Cosmetic injectable treatments, such as wrinkle reducers and dermal fillers, can work wonders in filling out lines and wrinkles, but they can cause temporary bruising and swelling. Many patients ask us how to prevent bruising and the good news is that there is a lot you can do before and after your appointment to minimize any unsightly coloring– and in some cases prevent it all together.

No injector can guarantee that you will not bruise from injectable treatments, but to avoid having any serious side effects it is always best to go to the most expert injector in your area. Also, to be on the safe side, please don’t plan any special events for at least 2 weeks after your injectable appointment. Remember, treatments can take anywhere from 1 to 2 weeks for results to fully settle in, so unless something is really off, most minor problems will resolve in that time by just being patient.

If you are just having a wrinkle reducer treatment (Botox, Dysport, or Xeomin) these suggestions are still good to follow even though bruising is uncommon. However, dermal fillers like Juvederm, Restylane, Radiesse, and Sculptra are slightly more invasive and following these instructions will help to prevent bruises or reduce the appearance, quicker.

Here are a few pre and post treatment tips that can help you avoid any unnecessary bruising:

#1 Avoid Aspirin & NSAIDS
Aspirin, NSAIDS (Motrin, Ibuprofen, Naproxen, Aleve, Advil), and NSAID-containing products (Midol, Excedrin, cold medicine) are the most potent of the “bruisers”. All of these medications stun your platelets, which are the cells in your bloodstream that stop bleeding and bruising when your blood vessels and capillaries are damaged. If your platelets can’t do their job in sealing off the tiny capillaries that are disrupted during injectable treatments, your likelihood of getting a bruise is much higher than normal. Avoid all of these medications for at least a week prior to your treatment. If you need pain medication, please consider Tylenol as a substitute.

#2 Avoid Wine & Alcohol
Wine and alcohol also have some anti-platelet effects and increase your chances of bruising in the same way that Aspirin and NSAIDS do. We hate to ruin any fun plans, but avoiding alcohol the night before and the night you have your injectable treatment really helps to prevent bruising.

#3 Avoid Green Tea, Vitamin E, and Herbal Supplements
High doses of Green Tea, Vitamin E, Fish Oil, Gingseng, Omega 3 Fatty Acids, Ginko Bilboa, Flaxseed Oil, and herbal supplements like St. John’s Wart, Garlic, Red Yeast Extract and many others, act like mild versions of prescription blood thinners and definitely increase your chances of bruising. In particular, Green Tea Extract is known to be one of the most potent “bruisers” on the market, so make sure you curb it well before any injectable treatment. Because there are so many herbal supplements that have unpredictable effects on bleeding and bruising, we recommend stopping ALL supplements at least one week before your treatment.

#4 Skip the Gym
No exercise except for walking for 24-48 hours after your treatment. Keep your heart rate under 100. Do not do any inversions in yoga or do hot yoga. Damaged capillaries need two things to repair themselves after an injection; functional platelets and minimal blood flow. Exercise and physical activity increases your heart rate, blood pressure, and the flow of blood through arteries, veins and capillaries, including the ones that get damaged during injectable treatments. Also, avoid squeezing or massaging the treated areas for several hours after treatment as this could subtly change the results. If you were treated with the injectable Sculptra, please disregard this note and massage as you were instructed.

#5 Choose a Qualified Injector
This seems like a no-brainer, but be careful. There are no enforceable regulations on who is allowed to inject wrinkle reducers and dermal fillers, so there are tons of unqualified injectors out there. Be particularly cautious about getting injected in clinics offering extremely low prices because they tend to rely heavily on counterfeit products.

#6 Icing
Apply a cold pack to the treatment area before and after your injection. Cold applied to the skin constricts blood vessels and constricted blood vessels are smaller and less likely to get in the way of the needle. An added bonus, the cold will desensitize the area so you will feel less pain.

#7 Numbing Cream
If your injector applies numbing cream about 20-30 minutes before starting the injections, it will help prevent bruising and make you more comfortable during the treatment. Some anesthetic creams constricts blood vessels slightly making bruising less likely. When you make your appointment, ask if you should come in early if you want to get numbing cream.

#8 Anti-Bruising Supplements
You can try taking two supplements that have been shown to prevent bruising; Arnica and Bromelain. Take Arnica pills 4 days before and after the procedure to aid in potential bruise reduction. Arnica is an herbal dietary supplement that has been used for centuries to reduce bleeding and inflammation. Place four pills underneath your tongue, twice a day. If you do bruise, you can take it each day until bruising has subsided. Bromelain is helpful in reducing any swelling after the procedure and may be taken three days prior to your treatment and continue for one week after. Bromelain is a pineapple-based enzyme that also helps to reduce inflammation and bruising.

Arnica and Bromelain are both available in our clinic for purchase, and there is enough in the bottle for several treatments. If you have ever had a cold sore around the mouth or near the injection site be sure to talk to your practitioner before treatment, so that they can properly prescribe you Valtrex or another anti-viral medication to prevent an outbreak.

#9 Sun Protection
No excessive sun or heat until any initial swelling and redness have resolved. Proper and frequent use of sunscreen is always important. The sunscreen should offer broadband protection (UVA and UVB) and have a sun protection factor of SPF 30 or more. Wear a hat when outdoors. I have created a list of some of my favorite sunscreens to help you find a good quality product.

#10 Plan accordingly
Another important part of getting injections is timing. Try to make your appointments at least two weeks prior to a big event just in case you have swelling or bruising. You should also make sure they are within your budget when you do get the treatment. There are times you might need more areas treated and sometimes less, depending on how your body responds. Injectables work differently on everyone, so you may not get the same results in terms of how long the treatments last as your friend.

What happens if you bruise?
If you do bruise, there is help. First of all, continue icing the bruised areas once you get home as long as you can. Next, take your Arnica and Bromelain as directed. A high-level concealer will also come in handy to hide those temporary bruises. If the bruise is on your lip, then lipstick should do the trick. The intensity and duration of your filler or Botox side effects will depend on the treatment aggressiveness and your individual healing characteristics, but normally can last for one to two weeks after the treatment.

Understand where you want the injections.
Finally, now that you have taken the plunge on facial injections, be careful not to get carried away. Some people go overboard with wrinkle reducers and dermal fillers and develop an artificial look to their face. A good injector will actually tell you they will not do the treatment on you at a certain point. If you feel like your face looks “done,” then you have done too much. You should look like a refreshed version of yourself!