{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:31:54Z","timestamp":1787567514049,"version":"build-2736575974"},"reference-count":55,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Cosmetic dermatologic products and procedures are increasingly utilized by women of reproductive age, including those who are pregnant or lactating. Pregnancy and lactation are associated with hormonal, vascular, and immunologic changes that may alter skin biology, cutaneous absorption, and susceptibility to adverse effects. Despite growing demand, clinicians frequently face uncertainty when counseling patients regarding cosmetic interventions, as high\u2010quality safety data and formal guidelines remain limited. This review summarizes the available evidence and practical counseling considerations for commonly used topical agents, chemical peels, injectable neuromodulators and fillers, lasers and light\u2010based therapies, and energy\u2010based devices, while proposing a practical counseling framework that distinguishes recommendations between pregnancy and lactation. This distinction is critical, as these states are often conflated despite differing pharmacokinetic profiles and safety considerations. Unlike a systematic review, this narrative review qualitatively synthesizes the available literature while emphasizing clinically applicable counseling. The published literature largely consists of observational studies, case reports, and extrapolation from nonpregnant populations, reflecting the ethical and practical limitations of conducting controlled trials in these populations. Overall, pregnancy and lactation should not be approached as equivalent counseling states. During pregnancy, elective cosmetic interventions are deferred, and pregnancy\u2010related physiologic changes may alter both treatment risk and cosmetic outcome. During lactation, many interventions may be considered following individualized risk assessment when systemic exposure is expected to be minimal, and treatment sites avoid direct infant contact. Counseling should emphasize conservative management, transparent discussion of uncertainty, and shared decision\u2010making tailored to the patient's reproductive status and treatment goals.<\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/ijd70620-gra-0001-m.png\">\n                        <jats:alt-text>image<\/jats:alt-text>\n                      <\/jats:graphic>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1111\/ijd.70620","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:20:38Z","timestamp":1787563238000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cosmetic Dermatology in Pregnancy and Lactation: A Risk\u2013Benefit Framework for Clinical Practice"],"prefix":"10.1111","author":[{"given":"Timea","family":"Kovacs","sequence":"first","affiliation":[{"name":"Department of Dermatology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2140-9302","authenticated-orcid":false,"given":"Umer","family":"Nadir","sequence":"additional","affiliation":[{"name":"Division of Dermatology Baylor University Medical Center  Dallas Texas USA"},{"name":"Epiphany Dermatology  Dallas Texas USA"},{"name":"Texas A&amp;M School of Medicine  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3428-3566","authenticated-orcid":false,"given":"Michael","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Rohrer","sequence":"additional","affiliation":[{"name":"SkinCare Physicians  Chestnut Hill Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Hooper","sequence":"additional","affiliation":[{"name":"Audubon Dermatology  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0442-2836","authenticated-orcid":false,"given":"George M.","family":"Jeha","sequence":"additional","affiliation":[{"name":"Division of Dermatology Baylor University Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0725-1649","authenticated-orcid":false,"given":"Stanislav N.","family":"Tolkachjov","sequence":"additional","affiliation":[{"name":"Division of Dermatology Baylor University Medical Center  Dallas Texas USA"},{"name":"Epiphany Dermatology  Dallas Texas USA"},{"name":"Texas A&amp;M School of Medicine  Dallas Texas USA"},{"name":"Department of Dermatology University of Texas at Southwestern  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"American Society for Dermatologic Surgery Consumer Survey on Cosmetic Dermatologic Procedures 2025accessed at March 1 2026 https:\/\/publications.asds.net\/2025\u2010Consumer\u2010Survey?sharedOn=."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.70132"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dsu.12322"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/JCAS.JCAS_226_20"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijwd.2017.09.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.16105"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190\u20109622(84)80305\u20109"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijwd.2017.01.005"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijwd.2018.10.003"},{"issue":"6","key":"e_1_2_10_11_1","first-page":"665","article-title":"Safety of Skin Care Products During Pregnancy","volume":"57","author":"Bozzo P.","year":"2011","journal-title":"Canadian Family Physician"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.114595"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2005.10.007"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.64550\/joid.97jp5737"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004072.pub3"},{"issue":"2","key":"e_1_2_10_16_1","first-page":"49","article-title":"Skin Changes and Safety Profile of Topical Products During Pregnancy","volume":"15","author":"Putra I. 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