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How To Prevent Bruising After Botox

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How To Prevent Bruising After Botox

Botox is one of the most popular minimally invasive cosmetic procedures on the market, with over 7.7 million procedures performed in the United States in 2019. However, Botox isn’t an entirely painless experience: some patients report bruising, swelling, and acute pain after Botox injections.

So how do you prevent bruising after Botox treatments? You can combine home remedies and over the counter medications to help manage swelling. Alternative methods of injecting Botox like using blunt-tipped cannulas may also help.

Why Do Bruises Happen After A Botox Injection?

Botox treatments are usually done via sharp-tip needles. Since Botox needs multiple injections spread over multiple sessions, some bruising after treatment is to be expected. What can make this condition better or worse depends on two things: the skill of the injector and the facial anatomy of the patient.

Sharp-tip needles have maximum penetrating power to help dermatologists inject medication directly underneath the dermal layer. Depending on the number of the injection sites, patients can expect very little to moderate bruising with most procedures.

While Botox itself doesn’t cause any bruises, discoloration, inflammation, and tingling are all very common side it is possible to experience discoloration if it’s applied improperly. Certain conditions like anemia can also increase the likelihood of bruising after Botox treatments.

But one of the most significant factors in bruises after Botox is the injection needle itself. Sharp-tip needles can penetrate straight through blood vessels and arteries, or puncture veins if there are a lot of them in the injection site. In rare cases, excessive bleeding may occur. Multiple injection sites only compound this problem.

Finally, the differing facial anatomies of each patient can make the accurate placement of Botox difficult. While doctors and dermatologists have a rough idea of the different veins, arteries, nerves, and other tissues to avoid when doing Botox injections, sometimes a patient will have a facial structure that doesn’t conform to those guidelines.

These all increase the risk of puncturing a vein, damaging blood vessels, or hitting delicate tissue, which causes bruising after Botox treatments. 

How To Avoid Bruising After Botox

It’s possible to not experience bruising at all after Botox treatments. For patients that experience bruising, there are ways that dermatologists can try to reduce their severity. Two of the best things to do are:


1. Look for a skilled cosmetic surgeon


The level of skill in handling a needle is one of the most crucial factors that determine a successful Botox treatment. Dermatologists and trained aestheticians that can properly administer the injection can reduce the incidences of bruising while still applying the right dose of Botox in the correct places.

A skilled injector will also have a thorough understanding of a patient’s pain tolerance and their tendency for bruising. Even though Botox is considered a non-invasive procedure, there is still the possibility that the patient’s body will react to it poorly. Dermatologists will need to work with the patient to establish how the treatment will be administered and follow up with them after their session if any post-operative care is needed.

Finally, a skilled cosmetic surgeon can also reduce the number of injection sites needed for the entire Botox treatment. With interconnected areas like the brow, areas under the eyes, cheeks, and lips, it’s possible for a skilled injector to navigate their way around the tissue without making multiple entry points. This reduces the amount of overall bruising, swelling, and scarring that the patient will have to recover from.


2. Using alternative medical devices like blunt-tip cannulas


One increasingly popular alternative to the use of sharp-tip needles in Botox injections is blunt-tip cannulas. These needles are flexible, are less likely to puncture veins and blood vessels, and are more suited to navigating deep tissue underneath the dermal layer.

Their most significant feature is their blunt tips, which push rather than pierce through the skin. This allows a skilled dermatologist to navigate their way around major arteries and blood vessels, reducing the chance of puncturing them and leaving bruises. They also prevent damaged tissue and other trauma to your skin.

Another useful by-product of the blunt tips is that dermatologists can also reach delicate areas of the skin from adjacent injection sites, eliminating the need for multiple entry points. It’s possible to make one incision point near the cheek to reach areas like the underside of the eyes or on the side of the nose – areas that are vulnerable to scarring or bruising.

