Are cosmetic procedures safe during pregnancy and breastfeeding?

There is limited research about the safety of many cosmetic products and procedures in pregnancy and breastfeeding. This article gives you a summary of the recommendations based on available research, but it is always best to speak to your own doctor. Let all your health professionals know if you are pregnant or breastfeeding, before booking in for any procedure.

Cosmetic surgery

Cosmetic surgery during pregnancy

Your doctor can help you understand the risks of cosmetic surgery, based on your circumstances. Often, there is not much evidence in this area to make safety recommendations. This is why they may recommend you wait until after you’ve finished breastfeeding. If you must go ahead with cosmetic surgery in pregnancy, you should wait until the second trimester.

Cosmetic procedures often involve local anaesthetic injections that may cross the placenta. Depending on how far along you are in your pregnancy and the type of anaesthetic used, there are risks involved, including slowing your baby’s heart rate, triggering early labour, or even a risk of birth differences (congenital anomalies).

There are many types of local anaesthetics, and some are safer than others. To prevent too much local anaesthetic from spreading around your body, a medicine called adrenaline may be used. If this is used in a high dose it can reduce the blood flow to your uterus and your baby, and may cause your baby to be born early. Even local anaesthetics applied directly to the area of the body can put your baby at serious risk by reducing the oxygen going to its organs.

Some cosmetic procedures such as removing skin tags and other non-cancerous (benign) skin lesions have been done for a long time and are thought to be safe. If a skin procedure needs to be done (for example, urgent removal of a skin cancer) it should be done in the second trimester or after your baby is born. This is because your baby’s organs are developing in the first trimester, while in the third trimester you risk having a premature baby.

If the procedure is only for cosmetic reasons, then the advice is usually to wait until after your baby is born. In some cases after having a discussion and providing informed consent, your doctor will carry out a cosmetic procedure.

Cosmetic surgery while you’re breastfeeding

There is very little information about the safety of cosmetic procedures when breastfeeding.

If you’re worried about varicose veins that occur in pregnancy, remember that these often resolve on their own once your baby is born. It’s best to wait until after you’ve finished breastfeeding since the chemicals used in sclerotherapy (a type of treatment for varicose veins) may pass to your breastmilk.

Laser hair removal and laser skin treatments

The laser light used in hair-removal treatments heats the skin from the outside only; it doesn’t affect any deep layers. It is not a risk to your unborn baby. Due to changes to your hormones and body during pregnancy laser hair removal may be less effective and long-term results less predictable.

There is no evidence that laser hair removal affects breastfeeding or your breastfed baby.

There is limited research about laser treatments during pregnancy and breastfeeding. For this reason it is recommended that you speak to your doctor before having light-based cosmetic treatments.

Botox and dermal fillers

Botulinum toxin Type A (Botox) is used to treat wrinkles by injecting it into the muscles of your face. Small amounts are unlikely to enter your blood and do not cross the placenta so it is unlikely to reach your unborn baby. If you were to get Botox before you knew you were pregnant, it is not likely to cause any problems. Because it is not a medically necessary procedure, it is not recommended have this treatment when you’re pregnant.

There is not enough research on Botox while breastfeeding to make a recommendation, but based on the existing research, it is not likely to enter breastmilk. There are no special considerations or recommendations on the use of Botox while you’re breastfeeding.

There is not enough research about dermal fillers, so no recommendations can be made for this procedure.

Skin care products

Most cosmetics and products that you apply to your skin and can buy over the counter are not likely to be harmful. Because the general recommendation is to avoid using anything not essential and not proven to be safe while pregnant or breastfeeding, always consider if you really need to use the product, and check with your doctor or pharmacist if you’re concerned.

Acne treatments

Acne treatments often contain benzoyl peroxide, salicylic acid or glycolic acid and these are safe to use in pregnancy.

Over-the-counter products containing vitamin A (or retinol) usually only have low concentrations so you can use them in pregnancy. Check with your pharmacist before you buy these products.

Tretinoin for acne and minoxidil for hair growth both need a prescription, and they should not be used in pregnancy.

Hydroxyquinone is available over the counter and used for skin bleaching. It should not be used in pregnancy as large amounts are absorbed.

Don’t use unbranded products, or buy products on the internet since you don’t know what they may contain.

Spray (‘fake’) tan

Self-tanning is safe in pregnancy since only very small amounts of the product are absorbed. There are higher levels of chemicals in spray tans. If you are getting a spray tan or if you spray tan as your job, you should use protective measures such as a nose plug to prevent breathing too much of the product in.

Spray tan is safe in breastfeeding, but avoid applying it to the nipple, areola or any area that your baby comes in direct contact with.

Hair dye

Hair dye is applied to your hair and scalp, so your unborn baby would have very little exposure. Females commonly dye their hair in pregnancy and no harmful effects have been recorded. You can safely have your hair done in pregnancy.

If you are a pregnant hairdresser, most studies have shown no increased risk of pregnancy problems or birth differences. It is recommended to lower your exposure by opening windows, using glovers, washing your hands before eating and storing and disposing of chemicals safely. Most masks don’t prevent you from breathing in chemicals.

Manicures and pedicures

It's generally considered safe to have nail treatments. The chemicals used in these processes are typically in low concentrations and are not easily absorbed by the skin. Following the same precautions recommended for hair colouring can help minimise any potential absorption and, in turn, reduce risks to your baby.

However, it's advisable to avoid nail treatments if you have any cuts around the nail bed and ensure that your nail technician uses sterilised tools to prevent infections.

If you're uncertain about the type of nail polish used at your salon, it's a good idea to inform them to steer clear of polishes containing dibutyl phthalate, toluene or formaldehyde.

Fortunately, pregnancy often brings about healthier and stronger nails, making manicures a matter of personal preference rather than a necessity for many women during this time.

Waxing

You may choose to wax your legs or other parts of your body to remove hair. Waxing can be safely done during pregnancy and while breastfeeding.

Tattoos

The general recommendation is that you should not get a tattoo while pregnant or breastfeeding. However, there is little research available and nothing reporting a bad outcome to a baby after their mother got a tattoo. There is a very low risk of any tattoo ink passing to the baby through the breast milk. Tattoo ink mainly has large particles, but there might be some very small particles in the ink and it is not known how they can affect the breast milk. There is also a risk of infection if the tattoo is done in an environment that is not hygienic.

Resources and support

For information on specific cosmetic procedures during pregnancy and breastfeeding, speak with your doctor.

MotherSafe has a helpful factsheet with information about the safety of different types of cosmetic procedures and products.

The Australian Breastfeeding Association has a website that covers beauty treatments and their safety in breastfeeding.