Botox is an injectable drug made from highly-purified botulinum toxin type A, a neurotoxin that temporarily paralyzes muscles and comes from the bacterium Clostridium botulinum.
Clostridium is found naturally in the environment and the gastrointestinal tract of animals. Usually, the bacterium only produces toxins when it overgrows and causes infection.
The American Society of Plastic Surgeons estimate that 6.6 million women underwent Botox injections in 2016, making it the most popular form of minimally invasive cosmetic surgery performed in the United States.
There are medical conditions that may benefit from Botox therapy. These include:
- neuromuscular conditions that impact muscle control, such as cerebral palsy
- severe migraine headaches
- excessive sweating
- incontinence or urine leakage
- gastrointestinal tract conditions, such as irritable bowel syndrome
- spasm of the eyelids
- spasms of the neck and shoulder muscles
- conditions that cause intense muscle stiffness
According to the United States Food and Drug Administration (FDA), whether Botox injections are safe during pregnancy or breast-feeding is not currently known.
The neurotoxic proteins in Botox injections affect nerve impulses by blocking the neurotransmitter acetylcholine, which temporarily prevents muscle cell contraction and glandular cell activity.
When used cosmetically, Botox is injected into specific facial or neck muscles, forcing them to relax and reducing the appearance of wrinkles, fine lines, crow's feet, and forehead and frown lines.
Botox toxins may also be injected directly into overactive muscles or glands to limit their activity, such as the sweat glands under the armpits, neck muscles, or hand muscles.
Normally, Botox injections begin working within a few days of an injection. They tend to have only a localized, not systemic or whole body effect.
Botox toxins are thought to remain active in the body or target area for 4 to 6 months before being metabolized and excreted from the body.
Botox injections are recognized as safe and, as yet, they have not been reported to transfer from mother to child.
But, Botox injections contain neurotoxins that can be dangerous in large doses or for people allergic to these chemicals.
Disease or infection caused by botulinum toxins is called botulism. Botulism can be life-threatening, especially in pregnant women, infants, those who are immune compromised or with gastrointestinal conditions.
Though some research has found that botulinum toxins may be too large to cross the placenta during pregnancy, pregnant and nursing women are encouraged to avoid potential sources of the toxin, including certain foods.
All infants should not be allowed to consume foods that are considered common sources of botulinum.
Common causes of botulism include:
- canned fruits and vegetables
- corn syrup
- food kept warm for a long time or left unrefrigerated
- cheeses and cheese sauces
- packaged baked potatoes
- bottled garlic
- infused oils
- fermented fish and meats
- infected wounds
Though the research is still limited, Botox injections may also be able to spread to other nerves or cells in the body, causing unintended symptoms.
A 2016 study found evidence that botulinum toxin injected into one area can travel through connected nerve cells or neurons, paralyzing non-target muscles and glands.
Anytime side effects accompany or follow Botox injections, a person should seek immediate medical attention.
Though considered very rare, Botox injections can cause severe symptoms, predominantly respiratory distress, which can be fatal if untreated.
Rare complications associated with Botox injections include:
- rash, welts, or itchy skin at injection site
- inflammation, pain, redness, swelling, and bleeding at injection site
- undesired muscle paralysis or muscle weakness
- difficulty swallowing, breathing, or speaking
- increased or reduced saliva production or sweating
- nausea, stomach pain, and diarrhea
- sore throat
- loss of bladder control
- urinary tract infection
- unexplained exhaustion
- droopy eyelid
- double or blurred vision
- asthma-type symptoms
- dizziness or feeling faint
It is unclear how cosmetic fillers impact unborn babies and nursing infants.
So in most cases, pregnant and nursing women should avoid getting cosmetic procedures that involve filling or plumping agents.
Though the research is very limited, a few different supplements, creams, therapies, and lifestyle habits may help reduce the appearance of fine lines and wrinkles and may be appropriate for nursing and pregnant women.
Potential medical alternatives to Botox injections include the following, although not all should be used by breast-feeding women:
- massage and cupping therapy combined, or FaceXercise
- collagen supplements and creams
- chemical peels
- cinnamon powder and peppermint oil injections
- hyaluronic acid injections
- Face Saver Ball (Yamuna Face Ball) which is available to purchase online.
- Frotox, or patches that contain liquid nitrogen
- Frownies (which are available to purchase online), or sticky patches that help limit muscle activity while sleeping
- VTOX, patches with neuro-peptides and algae compounds
- C02 laser resurfacing
- prescription strength creams, containing retinoid (vitamin A), vitamin C, tretinoin, α-hydroxy acid, or N6-furfuryladenine (kinerase cream)
Home remedies for wrinkles
Home remedies that may help prevent or reduce the appearance of fine lines and wrinkles include:
- always wear sunscreens or creams, containing at least 30 percent SPF and both UVB and UVA protection
- stay hydrated all day
- avoid the use of tanning beds, lights, and products
- avoid lightening or whitening products
- always wash your face and remove makeup before bed
- wear protection in the sun and wind, including hats, long sleeves, and sunglasses
- use a homemade mask or serum with pineapple juice, lemon juice, and apple cider vinegar
- use a homemade scrub made of finely ground white sugar mixed with coconut oil or olive oil
- use hydrating creams, oils, and serums, such as those rich in glycerine and hyaluronic acids
Nutrients and supplements to consume or use to help prevent or reduce fine lines and wrinkles include:
- a variety of fruits, vegetables, and whole grain foods
- vitamin C, E, and A
- omega-3s, omega-6s, and omega-9s
Because it is still unclear whether or not Botox toxins can spread to a nursing child through breast milk or impact unborn babies during pregnancy, most doctors recommend avoiding Botox therapy during pregnancy and breast-feeding.
As botulinum toxins can stay active in the body for 6 months or more, it is sensible for women trying to become pregnant or planning on nursing, to avoid Botox injections.
The company that manufactures Botox, Allergan Inc., states that, although the complications remain unknown, pregnant and breast-feeding women should always tell their doctor if they are thinking of using Botox.