Pregnancy, breastfeeding and aesthetic treatments: what's safe and what isn't

The short version

• · Botox, fillers, and Profhilo are not advised during pregnancy or breastfeeding due to insufficient safety data.
• · Microneedling should be paused during pregnancy; data is limited for breastfeeding.
• · Retinol and retinoids (prescription-strength) must be stopped when trying to conceive and throughout pregnancy.
• · Topical retinoids carry low absorption risk during breastfeeding but conservative practice still recommends avoidance.
• · Vitamin C serums and broad-spectrum SPF are safe throughout pregnancy and breastfeeding.
• · The decision to pause treatment is precautionary, not permanent. Most aesthetic treatments can resume once breastfeeding stops.

Why we pause aesthetic treatments: the safety principle

Aesthetic injectables and procedures occupy a curious space in UK medical practice. They are not licensed as pregnancy or breastfeeding treatments. This does not mean they are dangerous. It means we do not have robust clinical trial data showing they are safe, and pregnant or nursing bodies differ substantially from non-pregnant ones in how they absorb, metabolise, and distribute foreign substances.

The precautionary principle applies here: if we cannot demonstrate safety with confidence, we recommend pause. This is particularly true in the first trimester, when foetal organ development is rapid, and during breastfeeding, when we must consider not just maternal safety but infant exposure via breast milk.

This stance is not unique to Visage. It reflects guidance from the UK National Childbirth Trust, the FDA, and professional bodies across dermatology and aesthetic medicine.

Botox during pregnancy and breastfeeding

The FDA explicitly states that whether Botox injections are safe during pregnancy or breastfeeding is not currently known. This is not a ban based on observed harm; it is an absence of safety data.

During pregnancy, the concern is theoretical but significant. Botulinum toxin works by blocking acetylcholine release at the neuromuscular junction. While the toxin is large and unlikely to cross the placenta, we have no studies measuring foetal exposure or long-term outcomes. The responsible position is to stop Botox at least three months before trying to conceive, or immediately upon learning of a pregnancy.

For breastfeeding, the picture is becoming slightly clearer. Emerging research suggests the risk of Botox entering breast milk is extremely low, because the toxin is not thought to enter the maternal bloodstream. A 2024 pilot study measured botulinum toxin A in breast milk samples and found levels were highest in the first week after injection, declining thereafter. Because the toxin's large molecular size prevents absorption into circulation, passage into milk appears minimal.

However, regulatory guidance remains conservative. The FDA advises against Botox during breastfeeding. In my clinic, I recommend that clients wait until breastfeeding has stopped completely before resuming treatment. If a client has had Botox and then discovers she is breastfeeding, this is not an emergency; the evidence suggests risk is low, but we do not yet have enough data to counsel her with full confidence.

Fillers and Profhilo: what the evidence says

Dermal fillers, including hyaluronic acid (HA) and bio-stimulating fillers, are not advised during pregnancy or breastfeeding. The reason is straightforward: we do not know how cosmetic filler particles or their components distribute through a pregnant or nursing body, how they might affect foetal development, or whether they pass into breast milk.

Profhilo, a hybrid of hyaluronic acid, is explicitly contraindicated by its manufacturer during pregnancy and lactation. The product guidance is clear: insufficient safety data in these populations means it should not be used.

If you have had filler placed and then become pregnant, this is not harmful retroactively. The filler is already integrated into tissue. The concern is only about introducing new material during a period when pregnancy-related changes (increased plasma volume, altered immune function, hormonal shifts) might change how your body handles a foreign substance.

Most clients can resume filler treatment once breastfeeding has finished. HA fillers metabolise naturally within 6 to 18 months, so there is no "build-up" to worry about when you restart.

Microneedling and laser treatments

Microneedling should be paused during pregnancy. The primary concern is not the microneedling itself, but the physiological changes of pregnancy: increased blood volume, hormonal shifts, and heightened risk of infection. Pregnancy also increases the risk of post-inflammatory hyperpigmentation, making it a poor time to trigger controlled skin injury.

