# Medications and *treatment.*

> Which medicines matter before aesthetic injections: blood thinners, aspirin, ibuprofen, certain antibiotics, muscle relaxants, isotretinoin, supplements.

- Source: https://www.vivaderm.de/guide-medications-interactions-en.html
- Language: en
- Publisher: VIVA DERM, Privatpraxis für ästhetische Medizin, Rosastraße 6a, 45130 Essen, Germany, +49 1520 8367711
- Responsible physician: Katayoun Mostaghimi (Fachärztin für Allgemeinmedizin)
- Updated: 2026-10-15

The medication list is the most important part of the history. Not because much excludes – but because some things change timing and technique.

## What you must disclose.

**Blood thinners (warfarin, apixaban, rivaroxaban, clopidogrel):** no exclusion, but more bruising. **Never** stop them on your own – the risk of thrombosis or stroke is far higher than a bruise. The practice works with a cannula, smaller amounts and cooling.

**Aspirin, ibuprofen, diclofenac, naproxen:** inhibit platelets. If not prescribed (e.g. aspirin 100 after a heart attack), switch to paracetamol five to seven days before. Prescribed aspirin is continued.

**Supplements:** fish oil, omega-3, ginkgo, garlic capsules, high-dose vitamin E, St John's wort – all slightly raise bleeding tendency. Pause one week before.

**Aminoglycoside antibiotics (gentamicin, tobramycin) and muscle relaxants:** can enhance the effect of botulinum toxin. With ongoing intake the treatment is postponed. Usual antibiotics (amoxicillin, doxycycline) are no problem – but an infection is.

**Isotretinoin (acne therapy):** during and six months after intake no peels, no microneedling, no thread lift (scarring risk). Botulinum toxin and fillers are possible.

**Cortisone, immunosuppressants, chemotherapy:** raised infection risk and delayed healing – individual decision with the treating specialist.
**Vaccinations:** two weeks' gap to fillers in both directions is a sensible buffer because delayed swelling has been described.
**Herbal remedies and 'teas'** count too. Bring a complete list – including supplements.

## The essentials.

- **Blood thinners:** never stop on your own
- **Aspirin/ibuprofen:** pause 5–7 days before (if not prescribed)
- **Aminoglycosides:** postpone botulinum toxin
- **Isotretinoin:** no needling/peels for 6 months

## Important note.

This text is general information. It replaces neither a medical examination nor the consultation required before any treatment under German law (§ 630e BGB). Whether and which treatment is suitable for you can only be said after examination and consultation. No treatment results are promised.

## Frequently asked questions.

**I take the pill – is that relevant?**

No. Hormonal contraception affects neither botulinum toxin nor fillers. With a tendency to melasma, peels should be planned more cautiously.

**Antidepressants and Botox?**

No problem. There are even studies on a mood-lifting effect of frown-line treatment – but that is not a therapy.

## Related.

- [Allergies](https://www.vivaderm.de/guide-allergies-aesthetic-treatments-en.html) – Guide
- [Alcohol & skin](https://www.vivaderm.de/guide-alcohol-skin-treatment-en.html) – Guide
- [Haematoma](https://www.vivaderm.de/lexicon-haematom-en.html) – Lexicon

## Sources

- [§ 630e BGB – duty to inform before treatment (German Civil Code)](https://www.gesetze-im-internet.de/bgb/__630e.html)
- [GOÄ – German scale of medical fees (official text)](https://www.gesetze-im-internet.de/go__1982/)
- [§ 11 HWG – ban on before/after images and advertising promises](https://www.gesetze-im-internet.de/heilmwerbg/__11.html)
- [Professional code of the Medical Association North Rhine](https://www.aekno.de/aerzte/berufsordnung)
- [NHS: non-surgical cosmetic procedures](https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/)
- [Medical Association North Rhine – patient information](https://www.aekno.de/patienten)
- [DGBT – German Society for Aesthetic Botulinum Toxin Therapy](https://www.dgbt.de/)

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This page is general information and does not replace medical consultation and informed consent (§ 630e BGB). No guarantee of results. Prices are guide prices per GOÄ. Quoting with attribution (VIVA DERM, Essen) is expressly permitted.