How to Avoid Bruising After Injectables

The face is a very complicated and complex network of blood vessels, nerves and soft tissues. It is actually quite remarkable how little bruising occurs relative to the number of veins and arteries that supply the face. But, each time a needle penetrates the skin surface, there is a risk of bruising.

Sometimes it is just bad luck when the tip of the needle penetrates an invisible blood vessel and causes bruising. Occasionally, injection techniques carry a higher risk for bruising, but there are always ways to reduce the risk of bruising that often start in the days leading up to your injectable appointment.

Before Your Appointment:

Avoid medications or supplements that have a blood-thinning effect.

Always talk to your doctor before stopping any important medications, but there are common medications and supplements that can thin the blood and increase the risk for bruising after getting an injectable treatment. Common drugs include anti-inflammatories like Advil, Aspirin, Ibuprofen, Motrin and Naproxen. Common supplements that can have a similar blood-thinning effect include vitamin E, fish oils, St. John’s wort, Ginkgo biloba, and other oils high in mega-3 fatty acids.

Try and avoid these medications and supplements for at least a week before your appointment.

Avoid Alcohol.

Alcohol has an effect on your blood vessels we call vasodilation. This means that for a short period of time after drinking alcohol blood vessels will dilate and relax. This increases the risk for bruising after an injectable. Even small amounts (like a glass of wine) can do this. It is best to avoid alcohol for 24hrs before and after your injectable appointment to reduce the risk of bruising.

Try taking Arnica.

Although there are no real scientific studies proving the efficacy of Arnica, I have many patients that swear by this homeopathic remedy. It can be taken in pill form before a procedure and in ointment or gel form after a procedure. It is a completely natural remedy that has been used to treat a variety of conditions. We often give it sublingually to patients in the office who say they bruise easily. It is over the counter and can be found at most drugstores and health food stores. You can also eat lots of fresh pineapple which contains Bromelain, that has been known to decrease bruising.

During Your Appointment:

Ice packs applied during and after the treatment can reduce bruising by having a constricting effect – the opposite of what alcohol does. We always apply an ice pack immediately after lip injections as this is a high-risk area for bruising. We also provide our injectable patients with a sterile ice pack to put in their freezers to reapply once they get home.

There are injection techniques that help reduce the risk of bruising. The use of a blunt tip cannula versus a sharp needle has significantly reduced the incidence of bruising in my practice. I also find injecting slowly reduces bruising as there is no sudden injury to the blood vessels.

After Your Appointment:

It’s best to avoid vigorous exercise for 1-2 days after your appointment as this can increase blood flow to the injected areas and increase or aggravate bruising.

As mentioned earlier avoid alcohol for 24 hours after your appointment and continue icing if necessary.

Fortunately, a bruise is only temporary and will always resolve, however, don’t plan your injectables around any special events where you may not want to have a bruise! I can’t remember how many times a patient has asked me to be careful as they have a special event to attend RIGHT AFTER their injectable appointment!

Bruising vs. Tyndall effect

Both bruising and the Tyndall effect occur when small blood vessels are damaged, but some key distinctions exist between the two. Bruising occurs when the blood vessels are ruptured, causing blood to leak into the surrounding tissue. This can cause pain, swelling, and discoloration of the skin. On the other hand, the Tyndall effect occurs when blood vessels are merely damaged, not ruptured. As a result, there is no leakage of blood, but the area may appear blue or purple due to the scattering of light by the red blood cells. 

Treating Bruising

Even if you follow these recommendations, there is still a chance you may bruise. Research shows that 16%-68% of patients will have bruising after injections. That is quite a high range and can include any one of us. If you bruise easily or bruised after your previous treatment, let your injector know!

One of my favourite injectors, Dr. Arthur Swift, always says “if you bruise ’em you lose ’em.” While this may be true, I think understanding the risks of bruising, knowing that it will resolve completely, and accepting that it is always a risk with any injectable procedure makes this temporary nuisance easier to bear, considering the remarkable results that can be achieved with that little needle.

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