Blunt tip cannulas are also longer and more flexible than sharp-tip needles. This allows for a deeper injection of Botox without the usual pain that happens with penetrating the lower dermis. If you’re getting your Botox injection for the first time, ask your dermatologist if they’re skilled with blunt-tip cannulas.

Bruises from Botox treatments will generally fade within a week. If you experience prolonged bruising or other side effects not associated with other injections, call your doctor immediately.

What Can I Do To Make Botox Bruises Fade Faster?

Treatment of any bruises that remain after Botox is like how you would treat any bruise on your body, with some special considerations depending on the area.


1. Ice


Any discomfort, pain, or swelling on the injection site can be eased with a cold compress or some ice wrapped in a towel. Avoid applying any pressure or moving the ice around the area and only hold it there for 20 minutes at a time. Avoid direct application of ice to the treated area.

You can also supplement this treatment with heat packs similar to hot and cold therapy, but make sure to get your doctor’s approval.


2. Elevate the head to avoid blood rush


Your dermatologist will most likely recommend that you keep your head up for two to three hours after your treatment and avoid bending or lying down. Any rigorous movement can aggravate the bruises that you already have and may develop into bigger marks if you aren’t careful.


3. Avoid certain medications and vitamin supplements


NSAIDs (non-steroidal anti-inflammatory drugs) like Ibuprofen limit your blood’s ability to clot, which can cause you to bruise more easily. Anticoagulants and certain antibiotics also react poorly to Botox injections. If you are taking any medications (like aspirin) for an ongoing condition, inform your doctor immediately.

This also applies to vitamin supplements. While you can take supplements to offset the immediate short-term effects of injections like Botox, you should consult your doctor or nutritionist about how specific vitamins may affect your treatment or recovery. Specific vitamin supplements may be allowed depending on your general health at the time of your treatment.

Any other concerns you may have about post-operative bruising and recovery can be discussed with your doctor. If any severe side effects occur or your bruising lasts longer than a week, call your doctor immediately.


4. Adjust your diet


Reducing alcohol intake is a significant factor in managing bruises, primarily due to the liver’s job of blood cell management. Alcohol can tax the liver, which cuts down on its ability to help your body heal from bruises.

Fish oil (and Omega-3 fatty acid) is another dietary culprit behind bruising: while it’s a healthy addition to your diet, it also causes blood to slow down clotting. Avoiding fish oil for a few days after your Botox treatment should help your bruises heal faster.

You should also avoid:

  • Ginkgo Biloba
  • Ginseng
  • St. John’s Wort
  • Green tea
  • Garlic

For other food considerations after Botox, it’s best to call your doctor.


5. Look for anti-bruising creams like Arnica


Natural remedies like Arnica montana extract can help manage bruising. Always consult with your dermatologist or doctor about using Arnica creams, as while they’ve been shown to reduce bruising, they’re also poisonous if not prepared properly. If possible, get your Arnica product from a trusted brand.

One good way to make sure that your Arnica cream is legitimate is to check how its concentration. Studies have shown that arnica-based products that have less than 10% active Arnica don’t help with bruising at all.

Botox Injections And Post-Treatment Therapy At Anand Medical Spa

Botox treatments will not always leave any bruising. While it’s largely up to dermatologists to set expectations and administer Botox in such a way that avoids bruises and scars, the patient’s compliance with aftercare is crucial to managing any bruises that appear.

At the Anand Medical Spa, we have extensive experience with Botox treatments and aftercare. For more information on how to make your next Botox injections easier to recover from, schedule an appointment with us today. 

Read more: What Happens When Botox Wears Off

About the Author:

Dr. Sunanda Chugh is the Founder and Medical Director of Anand Medical Spa and has been practicing in NYC since 2004. She is a graduate of Cornell University and has completed her training at St. Luke's Roosevelt Hospital/Columbia Presbyterian Hospital. Dr. Chugh has worked and trained with top Plastic Surgeons and Dermatologists in NYC. Her special interest on the effect of the aging process on the face and body inspired her to specialize in Aesthetic Medicine.

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