Aesthetic procedures during pregnancy can have undesirable consequences due to temporary but significant physiological changes in the female body during this period, as well as the exchange of blood and nutrients (or toxins) between mother and fetus. Due to the risks and ethical considerations, drugs are rarely tested on pregnant women, which means that data on the safety of using drugs during pregnancy is almost non-existent. But scientists and leading doctors are trying to study this issue as deeply as possible in order to guarantee the safety of the procedures for both the woman and the fetus. In the article on estet-portal.com read about the results of the latest research in this direction.
Aesthetic procedures and pregnancy: common risks
Any procedure that is accompanied by injury to the skin entails a high risk of developing an infectious process. It, in turn, can lead to complications in the mother and fetus, such as: chorioamnionitis, sepsis, malformations and prematurity, intrauterine fetal pathologies. Therefore, in order to prevent infection, the doctor must be as careful as possible, paying special attention to the sterility of instruments and proper preparation of the skin.
Iodine and hexachlorophene are contraindicated during pregnancy due to toxicity to the thyroid gland and, accordingly, the central nervous system. Therefore, alcohol or chlorhexidine solutions should be used for disinfection before the procedure.
Along with the increased risk of infection, it is also important that infections during pregnancy are difficult to treat, since most common antibiotics are FDA categories B or C (prior to 2015).
Another significant risk that aesthetic procedures entail – this is bleeding, as pregnant women are particularly prone to anemia. However, pregnancy itself is a hypercoagulable state, so the risk of significant bleeding is reduced.
Wound care does not pose a significant threat to the health of the patient, but can provoke many problems associated with aesthetic procedures .
Due to hormonal changes and tension factors, pregnancy can trigger the development of hypertrophic and keloid scars. It also increases the risk of hyperpigmentation. Considering these factors, the decision to undergo aesthetic procedures can be ill-advised, since there is a rather high risk of deterioration in aesthetic results in the long term due to changes in the scar healing process.
The subtleties of using dermal fillers during pregnancy
There are many fillers on the market, the most common being collagen, hyaluronic acid, hydroxylapatite and poly-L-lactic acid. To the best of our knowledge, there are no published studies on the safety of fillers during pregnancy. But it should be taken into account that the most frequent complications of the use of dermal fillers – hypersensitivity reactions and infectious inflammation.
Theoretically, fillers should not harm pregnant patient and fetus due to the limited range of exposure. Also, large polymers are unlikely to be able to diffuse through tissue/vessels and enter the systemic circulation.
However, the lack of safety evidence and manufacturer recommendations suggest that fillers should be used with caution during pregnancy. And this means that the procedure during pregnancy should be postponed.
Another factor to consider when administering fillers to a pregnant woman is – this is a longer scar healing process, susceptibility to hyperpigmentation and the need to use lidocaine for the procedure (which will be discussed in more detail in the second part of the article).
Chemical peels: taking into account the depth and composition
Chemical peels are rapidly gaining popularity. Today, estheticians use them for a variety of purposes, including the treatment of melasma. However, some experts studying the effectiveness of the use of peels in the treatment of melasma have excluded pregnant women from studies.
2% lactic acid is known to be used to treat gestational acne without any adverse effect on the fetus and has a low skin penetration rate. This means that systemic effects are likely to be negligible.
Salicylic acid is classified as a Pregnancy Category C drug under the aforementioned classification, so the FDA states that its use during pregnancy is acceptable if the potential benefits justify the potential risks to the fetus.
Lactic acid is also used in combination with salicylic acid and resorcinol in a combination known as a Jessner peel. This is a medium-depth peel, which means it penetrates deep enough into the skin, so the safety of its use during pregnancy — a very controversial issue, especially because of the content of salicylic acid (a category C drug). Although its penetration through the skin is 25%, it will probably still lead to a negligible systemic concentration.
Studies on the effects of salicylic acid during pregnancy are limited, both on their own and as part of a Jessner peel . However, there have been a large number of large-scale studies evaluating the safety of low-dose oral acetylsalicylic acid (aspirin) during pregnancy. This drug is commonly used as a prophylactic in women at high risk of developing hypertension and preeclampsia.
A study that analyzed data from over 12,000 women showed no increase in baseline adverse events such as preterm birth, major malformations, or low fetal weight.
These peels are unlikely to cause adverse outcomes when used during pregnancy as absorption after topical application will result in even lower systemic concentrations.
However, experts still recommend its use during pregnancy with caution, with a small area of application and no occlusion.
Another popular active ingredient in chemical peels — glycolic acid. It is also widely used to treat acne. A study in rats showed the development of adverse reproductive effects. However, it is worth noting that the doses were significantly higher than those required by aesthetic procedures. In turn, studies of the effect of this substance on the fetus in pregnant women have not been conducted, so glycolic acid can be considered a category C product. In fact, this acid is with minimal skin invasion. Accordingly, it should be safe for use during pregnancy.
Continuation of the article estet-portal.com read here. Article based on Aesthetics.
Read also: Current caesarean section techniques
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