Bruising is the most common side effect that might happen after having Botox injections and, while it’s not likely to be very bad, it’s still a bit annoying – especially if you might not want to admit to everyone why you suddenly look so rested! So, why does bruising after Botox happen, what can you do to prevent it – and, if you do get a bruise, how should you handle it. We answer all these questions – and more…
How Common is Bruising After Botox?
It’s the most common side effect of Botox, but, despite that, most people actually don’t bruise after Botox injections – or, don’t really notice if they do.
Personally, I’ve never had a Botox bruise from hundreds of different single jabs in my frown (11) lines, forehead, crows feet or cheeks – but I’ve had some big ones from having fillers.
Why Might Botox Cause Bruising?
The needles used to give Botox are very thin but even so, the act of injecting Botox into the skin does cause a little bit of damage.
‘During the procedure, small tiny capillaries under the skin can be punctured which causes blood to pool under the skin leading to a bruise,’ explains Rachel Green, a nursing practitioner specialising in aesthetic medicine at Evolve Medical in Leeds.
And because the skin around the eyes, is particularly thin and the veins closer to the surface, bruises might be a bit more likely.
Is Anyone More Prone?
It can be totally random. ‘You can have lots of Botox injections with the same person and still get a bruise that one time,’ Rachel told us.
However, there are a few things that might affect your risk of bruising.
The more experienced your injector, the less chances of bruising as they will be better and locating any veins before they put the needle in.
Some people just generally bruise more easily than others.
Older skin can bruise more easily, people who are low in iron bruise more easily – and, most importantly, what you did in the days before your treatment might also make you more prone to bruising. Which brings us to …
How to Prevent Bruising After Botox
What you do in the days before your treatment is the number one way you can try and prevent bruising after Botox.
And there’s a bit of a list…
‘Avoid alcohol in the 24 hours before, don’t exercise too close to your appointment and try and be relaxed,’ says Rachel
If you’re now wondering, how close is too close – check out our post on all the rules associated with exercise and Botox here.
It’s also important that you tell your injector if you’re taking any kind of blood thinning medication as blood thinners increase the risk of bruising.
Some over-the-counter supplements and medicine also thin the blood. These include aspirin and ibuprofen, vitamin E, fish oils, ginkgo biloba and turmeric.
While you shouldn’t come off any medication prescribed by your doctor, according to the authors of this paper on how to minimise bruising after injectables, you should avoid using aspirin for things like headache a week before your procedure and keep clear of non-steroidal anti-inflammatories like ibuprofen – and drugs that contain it like Nurofen – for five days before your jabs.
Supplements like high dose vitamin E, garlic, omega 3 or fish oils, St John’s Wort and ginkgo biloba should be avoided for up to two weeks.
Ideally, go to your appointment with clean skin. While your injector will use an antiseptic wipe to clean the area they are going to inject, the more clearly they can see your skin, the more visible any veins underneath it will be – and the easier it’s going to be avoid them.
Love This Neat Trick
Okay, there’s a really interesting idea noted in the medical paper above.
One of the two dermatologists behind the paper mentioned above says to reduce risk of bruising after injectables, he asks patients food-related questions as thinking about food diverts blood to the stomach (and away from the face) – and therefore makes bruising less likely.
I have no idea whether that works, but ‘lie back and dream of cheesecake’ works for me as a command.
And What Not to Do Afterwards
While what you do before your appointment is most important in helping to reduce the risk of a bruise happening in the first place, what you do afterwards can determine if one gets worse.
As a general rule to reduce your risk of bruising, you need to avoid things that increase blood flow to the damaged areas – which means anything that increases circulation and/or widens blood vessels
And that list includes anything that increases your temperature like exercise, saunas, hot tubs, very hot baths or showers, getting your face too hot in sunlight and drinking alcohol.
For a full list of what you should and shouldn’t do after Botox, and how long you need to avoid things for, have a look at our guide to Botox aftercare here.
How Long Will a Botox Bruise Last?
According to Rachel anything between 3-14 days is normal – but there are a few things you might want to try that can speed up how fast things fade.
How to Fade a Botox Bruise Faster
There’s a number of topical creams that can help bruises of all kinds fade faster.
‘Arnica cream, like Arnicare helps speed up how quickly a bruise can disappear, but massaging the area is not advised after injecting so be careful how you apply it – gently dabbing is best,’ says Rachel.
Even then, you should wait at least 6 hours before touching the area – ideally 24.
If you’re worried, the Arnicare Bruise Gel might be a bit easier to apply than the thicker cream.
Another insider secret Huridoid Cream. Cosmetic expert Katherine Russo (who helped us out with our ‘alcohol and botox’ piece, recommends this to any patient she thinks might bruise.
The active ingredient in this is Heparinoid which promotes healing by dissolving small blood clots under the skin – and it’s these clots that lead to bruising,’ she told us.
You’ll find it in pharmacies
Another cream that research suggests may help is Bromelain.
This is an enzyme derived from pineapples and it has anti-inflammatory properties. It works on bruising by reducing inflammation and also breaking down the blood build up that leads to the discolouration of the bruise.
The Bruise MD range combines arnica, bromelain and vitamin K -= another bruise fader in one product.
How to Cover Up a Bruise?
Most bruises after Botox will be tiny but if you need to cover up something a bit bigger or darker, here’s how to do it…
Pick the Right Concealer
You want a thicker concealer than normal.
Dermablend is renowned for being able to cover up even quite dark bruises, and, has been studied after cosmetic procedures and shown to be quite safe.
It’s also what my injector in London used to use when she’d finished too
Just be careful when applying a thick concealer as you shouldn’t rub areas where Botox has been injected too hard, particularly in the first 24 hours, as this might cause the Botox to migrate.
The rule is to dab it on, not rub.
Or Use Colour Correctors
Another good option is to use a colour-corrective concealer.
These neutralise colours in the bruise which mean you can then just apply normal foundation over the top.
Which will work best depends on the colour of the bruise.
Yellow neutralises blue or purple tones on the skin, green neutralises more red shades.
Peach is good if the bruise is fading and more yellow
The NYX Colour Correcting Palette has a square of each so you can play around.
Other Questions You Might Have
Does Botox Leave Marks?
Even if you don’t bruise as part of your Botox treatment you might notice some red marks on the skin where the needle went in, and sometimes some small lumps – both of these are normal and will disappear quickly.
Is Bruising After Botox Bad?
It’s not a sign that your injector is bad (especially if you don’t have other side effects like drooping or uneven brows) nor does it mean there’s anything wrong with the way the Botox was used.
It can just be bad luck or be affected by something like getting too hot before your appointment so your veins were a bit more open than normal.
Do These Tips Also Work for Bruising After Fillers?
Yes – the principle is the same, although as I’ve said, bruising after dermal fillers is far more common than bruising after Botox injections.
The slight difference is that you can be a little bit firmer with your skin after fillers (I mean don’t go mad, but you can at least apply a decent amount of concealer)
There are also some different rules about exercise after fillers though – you need to take a rest for 48 hours, not 24 as with Botox. Have a look at all the rules for working out after fillers here.