Cosmetic Botox is generally postponed during pregnancy: the FDA label says there are no studies or adequate data on its developmental risk in pregnant women, and Cleveland Clinic notes that most healthcare providers recommend waiting until after birth. This guide explains what the label and other authoritative sources say, what to do if you were treated before you knew you were pregnant, and what to ask your clinician and your obstetric provider.
Can you get Botox while pregnant?
The short answer from authoritative sources is that cosmetic Botox is not recommended during pregnancy. MedlinePlus, from the National Library of Medicine, states that you should not use Botox if you are pregnant or breastfeeding. Cleveland Clinic lists pregnancy among the reasons not to have Botox injections.
The FDA label does not establish safety during pregnancy. Because cosmetic treatment is elective, discuss postponing it with your clinician and obstetric provider. If you were treated before learning you were pregnant, contact them for an individual assessment.
You may read confident claims online in either direction about Botox during pregnancy. The FDA advises checking with your health care provider about information you read online, because some websites say certain medicines are or are not safe to take during pregnancy. For Botox, the human evidence is limited.
This article is general education, not personal medical clearance. Decisions about any medicine during pregnancy belong with your treating clinician and your obstetric provider.
What does the FDA label say about pregnancy?
Botox Cosmetic (onabotulinumtoxinA) is approved by the FDA for adults for the temporary improvement in the appearance of moderate to severe frown lines between the eyebrows, crow's feet lines, forehead lines, and vertical neck bands (platysma bands).
The pregnancy section of the Botox Cosmetic prescribing information states that there are no studies or adequate data from postmarketing surveillance on the developmental risk of Botox Cosmetic in pregnant women. In animal studies, Botox Cosmetic given during pregnancy caused adverse effects on fetal growth, including lower fetal body weight and reduced bone formation, at clinically relevant doses that were also associated with toxicity in the mother. The label reports these animal findings alongside the lack of human data; it does not quantify potential risks for a human pregnancy.
A common question is whether Botox crosses the placenta. The label does not include human data on placental transfer, and it does not establish that any dose or stage of pregnancy, including the first trimester, is without risk. The FDA notes more generally that some medicines may harm a developing fetus during different stages of pregnancy, so any question about a medicine should be specific to your own timing.
The patient Medication Guide asks you to tell your doctor if you are pregnant or plan to become pregnant, and states that it is not known whether Botox or Botox Cosmetic can harm an unborn baby.
What if you had Botox before you knew you were pregnant?
This is a common worry. MedlinePlus advises calling your doctor if you become pregnant while receiving onabotulinumtoxinA injections. Tell your obstetric provider what you received, and share as much of the following as you can:
- The date of the treatment, which helps your obstetric provider place it in your pregnancy timeline, such as early pregnancy or the first trimester
- The product name, such as Botox Cosmetic or another botulinum toxin brand
- The areas treated and, if available, the dose recorded in your treatment notes
- Any symptoms you noticed afterward
Your aesthetic provider should be able to give you a copy of your treatment record. Your obstetric provider can then put that information in the context of your overall pregnancy care. Until you have had that conversation, hold off on any further Botox treatment.
Is Botox for a medical condition a different decision?
Botox is also used for medical conditions such as chronic migraine, overactive bladder, and certain muscle and eye disorders. When a medicine treats a health problem, the decision during pregnancy involves weighing the condition itself against what is known and unknown about the medicine. That conversation belongs with the prescribing doctor and your obstetric provider. This article is about cosmetic use, where the treatment can usually wait.
Are other cosmetic injectables a safer option during pregnancy?
Not necessarily. Other botulinum toxin products, such as Dysport, Xeomin, Jeuveau, Daxxify, and Letybo, are separate products with their own labels, so ask about the specific product rather than assuming they are interchangeable. For dermal fillers, the FDA states that the safety of these products is unknown when used during pregnancy and while breastfeeding.
The same approach applies to other cosmetic procedures you may be considering: ask what is known about the specific product during pregnancy and breastfeeding, and whether the procedure can wait.
The FDA's general advice for pregnant people is to talk with your health care provider before taking any medicine, to ask about the benefits and risks, and to check the label for what is known about effects on a developing fetus.
How should you think about timing?
Cosmetic Botox effects are temporary. For cosmetic wrinkle treatment, effects typically last a few months, and individual duration varies. That means pausing during pregnancy does not usually require a long-term decision.
If you are planning a pregnancy, tell your clinician before any treatment. The FDA suggests making a plan with your health care provider about your medicines before you get pregnant. If you plan to breastfeed after delivery, that is a separate question: the Botox Cosmetic label states there are no data on whether it is present in breast milk or how it might affect a breastfed child. Ask your clinician and your baby's health care provider before resuming treatment.
When should you seek urgent care after Botox?
The Botox Cosmetic label carries a boxed warning that the effects of botulinum toxin products may spread from the injection area and cause symptoms of botulism. These symptoms have been reported hours to weeks after injection. Call your doctor right away or get emergency care if you have:
- Trouble swallowing, speaking, or breathing
- Loss of strength or muscle weakness all over the body
- Double vision, blurred vision, or drooping eyelids
- Hoarseness or a change or loss of voice
- Difficulty saying words clearly or loss of bladder control
Call 911 for trouble breathing or any symptom that feels like an emergency. If you are pregnant, also tell your obstetric provider about any treatment and any symptoms.
Questions to ask your clinician and obstetric provider
Whether you are planning a pregnancy, are an expectant mother, or were treated before a positive test, these questions can help:
- Given that the label reports no adequate human data, should I wait until after pregnancy?
- I was treated before I knew I was pregnant. What, if anything, should we monitor?
- If I plan to breastfeed, when should we revisit treatment?
- Is my concern cosmetic, or is there a medical condition we should discuss separately?
- Are there skin-care steps that my obstetric provider considers appropriate during pregnancy?
For general preparation, read our Botox consultation safety questions and Botox aftercare and when to call. When you are ready to discuss treatment, use the contact page and ask whether the service is offered at your location.
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General educational information is not a diagnosis or treatment recommendation. Consult a qualified clinician about your individual circumstances.