Everyone wants to put their best face forward. To achieve that goal, many people turn to cosmetic procedures. Botox injections are one popular option for reducing the appearance of wrinkles on the face, especially those pesky glabellar lines that develop between your eyes.

While Botox (botulinum toxin A) gets a lot of press as a cosmetic treatment, it’s also used to treat headaches and abnormal sweating, among other conditions.

Many people who get Botox also find themselves wanting to start a family. So whether you use Botox for cosmetic or medical reasons, the question is the same: How safe is it to use during pregnancy?

The short answer: We don’t know enough to say it’s safe without a shadow of a doubt. However, here’s what we do know.

Ever wondered what’s being injected into your body when you get Botox?

Botox is the brand name of a product containing a neurotoxin generated by the bacterium Clostridium botulinum. When injected in very tiny amounts, it can temporarily paralyze muscles, causing them to relax. It was originally approved by the Food and Drug Administration (FDA) in the late 1980s as a treatment for lazy eye and uncontrolled blinking.

Later, Botox was approved to smooth away facial wrinkles and creases, as well as treat hyperhidrosis (excessive sweating).

Other products containing this toxin include Dysport, Xeomin, and Myobloc, although not all of them are used for cosmetic purposes.

If you’ve been using Botox for a while, you probably don’t think too much about it anymore, other than to make sure you’ve budgeted for it. Generally, research shows that botulinum toxin injections for erasing those annoying parallel lines between your eyebrows are safe for most people.

However, a positive pregnancy test might make you reconsider. Here’s the challenge: There’s just not a robust body of research about the use of botulinum toxin in pregnant people.

Animal studies provide some optimism for its safety. Researchers who injected botulinum toxin A into pregnant animals didn’t find any evidence that the toxin crossed the placenta, which suggests that it’s likewise unlikely to happen in humans. That said, animals aren’t people.

Furthermore, evidence that Botox may be OK during pregnancy relates to the molecules themselves. Size matters in an unusual way when it comes to this product: There’s some indication that the size of the toxin molecule likely inhibits it from crossing the placental barrier.

Ultimately, however, there’s not much data on the use of the toxin during pregnancy. As one 2017 review of cosmetic procedure safety during pregnancy and breastfeeding notes, no clinical trials have examined the effects of the use of botulinum toxin for cosmetic purposes in pregnant women. Thus, more research is needed.

One potential risk to consider is the spread of the toxin beyond the localized area. If the toxin spreads beyond the original injection site, it can cause botulism, a potentially dangerous condition. According to the FDA, common symptoms of botulism include:

  • muscle weakness
  • blurred vision or double vision
  • hoarseness
  • difficulty forming words
  • trouble breathing
  • trouble swallowing
  • loss of bladder control

These symptoms might develop within a few hours of receiving an injection, but they could take several days or even weeks to develop. If you experience them, be sure to notify your doctor right away.

However, while research is limited, some studies have pointed out that there’s not a lot of evidence linking Botox use with poor pregnancy outcomes.

If you’re like a lot of pregnant people, you’re probably looking ahead to when baby is actually here. If you’re planning to breastfeed, you may be stocking up on supplies. Nursing bras: check. Pump: check. Pumping supplies, bottles, and bottle nipples: check, check, and check.

But if you’re planning to breastfeed and you’re also a Botox aficionado, where do your Botox injections fit into your plans? It’s worthwhile to consider the benefits and risks.

Just as the FDA notes that it’s not yet known if Botox will harm an unborn baby, it’s also unknown whether Botox passes into breast milk. One 2017 study suggested that botulinum toxin A seems to be safe, as there seems to be only a negligible amount of systemic absorption and placental transfer.

Still not sure? That’s understandable. If you’re concerned, you could put Botox injections on hold while you’re breastfeeding until more safety information is available. Nevertheless, talk to your doctor — or your child’s doctor — about the issue and ask for their expert guidance.

If you decide to put your Botox injections on hold while you’re pregnant, you may be wondering when you can resume them again. There’s not a clear-cut answer.

Again, getting Botox injections when breastfeeding doesn’t appear to be risky, but there’s not a lot of research. So while it shouldn’t be harmful during breastfeeding, you might wish to have more robust data to support that claim.

Your safest bet is to wait until after weaning your baby to restart Botox.

Not everyone who uses botulinum toxin A is using it for cosmetic purposes, as there are medical reasons to turn to Botox or similar products.

For example, the FDA has given the green light to Botox as the only treatment for chronic migraine. Doctors also use it to treat a condition called dystonia, which involves repetitive movements that develop from uncontrolled muscle contractions, among other conditions.

If you use Botox for one of those purposes, you and your doctor may want to discuss whether the risks outweigh the benefits, or whether there are any other possible treatments you could try.

If you’re devoted to the way you look when you get Botox injections but don’t want to take any chances while you’re pregnant or breastfeeding, take heart. Although you won’t get the exact same results, there are other products you can try.

How about a peel? Research suggests that glycolic and lactic acid peels are safe during pregnancy, but you may want to steer clear of salicylic acid peels.

A few other possible strategies for minimizing frown lines include drinking plenty of water so your skin stays hydrated, moisturizing your face several times daily, and exfoliating your skin a couple of times per week.

And never discount the effects of a good night’s sleep. If you’re able to do so once baby arrives, hire a babysitter or enlist your partner to take middle-of-the-night duty so you can get some extra sleep.

Botox is generally considered safe for cosmetic and other purposes. But pregnancy might make you hesitate to keep your next appointment.

It may be better to err on the side of caution and delay your next series of Botox injections, but you can always consult your doctor before making the final call.