Over the past few months there have been headlines linking Covid-19 vaccines to problems with dermal fillers. I know lots of you have seen them, because, as the nationwide vaccination programme continues to roll out and the tweakments clinics prepare to re-open on April 12th, I've had a lot of messages asking for advice and reassurance about this.
Maybe you have already been vaccinated but want to have fillers when clinics re-open or you already have fillers and are worried about having the vaccination as a result. Whichever, what I'm being asked is whether it's ok to have filers when you've had the vaccine, and how long you should leave between one and the other.
What's the story on fillers and the vaccine?
Back in December 2020, reports emerged that the Covid vaccine might cause dermal fillers to puff up, after three participants involved in the phase-three clinical trial of the Moderna vaccine experienced facial or lip swelling due to dermal fillers.
The news hit global headlines and the warning had some clout behind it as it came from the US Food and Drug Administration (FDA) following a meeting of the Vaccines and Related Biological Products Advisory Committee (VRBPAC) on December 17.
How much of a problem is this?
The key thing is to get this in perspective: those three people who found their fillers swelled were three of 15,184 participants in that phase-three trial. Of course, most of those 15,000 people won't have had filler in their faces, but it's still only a very small risk, and the swellings went down after treatment with antihistamine or steroids.
How does the vaccine cause swelling in people who have had dermal fillers?
If you have had fillers, or are thinking of having fillers, one of the things you should be made aware of by your practitioner is the risk of something called Delayed Onset Nodules (DONs) or Delayed Onset Reactions (DORs). These are very rare but well-documented side-effects that can occur weeks, months or even years after having soft tissue fillers.
A DON is a visible or palpable lump or mass that appears in the area of the dermal filler injection site whereas a DOR usually refers to an immune response to the foreign body (the filler) and may cause things like swelling at the injection site.
This happens when the immune system is challenged, so it generally occurs after viral illnesses, a bacterial infection in the sinuses or ears and infections after dental procedures. The Covid-19 vaccines are what is known as mRNA vaccines. These new types of vaccines are highly immunogenic (ie, they're really good at provoking an immune response) so it’s little surprise that they are also capable of activating an immune response to foreign body implants i.e. dermal fillers.
Should I forgo the vaccine if I have dermal fillers?
The resounding answer from dermatologists, plastic surgeons and doctors around the world who perform dermal fillers is “no”. Since the news broke many of them have come out to say that the risk of transient swelling is extremely rare and so the advice is to still get the vaccine when you are offered it.1-2
In fact, a study of 106 participants from 18 different countries showed that Covid-19 vaccines do not pose any greater risk of a soft tissue reaction than any of the other already identified triggers.3 This means you are actually just as likely to get the reaction from catching Covid-19 itself as you would be from the vaccine.
If you've had the vaccine, wait a few weeks before filler treatment
Guidance has now been created for aesthetic practitioners which advises them not to provide dermal filler treatment either two weeks before or three weeks after Covid-19 vaccination. They are also recommending holding off on any aesthetic treatments for at least a week after receiving a vaccine to minimise any risks of side effects.
If you are having fillers make sure you speak to your practitioner about if and when you are due to have the vaccine. It won’t mean you can’t have your treatment but it is worth waiting and keeping the two appointments well apart.
- Dr Martyn King. The Impact of SARS-CoV-2 Vaccination and Infection on Soft Tissue Fillers. ACE Group Guidelines. https://uk.acegroup.online/blog/2021/03/06/covid-19-fillers/
- ASDS Provides Guidance Regarding SARS-CoV-2 mRNA Vaccine Side Effects. (2020, December 28). Retrieved January 07, 2021, from https://www.prweb.com/releases/asds_provides_guidance_regarding_sars_cov_2_mrna_vaccine_side_effects_in_dermal_filler_patients/prweb17636524.htm
- Gotkin, R.H., Gout, U., Sattler, S., Piansay-Soriano, M.E., Wanitphakdeedecha, R., Ghannam, S., Rossi, E., Ferrariz, T.S., Hexsel, D., Frank, K., Davidovic, K., Sarnoff, D.S. and Cotofana, S. (2021). Global Recommendations on COVID-19 Vaccines and Soft Tissue Filler Reactions: A Survey-Based Investigation in Cooperation With the International Society for Dermatologic and Aesthetic Surgery (ISDS). J Drugs Dermatol, 20(4): doi:10.36849/JDD.2021.6041 https://jddonline.com/articles/dermatology/S1545961621P6041X