What should I do with all those bruises?
Bruises after cosmetic procedures are very annoying, aren’t they?
It is by far the most common complication associated with procedures such as dermal fillers or botox injections. There are many causes leading to bruising with varying severity and healing time. Studies have indicated that the incidence of bruising can occur between 24% to 68% in patients.
What makes us bruise more: Many prescribed medications, such as aspirin, ibuprofen, naproxen, warfarin, non-Vitamin K-dependent oral anticoagulants (e.g., dabigatran, apixaban, and rivaroxaban), heparin, affect blood clotting and will increase the risk of hemorrhage and bruising. If aspirin is being taken for analgesia, it should be avoided for one week prior to the treatment being performed. Similarly, non-steroidal anti-inflammatory (NSAID) medications, (e.g., ibuprofen, naproxen, diclofenac, celecoxib, and meloxicam) should be avoided for a similar period of time. Corticosteroids will also increase the risk of bruising as they increase the fragility of capillaries within the skin.
Herbal and vitamin supplements: Over the counter herbal and vitamin supplements have been known to increase the length of clotting time leading to a greater risk of bruising after procedures. High-dose Vitamin E, gingko biloba, and St. John’s wort, fish oils, omega-3 fatty acids, and garlic supplements can all lead to longer healing times and more bruising after aesthetic procedures. It is recommended to avoid such supplements for at least two weeks prior to surgical procedures.
 Management: To reduce the risk of unsightly bruising, it is recommended to cool your skin prior to injections. Cold compress and local compressions reduce bruising by inducing vasoconstriction. Another effective method is applying vitamin K8, bromelain or arnica to reduce bruising risk and increase the speed of resolution. Bromelain is an enzyme derived from pineapple that can aid the bodies disposal of metabolic wastes and speed the healing process following injury. It is normally taken at a dose of 200mg to 400mg, three times per day. Patients who develop bruising should be advised to stay out of the sun initially to limit the risk of persistent staining. Any extreme physical exertions or exercise can increase blood pressure and really aggravate potential bruises, so this should be avoided for at least 24 hours after your procedure. Patients should also be advised to avoid extended sun and heat exposure. Finally, if unacceptable bruising does develop, camouflage make-up may be applied.
