Bruises are a sometimes unavoidable result of popular aesthetic treatments. From muscle relaxing toxins and polynucleotides to dermal filler, puncturing the skin with a needle or cannula during a non-invasive procedure can leave behind small, temporary marks, no matter how skilled your practitioner.

When we have a vaccination or blood test, any telltale marks are easily covered by clothing—bruises that pop up on the face however, are going to be more visible for their duration. Thankfully, our Experts are armed with tips and tricks that can be used in advance to keep them to a minimum, as well as afterwards to treat and speed up healing.

Bruising 101

It may sound pretty basic, but knowing how a bruise is actually caused can be the first step towards helping prep for potentially developing one. “A bruise occurs when blood vessels (capillaries) under the skin are disrupted, allowing a small amount of blood to leak into the surrounding tissue,” explains Dr Nestor Demosthenous, EV Expert, award-winning Aesthetic Doctor and Founder, The Mayfield Clinic.

 “Bruising can happen if a needle or cannula passes close to or through one of these vessels. Even with meticulous technique and advanced knowledge of facial anatomy, the skin is richly supplied with vessels, so the occasional bruise is inevitable.”

To put ‘occasional’ into context, when Dr Nestor audited 200 of his patients, 40 per cent of those who received filler saw a bruise afterwards, with less than one per cent bruised from neuromodulators such as botulinum toxin. Half said that the bruise had disappeared in just three days, the others seven.

Are some of us more susceptible?

Many people think they bruise easily—I know I certainly do. But there are actually facts behind the perception. “Some individuals are naturally more prone to bruising,” says Dr Nestor. “Factors include age, as skin becomes thinner and vessels more fragile; medications or supplements that affect clotting like aspirin, ibuprofen and fish oils; and genetic tendencies.”  

Julie Scott, EV Expert, Nurse Practitioner and Clinical Director at Facial Aesthetics, agrees. “Even with the gentlest technique, injectables can occasionally nick a capillary and some people are naturally more prone to bruising than others,” she adds.

“Hormonal changes can also play a role. I often notice patients bruise slightly more easily around their period or during menopause, when skin and blood vessels can be more delicate.” And while skin tone and ethnicity don’t significantly alter the likelihood of bruising, Dr Nestor notes that, “bruises may appear more visible on lighter skin and harder to notice on darker skin tones.”

Do some treatments cause more bruising than others? 

The short answer is yes. More specifically, exactly where on the face is being injected plays a huge part. “Certain areas, like the lips and around the eyes, bruise more easily because the skin is thinner or more fragile,” says Scott, while Dr Nestor adds that areas with fewer blood vessels, such as the upper face, are less likely to bruise. The finer needles used to inject neuromodulators also make the treatment less bruise-prone.

Perhaps surprisingly, given that they are wider, cannulas can also result in fewer bruises. “Fillers placed deeper in the face or performed with a cannula instead of a needle are generally less likely to cause bruising, as bigger vessels are more likely to be 'pushed out the way' by the blunt cannula,” explains Dr Nestor. “However those placed more superficially can disrupt the smaller vessels more readily, hence the bruising.” Added to this is the thinking that even if vessels are nicked deeper down, they are less likely to be visible than the equivalent happening near the surface.

EV Experts’ anti-bruise strategy 

Before your treatment...

“There’s a lot you can do to reduce the risk beforehand. I usually suggest pausing anything that thins the blood for a few days before treatment, if it’s medically safe for you to do so. This includes things like fish oil, vitamin E, aspirin, or anti-inflammatories such as ibuprofen.”
Dr Sandra Gamper, Medical Director, Miriderma Skin Health Clinic, Bournemouth
 
“Patients ask about this a lot and honestly, much of what you see online about avoiding bruises is over the top. I advise them to come in well hydrated and think about skipping the gym, sauna and alcohol the day before. Turning up dehydrated or hungover is the quickest way to guarantee a bruise.”
Jen Vittanuova, Clinical Nurse Director, Jen Vittanuova Medical Aesthetics Clinics, Huddersfield 

“Consider taking arnica tablets the day before and after, which may help reduce bruising for some people. There is some evidence to suggest it helps.”
Dr Nestor Demosthenous

And afterwards…

“Recent studies, including my own observational study on INsupport by Skinade, suggest that targeted nutritional supplementation can support post-procedure recovery. In my study, patients experienced faster healing and less visible bruising.”
Julie Scott

“To support healing, keep the area clean and avoid touching your face or applying makeup for at least 24 hours. Skip anything that heats the skin, such as saunas, steam rooms, or intense workouts, for the first 24 to 48 hours. Arnica or vitamin K creams are great options to help bruises fade faster, and I tell clients to plan treatments at least four weeks before a big event. That way, any small bruises or swelling has time to completely settle and your results can shine through beautifully.”
Dr Sandra Gamper

“Keep things calm. An ice pack/cool compress (think clean, wet flannel) for ten minutes at a time can help with swelling, and arnica gel or tablets can help with healing if you want to use them. I also tell people to keep it simple. Drink some water, stick to gentle skincare and let your body do its thing. If a bruise does show up, don’t panic, it’s a completely normal and temporary reaction by your body. Once the skin has settled, such as the next day, a light mineral makeup is okay to cover any marks—it’s breathable and kinder to the skin than heavy foundation.”
Jen Vittanuova