Botulinum toxin

Date: August 2023, Version 4.0

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.

Benefits

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.

Risks

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.

Alternatives

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.

No 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 been treated with Botox?

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 (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. 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 the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.