The safety of what you’re putting into your body – in the form of food, drinks and supplements – comes under strong scrutiny during childbearing and breast feeding.
According to skincare experts and dermatologists, the same should be said for those ingredients that you’re using on your skin in the form of skincare, sunscreens and cosmetic injectables.
It is always best to speak to your doctor about treating skin conditions when pregnant, as you need to be careful with which products you use. For example, topical creams like retinol (Vitamin A) and medication like isotretinoin are usually great treatments for acne, yet are definitely not safe to use while pregnant.
The concern in using cosmetic injectables and some cosmeceuticals during pregnancy is that potent active ingredients may diffuse into the blood stream and disrupt hormone levels or affect fetal development.
Anti-wrinkle injections
There is very little concrete evidence surrounding the effect of anti-wrinkle injections on a developing fetus.
One study, by Morgan J C et al (2006), found an ingredient in anti-wrinkle injections appeared to be relatively low-risk for both the expectant mother and fetus. However, it did recommend further research, and suggested that practitioners and patients carefully consider the risks and benefits before using anti-wrinkle injectables in pregnant women.
This caution seems to be mirrored by doctors and dermatologists around the world. It has been recommended that pregnant women should refrain from receiving any anti-wrinkle injections during pregnancy and breastfeeding, in an effort to keep the fetus as healthy as possible.
US dermatologist Dr Vivian Bucay discusses treatments during pregnancy on her website. She says: ‘cosmetic treatments, such as anti-wrinkle injections and chemical peels, should be avoided during pregnancy. Even though these treatments and procedures are considered low risk, expectant mothers should still try to avoid them.’
In the US, the Food and Drug Administration (FDA) classifies anti-wrinkle injections as a pregnancy risk Category C. This means the drug should only be administered during pregnancy if the potential benefit justifies the potential risk to the fetus.
Why the concern?
Anti-wrinkle injections are made of a natural, purified protein and neurotoxin produced by the bacterium called Clostridium botulinum – it is also one of the most potent food-related toxins known to humans.
“Botulism” is the poisoning associated with unsafe exposure to anti-wrinkle injections. In humans, this can cause blurred or double vision, nausea, vomiting, trouble breathing, difficulty swallowing, muscle weakness and impaired motor control. However, there is limited evidence as to how this poisoning could affect an unborn child.
While the size and weight of the molecule derived from an anti-wrinkle injection is too big to diffuse across the placental membrane, scientists do not know if transfer to the fetus is possible through an active transport mechanism. They also can’t be certain if the toxin’s neuromuscular effects could potentially affect fetal development.
Where does the toxin go?
Common claims that the toxin does not migrate from the treatment site following injection are inaccurate, according to research published in the Journal of Neuroscience. Earlier this year, scientists discovered some of the potent toxin escapes into the central nervous system (the brain and the spinal chord) following cosmetic injections.
Dr Tong Wang from the Queensland Brain Institute was involved in the study, explaining that for the first time, they have been able to visualise single molecules from cosmetic injections travelling at high speed through our nerves.
‘We found that some of the active toxins manage to escape this route and intoxicate neighbouring cells.’ This discovery adds weight to the argument for avoiding anti-wrinkle injections during pregnancy and breast-feeding.
Until researchers further understand the pathways of cosmetic injectables in the body – and the way the toxin might interact with or affect a developing fetes – the overarching recommendation is that patients and practitioners steer clear of cosmetic injectables during child bearing.
Skincare
In the skincare department, parabens, phthalates and retinoids are all of particular concern during pregnancy. Parabens and phthalates are commonly found in cosmetics, body lotions, nail polishes, hair sprays and fragrances. Both parabens and phthalates are considered endocrine-disruption chemicals, which have the potential to interfere with hormone function.
One study, by Braun, J.M. et al. in 2013, looked into the use of parabens and phthalates during pregnancy.
They found lotion, cosmetics and perfume use were all associated with an increase in phthalate metabolite and paraben concentration in the urine – of up to 111 percent. Avoid parabens and phthalates by using essential oils instead of fragrances, checking the ingredients listed on the label and opting for products that are ‘paraben-free’. Retinoids are a form of vitamin A and are used in skincare to accelerate skin cell renewal – this can be effective in reducing pigmentation, treating acne and reducing wrinkles.
Retinol, retinol, tretinoin (retinoic acid, Retin-A), isotretinoin and alitretinoin are all forms of first-generation retinoids. While there is limited evidence to show retinoids are harmful when used topically, many studies have shown that high doses of vitamin A during pregnancy can be harmful to an unborn child. As well as this, oral retinoids such as isotretinoin commonly used in acne treatments, have been shown to cause birth defects.
Chemical Peels
Salicylic acid is a chemical exfoliant and is the primary ingredient in many chemical peels. It is also the active ingredient in aspirin. High doses of salicylic acid in oral form have been associated with birth defects and various complications during pregnancy. With regards to topical application, the concern is around the use of chemical peels that contain salicylic acid.
The high concentration of salicylic acid, plus the greater quantities used in chemical peels, increase the chances of absorption into the bloodstream, which could affect fetal development. It is best to consult with an experienced dermatologist in undergoing treatment with chemical peels during pregnancy.
So, what is safe?
There are several effective topical treatments that can be used safely during pregnancy.
They include:
• Benzoyl peroxide – This has the ability to penetrate deep in oil glands, and kill off P. acnes; the acne provoking bacteria. This prevents the bacteria from driving the inflammation of acne.
• Azelaic acid – This works in a similar way to Benzoyl peroxide in that it is anti-bacterial and anti-inflammatory.
• Niacinamide (Vitamin B3) – This can be used for oil control and minimising pores and also has anti-inflammatory properties. If your skin is oilier than usual, adapting your skincare may also help manage your acne during pregnancy, for example switching to a less greasy moisturiser.
