Contraindications for Dermal Fillers

(Hyaluronic acid and other FDA-approved dermal filler types)

Before performing or assisting with a dermal filler procedure, it's essential to identify any contraindications to reduce the risk of complications and ensure safe, effective results. Below are the absolute and relative (precautionary) contraindications for dermal filler injections, commonly used to restore volume, contour, and smooth skin.

Absolute Contraindications

These conditions prohibit treatment entirely and pose a significant safety risk:

1. Pregnancy and Breastfeeding

   • Dermal fillers have not been tested for safety during pregnancy or lactation.

2. Known Allergy or Hypersensitivity

   • Allergic reaction to filler ingredients (e.g., hyaluronic acid or lidocaine, if included in the formulation).

   • Previous anaphylactic reaction to dermal fillers or cross-linked agents.

3. Active Infection or Skin Condition at the Injection Site

   • Includes acne, cold sores (herpes simplex), cellulitis, or dermatitis in the treatment area.

4. Autoimmune or Connective Tissue Disorders (in uncontrolled state)

   • Examples: lupus, scleroderma, rheumatoid arthritis. Immune response to filler material may be heightened.

5. Bleeding Disorders or History of Severe Coagulopathies

   • Increased risk of bruising and hematoma formation.

⚠️ Relative (Precautionary) Contraindications

These require caution or deferral of treatment based on clinical judgment:

1. Use of Blood-Thinning Medications or Supplements

   • Aspirin, NSAIDs, warfarin, fish oil, ginkgo biloba—these increase bruising risk.

2. History of Severe Allergies or Anaphylaxis

   • Particularly if a patient carries an epinephrine auto-injector.

3. Autoimmune Conditions (mild or stable)

   • May increase the likelihood of delayed hypersensitivity reactions.

4. Recent Dental Work, Vaccination, or Illness

   • May increase risk of infection or inflammation near the treatment area; wait at least 2 weeks.

5. Previous Adverse Reaction to Fillers

   • Including nodules, granulomas, or migration.

6. History of Keloids or Hypertrophic Scarring

   • Uncommon but possible with dermal fillers in some patients.

7. Unrealistic Expectations or Psychological Conditions

   • Patients with body dysmorphic disorder or those seeking perfection are not ideal candidates.

8. Immunocompromised Patients

   • Higher risk of infection or slower healing.

📝 Best Practices for Providers

• Conduct a thorough medical history and consultation before treatment.

• Educate patients on potential risks, side effects, and aftercare.

• If uncertain, defer treatment and recommend physician evaluation.