Beauty treatments: what to avoid when you're pregnant or breastfeeding

Dr A. Bolin

No drinking alcohol, no soft cheese and no pate. These are just a few of the things your advised against when your pregnant – but it doesn’t end there. There are certain cosmetic procedures and skincare ingredients you should avoid too. Dr A. Bolin explains.

Do you have a skin ritual that includes a few of the following: exfoliation, hydration, lifting, peels, serums, masques, botox, and fillers?  If you’re pregnant or breastfeeding there are a few things you might like to consider if you do. There is a whole host of medications, ingredients and chemicals that can cross the placenta or end up in breast milk so it’s important to know which which ones you should avoid for your baby’s safety.

While advice is constantly changing as new research comes to light, and very few studies are done on pregnant women, here are a few treatments and ingredients that you should add to your ‘avoid’ list – but also, some you can still enjoy.

 

BOTOX, FILLERS AND ANTI-WRINKLE TREATMENTS?

Botulinum Toxin: Botox? AVOID

Should you have your botox treatment while pregnant or breastfeeding to smooth away a few lines?  Currently there are no studies that test the effects of botox in pregnant women.  According to the British Skin Foundation, as well as the manufacturer, Allergan, the advice is to avoid any cosmetic treatments such as Botox during pregnancy and breastfeeding.  As you can imagine, many women might have had Botox and not realised they were pregnant.  If this is the case and you are concerned, speak with your healthcare provider.

 

Fillers?  AVOID

Lips and cheeks may have to miss out while your pregnant or breastfeeding as fillers such as Juvederm, Restylane and Perlane,are not recommended.  The safety of cosmetic dermatologic procedures during pregnancy has not been established, so for now, the experts say it is best to avoid them.

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Anti-Wrinkle Treatments containing Vitamin A? AVOID

Make sure you read the ingredients of creams and serums containing anti-aging elements or targeting lines on the face.  Many of these products will contain retinoids which are a derivative of vitamin A (also used for acne).  Various forms include retinoic acid, retinyl palmitate, retinaldehyde, adapalene, tretinoin, tazarotene and isotretinoin.  If you are planning on getting pregnant, are pregnant or are breastfeeding you should not use Vitamin A skincare products or take these medications containing Vitamin A unless advised by your doctor. Always tell your doctor if you are planning on getting pregnant, are pregnant or are breastfeeding.

 

SPA TREATMENTS: 

Hot tubs and saunas: AVOID

In pregnancy, it is important not to raise core body temperature above 38.9°C.  In hot tubs and saunas the temperature displayed on the thermometer may not be accurate.  Hyperthermia, or overheating, in pregnant women has been linked to an increase in neural tube defects in fetuses.  (Bikram Hot Yoga is usually practiced between 35-40 degrees Celsius, based on hyperthermia studies it might be best to avoid until further evidence of safety is established).

 

Body wraps: AVOID

Body wraps can cause overheating, therefore, the same precautions must be taken as with hot tubs and saunas.

 

Massage:  ENJOY!

With all the loosened ligaments, sore muscles and skin changes that occur with pregnancy, a massage can work wonders. It is recommended to book a session with a certified therapist who has been trained in prenatal care.

 

Facials: ENJOY! (but make sure products are safe for pregnancy – no vitamin A)

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Microdermabrasion: CAUTION

During pregnancy your skin may be more sensitive and the redness and swelling that some people get from microdermabrasion may be exacerbated. If you are considering having microdermabrasion for melasma, an increase in pigmentation that darkens patches of skin during pregnancy, then be aware that the hormones that caused the pigment levels to increase is still high and the melasma may reappear.

 

Peels: AVOID

Remember that your skin during pregnancy may be more sensitive than usual.  Find a beauty therapist who has experience, knows the products well, and ensures that they are safe for your pregnancy.  Avoid scrubs and harsh chemical peels.

 

SKIN: SUN TANNING, SKIN LIGHTENING

Sunbeds: AVOID (pregnant or not)

In pregnancy, sunbeds can increase core body temperature and UV rays break down folic acid.  Otherwise, the increased risk of skin cancer is predominantly to the mother.

 

Fake tans: CAUTION

Fake tans are safer alternatives to hours in the sun or sunbeds.  The active ingredient in spray self-tanners is DHA (Dihydroxyacetone).  It has a local effect on the skin which produces the pigmented tan.  There are minimal amounts that are absorbed into your system, therefore it can be used in pregnancy (concentrations of 1% – 15%).  Remember that changes in hormone levels during pregnancy can make a difference in the colour achieved so make sure to do a test area of skin first.  The test patch of skin can also be used to determine if you are allergic to the product if you never used it before.  Also, if you are using a spray tan, that you spray in a well-ventilated area and avoid inhaling as the effects are not known.

 

Tanning pills: NEVER

Tanning pills are illegal in the UK and are never recommended, pregnant or not. They tend to be made of beta-carotene or canthaxanthin, which can affect to an unborn baby. Other side effects may include inflammation to the liver and damage to the eye (retina).

