Autoimmune disease and treatment.

Hashimoto's thyroiditis: the most common autoimmune disease – and no obstacle to botulinum toxin, fillers or skin boosters if the thyroid is well controlled. There is no evidence of more complications.

Rheumatoid arthritis, psoriasis, Crohn's, colitis: treatment possible but with regard to medication. Under immunosuppressants (methotrexate, biologics, cortisone) infection risk is higher and wound healing delayed – fillers with special care, microneedling and PRP only in stable phases. No elective treatments during an active flare.

Lupus, scleroderma, dermatomyositis: here the skin itself is affected. Fillers can trigger reactions in active phases; treatment only in consultation with the treating rheumatologist and in remission. Botulinum toxin is mostly unproblematic.

Myasthenia gravis, Lambert-Eaton syndrome, ALS: these diseases affect signal transmission to the muscle – exactly where botulinum toxin acts. It is contraindicated here. Multiple sclerosis, by contrast, is no exclusion; botulinum toxin is even used therapeutically against spasticity in MS.

Fillers and 'autoimmune reactions': very rarely, delayed nodules appear weeks to months after fillers, often after infections or vaccinations. With an existing autoimmune disease the risk may be slightly higher. It is well treatable – but a reason for consent discussion and restrained amounts.

Important: state diagnosis, current medicines and the last flare in the consent talk. If unsure, the practice obtains the agreement of the treating specialist. No disclosure is too unimportant.