Contraindications for Neurotoxins (Botulinum Toxin Type A – e.g., Botox, Dysport, Xeomin, Jeuveau)

Administering neurotoxin treatments requires careful client screening to ensure safety and optimal results. Below is a comprehensive list of contraindications—both absolute and relative—that estheticians or licensed injectors should consider before proceeding with treatment.

🛑 Absolute Contraindications

These are conditions in which neurotoxin treatment should not be performed under any circumstance:

1. Pregnancy or Breastfeeding

   • Safety has not been established; neurotoxins are contraindicated in pregnant or nursing individuals.

2. Allergy to Botulinum Toxin or Formulation Components

   • Includes hypersensitivity to any ingredients like human albumin or lactose (varies by brand).

3. Active Skin Infection at the Injection Site

   • Includes bacterial infections, cold sores (herpes simplex), or open wounds.

4. Neuromuscular Disorders

   • Such as:

     • Myasthenia gravis

     • Lambert-Eaton syndrome

     • Amyotrophic lateral sclerosis (ALS)

   • These conditions may be exacerbated by neurotoxin use.

⚠️ Relative (Precautionary) Contraindications

These require careful consideration, medical clearance, or deferral of treatment:

1. Use of Aminoglycoside Antibiotics or Certain Medications

   • Drugs like gentamicin or tobramycin may potentiate the effects of neurotoxins.

2. Bleeding Disorders or Anticoagulant Use

   • Increased risk of bruising and hematomas; use caution and consider timing.

3. History of Keloid Scarring or Poor Wound Healing

   • Increased risk of undesirable injection site healing.

4. Psychological Instability or Unrealistic Expectations

   • Patients with body dysmorphic disorder or who expect perfection may not be good candidates.

5. Previous Adverse Reaction to Neurotoxins

   • Any history of prolonged muscle weakness, ptosis, or allergic reaction should be evaluated carefully.

6. Recent Facial Procedures or Surgery

   • Wait for healing or inflammation to subside before injecting.

7. Underlying Medical Conditions

   • Conditions that affect muscle function or systemic health may require physician consultation.

📝 Best Practices

• Always complete a full medical intake and health history review before treatment.

• Obtain informed consent and ensure the client understands risks and post-care.

• Collaborate with supervising medical professionals when needed, especially in complex cases.