From the Guidelines
Botox injections are not recommended during pregnancy due to insufficient safety data and potential unknown risks to the developing fetus. The use of botulinum toxin injections, including Botox, is considered a non-urgent medical procedure, and as such, it is recommended to postpone elective procedures until after delivery 1. According to guidelines for the use of local anesthesia in office-based dermatologic surgery, elective procedures and those not of urgent medical necessity requiring topical lidocaine in pregnant women should be postponed until after delivery 1. While topical lidocaine is safe for use on pregnant or nursing women, there is insufficient evidence to recommend the use of other topical anesthetics, including those used in conjunction with Botox injections 1.
When considering the use of Botox injections during pregnancy, it is essential to weigh the potential benefits against the potential risks. However, since the safety data is insufficient, the cautious approach is to avoid exposure during pregnancy. For those using Botox therapeutically for conditions like chronic migraines or muscle spasticity, it is crucial to consult with a healthcare provider about alternative treatments that are established as safe during pregnancy. Key points to consider include:
- Insufficient safety data for Botox use during pregnancy
- Potential unknown risks to the developing fetus
- Postponing elective procedures until after delivery
- Exploring alternative treatments for therapeutic uses of Botox during pregnancy
- Consulting with a healthcare provider for personalized advice 1.
In real-life clinical practice, the priority is to minimize risks and ensure the best possible outcomes for both the mother and the fetus. Given the current evidence, avoiding Botox injections during pregnancy is the recommended course of action. If you're currently pregnant and considering Botox for cosmetic purposes, it's best to postpone treatment until after delivery and the completion of breastfeeding if applicable.
From the FDA Drug Label
• are pregnant or plan to become pregnant. It is not known if JEUVEAU can harm your unborn baby. The FDA drug label does not answer the question.
From the Research
Botox Injections During Pregnancy
- The use of Botox injections during pregnancy has been studied in several cases, with some studies suggesting that it may be safe for use in pregnant women 2, 3, 4.
- A case report published in 2014 found that a woman who received Botox injections for migraine treatment while 18 weeks pregnant gave birth to a healthy full-term girl with no neuromuscular or developmental concerns 2.
- A review of the literature published in 2020 found that Botox injection does not increase the risk of complications in pregnant women and fetuses, but further research is needed to determine how to reduce the side effects of Botox injection during pregnancy 3.
- A study published in 2025 found that women who continued Botox treatment during pregnancy had a lower risk of miscarriage and no fetal malformations were reported 4.
Safety and Efficacy
- The safety and efficacy of Botox injections during pregnancy are not fully understood, and more research is needed to determine the potential risks and benefits 3, 4, 5, 6.
- Some studies have found that Botox injections may be effective in reducing the frequency and severity of migraines during pregnancy, but the evidence is limited and more research is needed to confirm these findings 2, 4, 5.
- The use of Botox injections during pregnancy should be approached with caution, and women should be fully informed of the potential risks and benefits before making a decision 3.
Current Research
- Current research suggests that Botox injections may be a valuable prophylactic agent for migraines, and may also be effective in preventing hormonal variations-triggered migraines 5.
- A systematic review and meta-analysis published in 2019 found that Botox treatment resulted in reduced frequency of migraine days per month in chronic migraineurs compared with placebo 6.
- However, more research is needed to fully understand the safety and efficacy of Botox injections during pregnancy, and to determine the potential long-term effects on the fetus and the mother 2, 3, 4, 5, 6.