What Skin Care Treatments Can I Get in Pregnancy?--A Plastic Surgeon Explains!

Botox and Fillers in Pregnancy and Breastfeeding

Botox is a neurotoxin that was approved in 1989 for cosmetic procedures by the FDA. It is injected into the soft tissues of the face to stop movement of the facial muscles and formation of wrinkles. Since its approval, many different types of neurotoxins are now available that work in a similar fashion and with similar effectiveness. Of note, the FDA has not approved the use of Botox 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 breastfeeding. But don’t worry if you get pregnant just after getting Botox, sometimes pregnancies are a pleasant surprise. However, I highly discourage anybody from getting further treatment while pregnant or breastfeeding. 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. Unfortunately, like Botox, fillers are not FDA-approved for use in patients who are pregnant, breastfeeding, 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. In addition, dermal fillers carry a higher risk of infection compared to Botox, as they are semi-permanent medical treatments, meaning they maintain shape and volume anywhere from 6 months to 2 years. What this means is that if you have recently been treated with facial fillers and then discover you are pregnant, don’t worry! This should not affect the development of your baby. Again, as with Botox, 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.

Facials in Pregnancy and Breastfeeding

I also recommend avoiding other treatments that might stress the skin or break down it’s protective barrier during pregnancy. Most facial peels are not a good idea during pregnancy. Microneedling is also not recommended, along with high energy treatments such as laser treatments.

So how do we help ourselves find that elusive “pregnancy glow”?

We have a lot of great options!

One challenge that we face during pregnancy is huge hormonal shifts. This does all kinds of things to our skin! For some lucky people, it induces that pregnancy glow. That is due, in part, to increased blood flow, estrogen levels, and fluid that cause our skin (and our lips) to plump and appear younger and fuller. This is great if you fall in this category, but for the rest of us, an increase in oil production, acne, and skin tone changes, including redness and dark spots, is more likely to happen.

Let's talk about skin care during pregnancy!

Many of us who fall in the “geriatric pregnancy” category are already using skin care products to help prevent and treat fine lines and wrinkles. Many of these products are not safe during pregnancy. Retin-A, tretinoin, 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, many types of antibiotics, and isotretinoin 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.

During pregnancy, our skin can often darken and produce dark spots. This is called melasma. This 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.

Sunscreen in Pregnancy

There are two types of sunscreens available on the market--barrier sunscreen and 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. While this hasn’t changed FDA recommendations regarding use,  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. The good thing is that we no longer have to walk around with a white stripe down our noses to be safe from UV rays. Now 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.

Acne In Pregnancy

Most of us will experience acne during pregnancy, even if you had clear skin before. 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 for those prescriptions.

Additionally, there are a few other products that are staples in my own skincare routine that 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 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. It’s a staple in my skin care routine and has been for years now!

Frequently Asked Questions

What are your qualifications?

I am a double board certified ObGyn and Maternal-Fetal Medicine Specialist. I have worked at a large academic center in academic medicine as a clinician, educator and researcher since 2004.  I am currently a tenured Professor and actively manage patients with high-risk pregnancies.

How can I contact you for a collaboration, interview or other opportunity?
Please send me an email.
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The best way to contact me about debunking social media content is to send that content to me in a DM on my Instagram account @babiesafter35. You can also email me.

Do you do private consults? Can I get you to review my medical records?

I do not do private consults or review medical records submitted by patients.

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Yes! Please email me for more info.