Botox Bruises: How to Prevent and Treat Contusions Caused by Botulinum Toxin Injections

Following a cosmetic procedure, it’s normal to be excited to see your results. It can take over a week for Botox results to show, and as you patiently wait to see the new you, bruising may rear their ugly head to distort the first impressions of your injection. 

Bruises following Botox are fairly rare, however, any time the skin is punctured by a needle, a mark is possible. There are a number of precautions that you can take to prevent bruising, and if bruising does occur there are several DIY and over-the-counter solutions to help treat them. 

What Causes Bruising after Botox? 

A bruise, also known as a contusion, is caused by damage to the capillaries that results in localized internal bleeding. As blood leaks into the surrounding tissue, the hemoglobin in the blood begins to break down and become starved of oxygen. This process leads to the temporary discoloration seen in bruises.  

While bruises are typically caused by blunt trauma that does not pierce the skin, Botox injections can damage small capillaries leading to blood leakage. If this occurs, your injector can help to prevent bruising by placing pressure at the injection site. If your injector fails to apply enough pressure, or minor bleeding goes unnoticed, a bruise will slowly take shape. 

Older patients, particularly women, are more prone to bruising as the skin becomes thinner with age. When injections are performed in certain areas, bruising is also more likely. The softer tissue around the eyes, in particular, leads to a high incidence of bruising during treatments for crow’s feet. If this is the area you are thinking about having injections, be sure to prepare.

Preventing Botox Bruising

It is much more simple and effective to avoid bruises rather than treat them after the fact. There are several products and techniques that can be utilized both in the lead up to injection and during the recovery process to hinder the formation of bruises. 

You can reduce your risk of developing post-injection bruising by avoiding any blood thinning medications or supplements in the two or three weeks leading up to your appointment. These include things like aspirin, ibuprofen, and vitamin E. If you are taking a prescription medication that acts as a blood thinner, be sure to speak with your doctor before altering your dosage.

Alcohol should also be avoided for at least 24 hours prior to injection as it prevents the blood clotting necessary to avoid bleeding and bruising. 

In the days leading up to your injection, you can prepare by using arnica montana. This flower, also known as wolf’s bane and the mountain daisy, has been used in herbal medicine for generations due to its anti-inflammatory properties. While studies of its use have yielded mixed results, some have found that taking arnica montana orally or applying it topically for at least three days prior to injection has helped to reduce the chances of bruising. Continuing to apply arnica montana cream for a week after injection may also reduce your chances of bruising.

Bromelain, an enzyme derived from pineapple, and quercetin, a flavonoid found in some fruits, both have anti-inflammatory properties. Applying creams containing these compounds prior to and following injection can help to minimize the likelihood of bruising.

Vitamin K is a key component in the blood clotting process. Topical vitamin K creams can prevent or minimize blood leakage when capillaries are damaged. Combining bromelain, quercetin, and vitamin K creams can further reduce your risk of bruising. 

After your Botox injection, make sure to follow any post-care instructions that your injector provides. If injections were made in the face, it is important to keep your head propped up when lying down. Keeping your head upright on top of a few pillows helps reduce bruising, swelling, and blood pooling in the area. Allow gravity to help move the blood away from the injection site and aid in the healing process.

Botox Bruising Treatments

Bruising after Botox injections is unlikely, especially when proper steps are taken prior to treatment. If bruising does occur, it typically only lasts for a week or less. However, there are a few treatment options that may speed up this process.

Most of the options available to prevent bruising from occurring can also also be used to speed up bruise fading. In fact, most over the counter bruise treatment creams use arnica montana to help speed up the fading process. 

The root and leaves of the comfrey plant have been used in traditional medicine in Japan for over 2000 years. This plant’s anti-inflammatory properties can also be harnessed in creams and ointments that may help to speed bruise fading. 

Some patients choose to try other over-the-counter creams or gels that claim to help alleviate dark, swollen bruising. Be sure to discuss this with your injector beforehand. They may prefer that you use a specific product or none at all.

Bruise Care

While treating a bruise may speed up its healing process, the majority of post-bruising options work to stop further blood leakage and to prevent bruises from spreading.

Crushed ice or cold compresses can be used to constrict the blood vessels in your face and help prevent any bruising from spreading. Be sure not to apply ice directly to your skin as this can cause burning. Instead, use a soft cloth to help distribute the cooling effect across your skin. This is especially effective during the first few days after your injections. Before you do this, talk to your injector to make sure this is suitable for you.

When possible, avoid rubbing the bruised area as this may encourage it to spread. If the injection was in your arms or legs, wrapping an elastic bandage around the site can create the compression needed to prevent the bruise from spreading.  

Staying away from any strenuous activity is another effective way to minimize and contain bruising. Anything that elevates your blood pressure can cause bruising or make it worse. In a worst-case scenario, overexerting yourself can even cause outright bleeding. You should avoid running, weight lifting, cycling, yoga, sex, and anything other activity that raises your heart rate and blood pressure. You’ll likely only need to avoid these activities for a few days at most.

What to Do If Botox Bruises Don’t Go Away?

It is extremely unlikely that bruises caused by a Botox injection result in permanent bruising. In most cases, bruises will fade within a week, however, some may linger slightly longer. 

The treatments explored in this article may help to speed up your recovery and prevent your bruise from growing larger. If post-Botox bruises don’t disappear as quickly as you would have hoped, normal makeup is often more than enough to hide them until they fade naturally.