leave the skin looking fresh and smooth.

Facials and chemical peels

Professional treatments, such as a HydraFacial, can temporarily smooth the skin. "Chemical peels are also pregnancy-safe and help to exfoliate the skin, improving the overall texture and tone of the skin, and minimizing the appearance of fine lines and wrinkles," Dr. Garshick says.

Also on the pregnancy-approved list of skincare treatments are traditional skin cleansing facials with extractions and facial massage, which can instantly amp up your glow factor.

Dermaplaning

Dermaplaning is another exfoliating treatment that many doctors feel is safe while expecting. The treatment often accompanies a facial and uses a sharp surgical blade to remove dead skin and peach fuzz from the face, leaving the skin feeling noticeably softer, smoother and more even.

Topical Products

While you should avoid retinoids while pregnant, Dr. Garshick says hyaluronic acid can help plump the skin. "Also, peptides boost collagen production and exfoliating acids, like glycolic acids at low concentrations and azelaic acid, can enhance texture and tone," she says. "Women can also use vitamin C during their pregnancy." Some pregnant women may opt for bakuchiol, a plant-based retinol alternative. 

When Is it Safe to Resume Botox?

Just because you’ve delivered your baby doesn’t mean you should run to your dermatologist immediately for Botox. “In general, Botox can be performed after the baby is delivered, though it is not recommended in breastfeeding given it has not been studied in breastfeeding,” Dr. Garshick says. 

It's also best to wait until facial swelling subsides post-pregnancy. Sometimes, injecting someone too soon after recently delivering a baby can cause a bit of a distorted look because their face is still holding onto water, and they may not like how they look with Botox if they’re still swollen.

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