During breastfeeding, the data is thinner. Most practitioners recommend a cautious pause, particularly in the first weeks postpartum when the body is still recovering. By three to four months postpartum, if breastfeeding is established and healing is complete, microneedling can cautiously resume. However, do discuss timing with your practitioner.

Laser treatments, IPL, and electrolysis carry similar uncertainty. Professional guidance recommends avoiding them during pregnancy and breastfeeding due to lack of safety and efficacy data in these populations. Wait until breastfeeding has stopped.

Skincare during pregnancy and breastfeeding: what to avoid and what to embrace

Skincare is where you have genuine control. There are clear recommendations here, and they make a real difference.

Stop all retinol, retinoids, and retinol derivatives immediately when trying to conceive, and throughout pregnancy. This includes over-the-counter retinol, prescription tretinoin (Retin-A), and adapalene. The concern is real: oral retinoids are known teratogens, and although topical retinoids have low absorption, the principle of caution applies. Elective cosmetic use of retinoids during pregnancy is not justified by the evidence.

During breastfeeding, the picture softens slightly. Topical retinoids have less than 6% absorption into the bloodstream, and there is no evidence they significantly alter milk retinol levels. However, conservative guidance still recommends avoidance. If you wish to use a mild topical retinol during breastfeeding, discuss it with your GP or dermatologist, and consider waiting until breastfeeding stops.

Oral retinoids (isotretinoin, acitretin) are absolutely contraindicated during breastfeeding and will be present in milk. If you are taking an oral retinoid, you should not breastfeed.

Instead, focus on what works and is safe: vitamin C serums (L-ascorbic acid or stabilised forms), niacinamide, and broad-spectrum SPF 30 or higher. Pregnancy increases melanin production, raising the risk of melasma (pregnancy mask), so daily sun protection is non-negotiable. Vitamin C supports collagen and offers antioxidant protection. These ingredients cause no harm and genuinely support skin health.

Avoid chemical sunscreens (oxybenzone, octinoxate) if you are concerned about systemic absorption; mineral sunscreens (zinc oxide, titanium dioxide) sit on skin and are considered safer during pregnancy. Moisturisers, hyaluronic acid serums, and gentle cleansers are all fine. Hydration matters more during pregnancy than it ever does.

When to stop before trying to conceive; when to start again

If you are planning a pregnancy, stop retinoid skincare at least one month before you start trying. Stop Botox at least three months before. This allows the toxin to metabolise fully from your system.

For fillers and skin boosters, there is less urgency (you are not introducing new material at the moment of conception), but it is reasonable to avoid scheduling these treatments in the weeks you plan to conceive.

After birth, timings depend on treatment type and breastfeeding status. If you are not breastfeeding, Botox, fillers, and microneedling can resume once you feel physically and emotionally ready, usually by six to eight weeks postpartum. If you are breastfeeding and wish to have aesthetic treatment, wait until breastfeeding has stopped completely. For some clients this is a few months; for others, much longer.

Retinoids can resume once breastfeeding has stopped. Skincare with vitamin C and SPF is safe to continue throughout.

A safety note on information and choice

Everything in this article is based on current evidence and professional guidance. Evidence evolves. If you are pregnant, planning a pregnancy, or breastfeeding, your GP, midwife, or dermatologist are the right people to discuss your individual circumstances. What I have written applies to most people, but pregnancy and breastfeeding introduce biological variation that means blanket rules sometimes miss nuance.

This is also not a moral judgment. Choosing to have or not have aesthetic treatment is entirely your decision. Pausing treatment during pregnancy and breastfeeding is a harm-reduction choice, not an ethical statement about your body or your priorities.

If you would like to discuss aesthetic options during this phase of your life, or to plan a timeline for treatment when breastfeeding finishes, a consultation at Visage is free and without pressure. We take time to understand your goals and the real constraints you are living within. You can book a consultation or call us to discuss your situation confidentially.

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