 

Skin Lightening Creams: AVOID

Hydroquinone is used medically to treat pigmented conditions such as chloasma, otherwise known as melasma, the ‘pregnancy mask’ as it’s sometimes known.  It also is for cosmetic purposes to lighten skin. Approximately 35% to 45% is absorbed systemically after applying it to the skin.  Until more evidence on the safety of hydroquinone in pregnancy is established, it is recommended to avoid using it due to its high absorption rate. One study found other ingredients in skin lightening products were associated with skin irritation and exacerbation of conditions such as eczema and dermatitis and acne.

 

TATTOO AND PIERCINGS

Temporary Tattoos: CAUTION

Henna is a natural plant-derived pigment which can stay on the skin temporarily.  Although it is possible to have an allergic reaction to henna, it is more common to have a reaction to added chemicals.  It is important to know the ingredients, which is not always possible.

 

Black henna: PPD, para-phenylenediamine?  NEVER

The director general of the Cosmetic, Toiletry and Perfumery Association, explained: “PPD is safely and legally used in permanent hair dyes where clear instructions are given, and where the maximum level is controlled by law. But black henna often contains PPD at high levels, to give a dark colour quickly.  “When applied to the skin in the form of a black henna temporary tattoo, PPD can cause chemical burns and lead to allergic reactions.”

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Tattoos and piercings? CAUTION

Either may become an issue or cause complications such as infections or allergic reactions. Additionally, with the changes that occur with the body often the tattoo may look remarkably different after the delivery.  Also, piercings of the nipples, navel, and genitalia may change in location after giving birth.  Nipple piercings need to be removed during breastfeeding as they can make it difficult for the baby to feed.

 

TO SUM UP:

Pregnancy can be wonderful experience but the beauty treatments you choose need to be safe for you and your baby.  For the products that do not have enough evidence or data, avoid using them to err on the side of caution.  If in doubt, ask your dermatologist, obstetrician, paediatrician, midwife or GP.

And when it comes to breastfeeding, a safe rule is if you did not take a medication or do a beauty treatment due to safety concerns while pregnant, avoid it while breastfeeding.  For the most part, if a medication is safe during pregnancy, it should be safe during lactation but always check with a medical professional.

For further patient information in pregnancy and breastfeeding from The British Association of Dermatologists (BAD):  http://www.bad.org.uk/for-the-public/patient-information-leaflets

 

 

[1] Moser, E., et al. “Botulinum toxin A (Botox) therapy during pregnancy.” Neurology. Vol. 48. No. 3. 227 East Washington SQ, Philadelphia, PA 19106: LIPPINCOTT-RAVEN PUBL, 1997.

[2] Lee K.C., et al. “Safety of cosmetic dermatologic procedures during pregnancy.” Dermatol Surg.  2013 Nov; 39(11): 1573-86. doi: 10.1111/dsu.12322. Epub 2013 Oct 29.

[3] Chambers, Christina D. “Risks of hyperthermia associated with hot tub or spa use by pregnant women.” Birth Defects Research Part A: Clinical and Molecular Teratology 76.8 (2006): 569-573.

[4] Moretti ME, Bar-Oz B, Fried S, Koren G. “Maternal hyperthermia and the risk for neural tube defects in offspring: systematic review and meta-analysis. ” Epidemiology. 2005;16(2):216–9.

[5] Duong HT, Shahrukh Hashmi S, Ramadhani T, Canfield MA, Scheuerle A, Kim Waller D, et al. “Maternal use of hot tub and major structural birth defects. ” Birth Defects Res A Clin Mol Teratol. 2011;91(9):836–41. Epub 2011 Jun 6

[6] Yourick JJ, Koenig ML, Yourick DL, Bronaugh RL. “Fate of chemicals in skin after dermal application: does the in vitro skin reservoir affect the estimate of systemic absorption? ” Toxicol Appl Pharmacol. 2004;195(3):309–20

[7] Source: http://www.nhs.uk/chq/Pages/955.aspx

[8] Bozzo, P, Chua-Gocheco, A and Einarson, A. “Safety of Skin Care Products during Pregnancy.” Canadian Family Physician 57.6 (2011): 665–667. Print.

[9] Mahé A, Perret JL, Ly F, Fall F, Rault JP, Dumont A. “The cosmetic use of skin-lightening products during pregnancy in Dakar, Senegal: a common and potentially hazardous practice. ” Trans R Soc Trop Med Hyg. 2007;101(2):183–7. Epub 2006 Oct 4

[10] Wolf, RMD; Wolf, Danny MD; Matz, Hagit; & Orion, Edit. (2003). “Cutaneous reactions to temporary tattoos. ” Dermatology Online Journal, 9(1). Retrieved from: http://escholarship.org/uc/item/5dd6616d

[11] Source: http://www.nhs.uk/Livewell/skin/Pages/black-henna-tattoo-ppd.aspx

[12] Chung W, Wang C, Hong H. “Allergic contact dermatitis to temporary tattoos with positive para-phenylenediamine reactions: report of four cases. ” Int J Dermatol (2001); 40:754-756.

[13] Kluger, N. “Body art and pregnancy.” European Journal of Obstetrics & Gynecology and Reproductive Biology 153.1 (2010): 3-7.

[14] Kluger, N. “Can a mother get a tattoo during pregnancy or while breastfeeding?” European Journal of Obstetrics & Gynecology and Reproductive Biology 161.2 (2012): 234-235.

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