Botulinum toxin
(Date: August 2023. Version: 4.0)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
Quick read
Botox can be used in pregnancy to treat a medical condition. As a precaution, it is recommended that cosmetic treatments with Botox are avoided in pregnancy.
What is Botox?
Botox is given as an injection to relax muscles. It is used medically to treat headaches, severe muscle spasms, bladder problems and excessive sweating. It is also used cosmetically to reduce facial lines.
What are the benefits of using Botox in pregnancy?
Botox can work well to treat some medical conditions caused by muscle spasms. This can help with movement, reduce pain, and improve quality of life. Botox is injected directly into the area that needs treatment and, if used correctly, does not enter the bloodstream in large amounts. This means that it should not reach the baby at levels high enough to cause harm. Use of Botox can mean that other medicines that do enter the bloodstream and reach the baby are not needed.
Are there any risks of using Botox in pregnancy?
No risks have been identified but only around 250 pregnant women using Botox have been studied. If Botox is correctly injected, it should stay in the muscles being treated and would therefore not be expected to cause problems for the baby. However, as a precaution, cosmetic treatments with Botox are not recommended during pregnancy as there is no clinical benefit to these treatments.
Are there any alternatives to using Botox in pregnancy?
Possibly. A number of drugs can be used to treat muscle spasms, so swapping might be an option. However, Botox does not enter the bloodstream in large amounts and using it can mean that drugs that do enter the bloodstream (and reach the baby) can be avoided. A doctor may therefore advise that Botox is the safest option. Women who are treated with Botox and who are pregnant or planning a pregnancy should consult their doctor to ensure they are receiving the best treatment.
What if I prefer not to use medicines in pregnancy?
Some women who are usually treated with Botox may decide, together with their doctor, that they can stop treatment in pregnancy. However, some medical conditions might require continued treatment. A doctor will be able to advise on what is best for each woman.
Will my baby need extra monitoring?
All pregnant women in the UK should be offered a detailed anomaly scan at around 20 weeks of pregnancy as part of their routine antenatal care. Extra monitoring for birth defects is not needed following Botox use in pregnancy.
Are there any risks to my baby if the father has used botulinum toxin?
We would not expect any increased risk to the baby if the father was treated with Botox before or around the time you became pregnant.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org
How can I help to improve drug safety information for pregnant women in the future?
Our online reporting system allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit https://www.medicinesinpregnancy.org/Login/ to register.
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General information
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.
www.medicinesinpregnancy.org