The potential impact of dermatological and health conditions on facial aesthetic treatments can be profound, in some cases having either a positive or negative effect. There are numerous contraindications and cautions to treatments such as botulinum toxin and hyaluronic acid fillers. In the case of providing a hyaluronic acid filler treatment to enhance a patient’s lip volume that has a history of cold sores, the patient needs to be aware that there may be psychological benefit and improved well-being from the enhanced lip appearance, however there may be a very rare but increased risk of causing a cold sore. Although cold sores do typically resolve in 10 days this may induce some transient pain and discomfort as well as an unpleasant appearance for the duration of the cold sore. Similarly, someone on blood thinning medication may benefit from the positive physical and mental effects of having dermal fillers, however they may suffer from significant facial bruising from the treatment.
In the case of somebody that has suffered Bell’s palsy in the past delivering botulinum toxin injections into the hypertonic muscles of the face may provide a transient improvement in facial symmetry and appearance. This can lead to a significant increase in confidence, well-being and sense of self-worth. Although the effects are short lived (approximately 3 months) repeated treatments can maintain this effect. There is no evidence to show that repeated botulinum toxin treatment overtime has any effects on general health although this is largely due to the limited research that is available on long-term follow-up or after toxin injection (Crook et al 2022).
Many aesthetics treatments are performed on young females. It has been suggested that all females in this age group who are requesting a treatment or who are being prescribed a medication should be considered to be pregnant unless proven otherwise. Careful questioning should be carried out prior to administering any prescription medication including botulinum toxin. There is no evidence that botulinum toxin is teratogenic, however as botulinum toxin may be found in breast milk it would be wise to avoid such treatment for aesthetic purposes whilst pregnant and breast feeding.
References
Crook, J. L., Hamidian Jahromi, A., and Konofaos, P. (2022). Long-term Effects of Repeated Botulinum Toxin Injection in Cosmetic Therapeutics. Annals of plastic surgery, 88(3), 345–352. https://doi.org/10.1097/SAP.0000000000002994
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