# The Risk of Using Cosmetics and Cosmetic Procedures During Pregnancy
## 4 The Risks of Cosmetics and Cosmetic Procedures
### Aesthetics and Biomedical Technology  
Endermology was developed in France by [PERSON] in the 1970s after he sustained soft tissue injuries in a car accident. The resulting scars were treated using hand massage, which inspired [PERSON] to develop a device that mimics this technique. The device was initially used for scars caused by trauma and burns. However, researchers observed that it also improved the appearance of cellulite and the distribution of fat. The most recent versions of this device are the Integral and Endermolab (LPG Systems). The mechanism of action involves negative pressure suction combined with a roller that passes over areas with fat deposits [31]. Medical LPG is also suitable for pregnant women, providing relief to the legs from swelling caused by increased weight. Additionally, it can alleviate lower back pain by facilitating lymphatic system mobility. The treatment is painless and non-invasive, and for pregnant women, it is conducted with great care, with the patient lying on their side rather than on the abdomen [32]. Massage is the oldest method of pain management and is integral to many facial and body aesthetic treatments. It involves a variety of techniques with numerous benefits at the organic level. Massage requires special attention during pregnancy, and the therapist must be knowledgeable about the anatomy and physiology of the female body. Stimulating massage is contraindicated during this sensitive period as it can cause contractions and potentially lead to premature birth [31]. The massage should be gentle and is not recommended if there are pregnancy complications. The primary goal is to relax and relieve the muscles bearing the extra weight, improve blood and lymph circulation, and reduce stress. It also helps alleviate fatigue, muscle cramps, headaches, back pain, and leg swelling [33]. Studies conducted over the past decade on pregnant women have shown a significant reduction in stress hormones such as cortisol, while dopamine and serotonin levels increased in women who received massage twice a week for five consecutive weeks. Low levels of dopamine and serotonin are associated with depression, so these hormonal changes can contribute to a reduction in pregnancy and childbirth complications. During the first trimester, when fetal organ formation occurs and the risk of miscarriage is high, it is recommended to avoid massage to prevent any association between massage and potential pregnancy failure. Almond oil is considered an ideal product for massage application, as strong-smelling oils may cause discomfort and nausea [31]. Radiofrequency (RF) applications have been used since 2002 to improve cellulite, skin laxity, and wrinkles, and more recently to reduce fat. The mechanism of action is based on volumetric heating of the skin and subcutaneous tissues. Unipolar RF devices can reduce fat circumference in about 60-80% of individuals. However, there are no studies examining the use of RF during pregnancy [34; 35]. During pregnancy and breastfeeding, laser hair removal, intense pulse light (IPL), or electrolysis is generally not recommended due to a lack of data and clinical studies on their safety and efficacy. There is a theoretical concern about electrolysis, as amniotic fluid is a conductor of galvanic current. For hair removal during pregnancy, shaving and depilatory creams are recommended. The use of lasers for aesthetic treatments has not been studied in pregnant women [36]. Repeated and prolonged exposure to ultraviolet radiation (UVA, UVB, and UVC) increases the risk of skin cancer due to DNA damage and impaired repair mechanisms. While the lamps used in IPL hair removal devices are capable of emitting UV radiation, these devices are designed to include cut-off filters that allow only wavelengths above 400 nm to pass through, preventing UV exposure. However, if these filters become damaged, UV emission could occur. The potential effects of IPL devices, based on their operating principles, have not been conclusively reported in recent studies.