Filler contraindications — what's on your 'do not treat' list?
Finalising my filler consult paperwork. What are people treating as absolute vs relative contraindications for HA filler?
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The course list, as a working reference: Avoid / do not treat: • Pregnancy and lactation. • Known allergy to hyaluronic acid or to the anaesthetic in the product. • Active infection or inflammation at the site; active herpes simplex in the lip area. • Active cancer treatment. • Active autoimmune/inflammatory disease (e.g. lupus, RA, scleroderma, vasculitis, active IBD) — assess carefully and often defer. • Under-18 for cosmetic treatment (not permitted in England). Caution / assess and often defer: • Untreated epilepsy, porphyria, tendency to keloid/hypertrophic scarring. • Anticoagulation (e.g. vitamin K antagonists) — bruising/bleeding risk. • BDD concerns, capacity concerns or unrealistic expectations — a reason to slow down or decline. Whether each item is 'absolute' or 'relative' depends on the individual and current guidance — when in doubt, don't treat today.
Screen for BDD properly (COPS/PHQ-9 have their place) and be willing to decline — it's part of safe practice. Document the discussion and your reasoning either way.
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