What to stop before injectable treatments

Medications and Supplements: What to Pause Before Injectables

Many commonly used medications and supplements can increase the risk of bruising or bleeding after injectable cosmetic treatments, such as fillers or botulinum toxin. Anticoagulants (blood thinners) like warfarin or aspirin, as well as non-steroidal anti-inflammatory drugs (NSAIDs) including ibuprofen, can contribute to this risk. Over-the-counter supplements such as fish oil, vitamin E, garlic, ginkgo biloba, and St John’s wort may also have mild blood-thinning effects.

It is important never to stop a prescribed medication without discussing it first with your GP or prescribing clinician. Pausing non-prescription supplements is generally considered safe for most people, but always confirm with your practitioner. The standard recommendation for many supplements is to stop them at least seven days before your appointment, unless otherwise directed.

Decision rule: If a product is prescribed, consult your doctor. For over-the-counter supplements, a 7-day pause is typical, but confirm with your practitioner.

Alcohol, Smoking and Caffeine: Lifestyle Factors to Adjust

Lifestyle habits can impact both the outcome and recovery from injectable treatments. Alcohol can increase the likelihood of bruising and swelling, while smoking may impair wound healing and skin health. High caffeine intake can contribute to dehydration, potentially affecting skin appearance post-treatment.

• Alcohol: It is generally advised to avoid alcohol for at least 24 to 48 hours before and after your appointment. Alcohol acts as a vasodilator, increasing blood flow and the risk of bruising.
• Smoking: Quitting or reducing smoking in the weeks before treatment may support skin healing. Even a short period of abstinence can be beneficial.
• Caffeine: While not as critical, limiting caffeine on the day of treatment may help some people avoid jitteriness or increased sensitivity during the procedure.

Decision rule: Avoid alcohol for 24-48 hours before and after injectables. Reduce or pause smoking where possible. Limit caffeine on the day of treatment.

Timing: How Far in Advance to Stop Products or Habits

The timing for stopping medications or supplements varies:

• Anticoagulants and prescribed drugs: Only stop under medical advice. Timing is individual.
• NSAIDs: Generally pause for 3-7 days, if approved by your healthcare provider.
• Supplements and herbal remedies: Seven days is a common guideline for most products with blood-thinning effects.
• Alcohol: Avoid for at least 24-48 hours before your appointment.
• Smoking: The longer the pause, the better for skin recovery, but even a few days can be helpful.
• Caffeine: Consider reducing only on the day of your treatment.

Decision rule: If in doubt, pause supplements seven days before and check with your practitioner about any medicines. Lifestyle habits like alcohol are best avoided 24-48 hours before and after.

Skin Care Products: Actives and Treatments to Pause

Some topical skin care products, especially those containing strong active ingredients, can increase skin sensitivity or the risk of irritation around the time of injectables. Retinoids (retinol, tretinoin), alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs) and exfoliating products are common examples. It is generally advised to stop these products for two to five days before and after your treatment.

• Retinoids: Pause for at least 48 hours before and after injectables.
• Exfoliating acids (AHA/BHA): Pause for 2-5 days before and after.
• Microdermabrasion or peels: Avoid scheduling within a week either side of injectables unless advised by your practitioner.

Decision rule: If a topical product causes peeling or tingling, pause it for two days before and after injectables unless your practitioner says otherwise.

Allergies, Illness and Immunisations: When to Postpone

If you are experiencing an active infection, illness, or allergic reaction, it is usually recommended to postpone injectable cosmetic treatments. Similarly, recent immunisations (such as the flu or COVID-19 vaccine) may prompt practitioners to suggest a short delay, often one to two weeks, to allow the immune system to settle.

• Allergic reactions: Wait until fully resolved.
• Fever, cold or infection: Postpone until fully recovered.
• Recent immunisations: Many practitioners suggest a gap of at least 7-14 days.

Decision rule: If you are unwell or have had a recent vaccine, inform your practitioner. Delay treatment until you feel fully recovered or as advised.

The Six Week Clock: Timing Your Preparation and Recovery

The Six Week Clock is a practical tool for timing your preparation and recovery around injectable cosmetic treatments. It highlights four key checkpoints:

1. 24 hours: Immediate reactions (swelling, bruising, redness)
2. 72 hours: Early signs of complications (persistent pain, unusual swelling)
3. Week two: Assessment of results and healing progress
4. Week six: Full recovery and final result review

Three signs to contact your practitioner today: severe or increasing pain, rapidly spreading redness, or visual changes. This framework helps patients know what to expect and when to seek advice.

A preparation checklist, by timing

Everything below restates the guidance in this article in the order the clock runs, so it can be read in one pass or taken into an appointment. It is a summary of general guidance, not advice about your own medicines: a prescribed medicine is only ever paused on the word of your GP or prescribing clinician.

• Two weeks before: after a recent immunisation, expect many practitioners to suggest a gap of at least 7 to 14 days. Reduce or pause smoking if you can, because the longer the pause the better for skin healing.
• Seven days before: pause non-prescription supplements and herbal remedies with mild blood thinning effects. Confirm with your practitioner, and never stop a prescribed medicine on your own.
• Seven to three days before: ask your healthcare provider whether to pause NSAIDs such as ibuprofen, and keep microdermabrasion and peels outside a week either side of the appointment unless your practitioner advises otherwise.
• Five to two days before: stop exfoliating acids, and pause retinoids for at least 48 hours.
• 48 to 24 hours before: avoid alcohol, and keep avoiding it for the same period afterwards.
• On the day: limit caffeine, and tell your practitioner if you are unwell, feverish, fighting an infection or in the middle of an allergic reaction. Each of those is a reason to postpone rather than proceed.
• Afterwards: the same pauses on alcohol, retinoids and acids apply on the way back out, and the four checkpoints in the Six Week Clock above are when to review how it is healing.

None of this is useful until the treatment itself is the right one, which is decided in the appointment rather than in advance: assessing a named treatment in consultation covers what to ask and how to judge the answers, aftercare in the first six weeks covers what to restart and when, and recognising a complication covers the signs that mean act now.

Limits: Who This Guidance Does Not Apply To

This information is intended for adults considering elective injectable cosmetic treatments. It does not apply to individuals with complex medical conditions, those who are pregnant or breastfeeding, or anyone under 18. For prescribed medications, always seek advice from your GP or consultant before making any changes. This guide does not cover surgical procedures or non-injectable treatments.