Why we ask about your medications before injecting

Before any injectable treatment at Nova Beauty Clinic we ask you to list every medicine you take, prescribed or not, along with supplements, recent illnesses, recent vaccinations and recent dental work. Most people expect one or two questions about allergies. The list is longer than that, and it is not paperwork. Each question maps to a specific thing that can go wrong, or to a decision about whether we treat you on the day at all.

What a needle actually does

An injectable treatment puts a needle or a cannula through skin and into tissue that contains small blood vessels. You cannot see them all and you cannot avoid them all. When a needle passes through a vessel, blood leaks into the surrounding tissue, and that is a bruise. How much leaks depends partly on how well your blood clots.

Medicines that reduce clotting or make platelets less sticky therefore make bruising more likely and more widespread. That includes medicines prescribed after a heart attack, a stroke or a clot, and it also includes ordinary painkillers off a supermarket shelf, because the anti inflammatory ones affect platelet function for several days. A 2017 review in the Journal of Clinical and Aesthetic Dermatology on managing bruising after non surgical cosmetic treatment lists both groups, and adds oral steroids, which make small vessels more fragile.

Here is the part people most often get wrong. We will not ask you to stop a prescribed blood thinning medicine for a cosmetic appointment. That same review is explicit: these should not be discontinued for an aesthetic procedure, and not stopped without specialist advice. Your prescriber weighed a clot against a bruise when they started it, and a bruise is the acceptable side of that trade. What we do instead is tell you plainly that bruising is more likely, discuss whether the area you have in mind is a sensible one to treat, and sometimes suggest a different treatment or a different week. The same applies to the injectable skin boosters and bioremodelling treatments, which use finer needles but still cross the same vessels.

The supplements people forget to mention

Fish oil and omega 3, high dose vitamin E, garlic supplements, ginkgo biloba and St John's wort all appear in that review as things that increase bruising, with a suggestion to pause them around two weeks beforehand. Worth being honest about the strength of this: the associations rest largely on small studies and case reports, not trials in aesthetic patients. We raise it because a fortnight without a supplement costs you almost nothing, not because the evidence is strong.

Your immune system, and what has happened to it lately

Hyaluronic acid dermal filler sits in your tissue for months. Your immune system notices it. Usually nothing comes of that. Occasionally something does: a delayed inflammatory reaction, where an area that settled weeks or months ago becomes swollen, red and tender.

The triggers are why we ask about recent events and not only current medicines. A 2025 systematic review in Medicina collected the published cases of delayed inflammation after viral illness and after vaccination, 25 patients across six papers, with onset anywhere from a few hours to several weeks after the trigger. Most resolved, some without treatment and others with steroids or with the enzyme used to dissolve filler. These are case reports and the numbers are small, so nobody can give you a reliable risk figure. What they do establish is that the question is worth asking.

The 2021 American Society for Dermatologic Surgery task force recommendations on filler adverse events ask for the same history: active facial infection, autoimmune disease, recent dental work, recent immunisations, facial trauma, and any filler you have had that was not hyaluronic acid. That last one matters more than people expect. Product placed years ago by somebody else, of a type you may not know the name of, changes what we are willing to put on top of it.

Medicines that change how skin heals

Some medicines alter healing rather than bleeding. The strong oral acne medicine in the vitamin A family is the one most often discussed, and the received wisdom, wait six months before anything, is shakier than its confidence suggests. A 2017 consensus review in Dermatologic Surgery examined the evidence and found none supporting a delay for superficial chemical peels, vascular lasers, hair removal lasers, non ablative devices or focal dermabrasion. The panel still advised caution with full ablative laser and full face mechanical dermabrasion, and judged the evidence insufficient either way for medium and deep peels and for cutting surgery.

We work to that rather than to the folklore. For some people it means we can treat sooner than they were told elsewhere. For others it means we still wait.

Rapid weight change

We ask about weight management medication for a different reason, not risk but result. Losing weight quickly takes fat from the face along with everywhere else, and midface fat loss tends to read as ageing rather than as slimming. If you are still losing, restoring volume now means aiming at a moving target, so the usual advice is to wait until your weight is stable. This is clinical judgement rather than trial evidence, and we will say so at the time.

What we do with your answers

Four things, usually. We adjust the plan: a different product, a smaller volume, a cannula instead of a needle, a later date. We defer: an active cold sore, a chest infection, a vaccination last week or dental work next week are all reasons to come back. We contact your GP where something we may use could interact with a medicine you already take, which is what the Joint Council for Cosmetic Practitioners code of practice, revised in 2023, asks of us. And occasionally we decline, which is the least popular answer and sometimes the correct one.

That code also requires a full clinical history taken face to face before any injectable prescription. It is not a rule we invented, and a clinic that skips it is skipping something.

Who we will not treat on the day

Anyone with an active infection on or near the area. Anyone who has had a vaccination or significant dental work in the past couple of weeks, until that has settled. Anyone with a previous reaction to filler or to an injected medicine, until we understand what happened. Anyone pregnant or breastfeeding. Anyone under 18, for whom we do not provide these treatments at all. And anyone who cannot give us a medication history, because a consultation built on guesswork is not a consultation.

If something does go wrong after a treatment, anywhere, you can report it yourself. The MHRA Yellow Card scheme accepts reports from patients as well as from clinicians, and it covers medical devices, which is what a dermal filler is in the United Kingdom, as well as medicines.

Bring the list

Consultations here are free and last 30 minutes, and the medication conversation takes up much of the first half. Bring your repeat prescription list, or a photograph of your packets, because remembering names in the chair rarely works. Book a consultation online, and if the honest answer is that a treatment is not worth your time, you will hear that instead.

The same check applies at a consultation for lines and wrinkles, where a prescription treatment for expression lines always starts with a prescribing assessment.

Written by the clinical team at Nova Beauty Clinic.