Botox, Fillers, Skincare, and Other Cosmetic Procedures in Pregnancy and Breast/chestfeeding

Shannon M. Clark, MD
May 15, 2021
Botox, Fillers, Skincare, and Other Cosmetic Procedures in Pregnancy and Breast/chestfeeding

Skincare and cosmetic procedures in pregnancy and postpartum

The “pregnancy glow” that some get is not a myth, but it’s also not the experience everyone has or will have. So what are your options for skincare and cosmetic procedures when you’re trying to conceive, pregnant, and postpartum or breastfeeding? Today, we’re talking all about facials, botox, fillers and more during these periods! I teamed up with plastic surgeon, Dr. Elise Mecham @plasticdocmom of Utah Valley Plastic Surgery, to learn more about this topic. Check out our full conversation here!

Dr. Elise Mecham and Babies After 35

The pregnancy glow

First let’s take a closer look at what the “pregnancy glow” actually refers to and why some pregnant persons get it while others don’t. Pregnancy creates huge hormonal shifts, which can do all kinds of things to our skin!For some lucky people, it induces that “pregnancy glow.” That occurs partly due to increased blood flow, estrogen levels, and fluid that causes our skin (and our lips) to appear younger and fuller.

This is great if you fall in this category, but for many an increase in oil production, acne, and skin tone changes, including redness and dark spots, is more likely to happen.

Acne in pregnancy

Acne in pregnancy is not uncommon, even if you had clear skin before. Don’t worry though- there are a lot of safe treatments for acne during pregnancy, including topical salicylic acid, azelaic acid (which also helps with hyperpigmentation), benzoyl peroxide, and glycolic acid!

Both glycolic acid and salicylic acid can help brighten skin and reduce fine lines and wrinkles, so they are great additions to a pregnancy skin care routine. If your acne is still out of control, there are a few oral antibiotics that can be safely prescribed, but you should see your ObGyn, dermatologist or plastic surgeon for those prescriptions.

Skin changes in pregnancy

During pregnancy, our skin can often darken and produce dark spots. This is called melasma. Melasma can be made worse by sun exposure during pregnancy. While this darkening usually fades after pregnancy, some of us can experience the results for years afterwards. The number one thing you can do to prevent melasma from worsening is to avoid sun exposure on your face. Wear a good sunscreen and a wide-brimmed hat for protection!

Types of sunscreen

There are two types of sunscreens available on the market.

  1. Chemical sunscreen: Chemical sunscreens produce a chemical reaction in the skin to protect the skin from UV rays. These are FDA approved, but studies have recently shown that we may absorb more of the chemicals through our skin than previously thought.
  2. Barrier sunscreen: I recommend using a good barrier sunscreen in pregnancy. We are talking old-school “Beach Boys” era blocking sunscreen, typically made with titanium oxide and zinc oxide. These physically block the sun’s rays from reaching your skin by forming a barrier, plus they don’t carry the chemicals other sunscreens have.

What sunscreen should you use?

Many barrier sunscreens can go on clear or have a mild, neutral tint that is good for all skin types. One of my favorite brands is ELTA MD, but there are also brands carried at stores like Walmart that are also barrier sunscreens, and those are the types I tend to use on my own children.

Here are some of my favorite sunscreens in the Babies After 35 curated Amazon shop! *As an Amazon Associate I earn from qualifying purchases.

What to avoid

Retin-A, tretinoin, isotretinoin, adapalene, certain chemicals in facial peels, and some of the newer products on the market are not safe during pregnancy. Also, oral treatments such as spironolactone, other hormonal therapies, and some antibiotics should be avoided during pregnancy, as well. For specific questions on what is safe, ask your OBGYN provider, and stop using the product until you have verified it is safe for you and your baby.


Botox, a neurotoxin that was approved in 1989 for cosmetic procedures by the FDA, is not approved for use during pregnancy or while breastfeeding. Although we believe that once the Botox binds to the muscle where it’s injected it doesn’t continue to spread, Botox has not been studied in the setting of pregnancy or in breast/chestfeeding so it is best to avoid.

If you get pregnant just after getting Botox, don’t panic, but you will need to refrain from getting further treatment while pregnant or breast/chestfeeding. For those trying to conceive, stopping 3 months prior is ideal.


Dermal fillers are made of hyaluronic acid--a substance that is naturally found in the body. With a good understanding of facial anatomy, these substances can be safely injected into the face to restore volume and contour. Like Botox, fillers are not FDA-approved for use in patients who are pregnant, breast/chestfeeding, or under the age of 18. They also often contain lidocaine to make the injection more comfortable, and lidocaine is one of those substances we like to avoid during pregnancy, especially during the first trimester.

I highly discourage anyone who is pregnant from having additional treatment with fillers until their pregnancy is over and they are no longer breastfeeding. As with Botox, if you are trying to conceive, stopping fillers 3 months prior is ideal.

Safe skincare products

There are a few other products that are staples in my own skincare routine, all of which are safe for use during pregnancy. My favorites are vitamin C serum and topical vitamin E. These help brighten and rejuvenate skin, and help with fine lines and wrinkles. They are antioxidants that help protect skin against damage throughout the day. Also, even though we discourage injecting hyaluronic acid fillers during pregnancy, it is safe to use this topically on your skin and it can help minimize fine lines and wrinkles, and increase skin hydration and fullness. Finally, using a wash or scrub that gently exfoliates can help to improve skin tone and remove dead and dry skin, really helping achieve a refreshed look during pregnancy. One of my favorites is ZO face scrub. It contains lipids, glycerine, vitamins A, C, E, tea tree oil, and magnesium crystals.

Click here to find more skincare products!

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Shannon M. Clark, MD

Shannon M. Clark, MD

Shannon M. Clark, MD, MMS is a double board certified ObGyn and Maternal-Fetal Medicine Specialist, and founder of Babies After 35. In her roles as a clinician, educator and researcher at UTMB-Galveston, she focuses on the care of people with maternal and/or fetal complications of pregnancy. Dr. Clark has taken a special interest in pregnancy after the age of 35, which according to age alone, is considered a high-risk pregnancy.

Follow Shannon on TikTok @tiktokbabydoc, Facebook @babiesafter35, and Instagram @babiesafter35.

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