Botox and Bruising: What’s Normal and How to Minimize It

Botox is one of the most trusted and effective non-surgical treatments for reducing fine lines and wrinkles, but many patients have questions about what to expect afterward, especially when it comes to bruising.

If you've noticed light discoloration or a tender spot at the injection site, don’t panic. Bruising after Botox is both common and manageable. In this article, we’ll explore why it happens, how to minimize it, and when to seek guidance from your provider. 

Does Botox Cause Bruising?

Yes, Botox can cause bruising, but it's typically mild and short-lived. Bruising occurs when the needle accidentally punctures a small blood vessel just under the skin, causing minor bleeding and discoloration. Even the most experienced injectors can encounter this, some blood vessels are simply not visible or avoidable.

The good news? These bruises are usually harmless and fade on their own within a few days.

Is It Normal to Bruise After Botox?

Absolutely! Bruising is a completely normal and expected side effect, especially in more delicate areas of the face, like around the eyes and forehead. The skin is thin around the eyes, and there are a lot of capillaries, which can make it more prone to bruising. It is helpful to inject with a smaller needle and more superficially if appropriate; however, some areas need to be injected deeper and can nick vessels, causing a bruise.

Factors like skin sensitivity, age, medications, and even the time of month can influence how easily you bruise. People with thinner skin, more superficial vessels, or who are prescribed blood-thinning medications or take certain supplements are more likely to bruise.  

How Long Does Botox Bruising Last?

In most cases, Botox-related bruising fades within 5 to 7 days. However, if a deeper vessel is affected or if you’re more prone to bruising, it may take up to two weeks to fully resolve.

You can safely use makeup to cover bruising after 24 hours, once the injection sites have closed and begun to heal.

To speed up the healing, apply arnica gel or use cold compresses within the first 24 hours, taking care to avoid putting pressure on the injection sites. For best results, apply Alastin INhance Post-Injection Serum directly on and around the bruised area up to four times daily to help reduce bruising and accelerate recovery.

Can Botox Cause Bruising Under the Eyes?

The under-eye area bruises easily because the skin is thin and there are lots of tiny blood vessels just under the surface. That’s why injections here need to be done with extra care.

If you're getting Botox for crow’s feet or under-eye lines, it’s really important to go to someone who knows this area well. Using a small needle and injecting closer to the surface can help reduce bruising, but it can still happen sometimes. 

What Increases the Risk of Bruising After Botox?

Certain medications, lifestyle habits, and even genetics can all affect your likelihood of bruising. Common contributors include:

• Blood-thinning medications and supplements —Aspirin, ibuprofen, naproxen, fish oil, vitamin E, ginkgo biloba, and turmeric can impair clotting.
  
  

• Alcohol — Drinking within 24 hours of your treatment can increase the risk of bruising by dilating blood vessels.

• Exercise too soon — Intense physical activity right after your appointment can increase blood flow and interfere with healing.

• Individual skin type — Those with fair or thin skin may naturally bruise more easily.

How to Prevent Bruising from Botox?

While there’s no guaranteed way to prevent bruising entirely, there are several steps you can take to significantly reduce your risk:

Before Your Appointment

• Avoid blood thinners: Refrain from medications and supplements that thin the blood for 5–7 days beforehand (with your doctor’s permission).

• Skip alcohol: Avoid alcohol and caffeine for at least 24 hours before treatment.

• Take natural anti-inflammatories: Consider taking arnica or bromelain, which may help reduce bruising (ask your injector before use).

• Book strategically: Try not to schedule your treatment right before major events or during your menstrual cycle, when bruising may be more likely.

Learn more in our First-Time Botox Guide for additional preparation tips.

Other Tips Before Your Appointment

• Mid-cycle is often a better time to schedule Botox treatments.

• Getting Botox right before or during your period can increase the risk of bruising.

• Pain tolerance tends to be lower during your period, which can make the treatment feel more uncomfortable.

• Heat causes vasodilation (widening of blood vessels), which can also raise the risk of bruising.

How to Reduce Bruising After Botox?

Your post-treatment care is just as important as preparation. Here's how to give your skin the best chance at a quick recovery:

After Your Appointment

• Avoid touching or massaging the area: Let the Botox settle naturally without added pressure.

• Sleep with your head elevated: This helps minimize fluid retention and swelling.

• Wait to work out: Skip exercise for 24 hours to reduce blood flow that could worsen bruising.

We’ve outlined even more helpful tips in our Botox Aftercare Guide.

When Should You Be Concerned About Bruising?

Most Botox bruises are minor and disappear without issue. Here is a description of the normal healing process and when you need to see a provider:

Normal Healing After Botox

• Mild bruising

• Slight redness at the injection site

• Mild swelling

• Temporary headache

When to Contact Your Provider

• Severe pain or large, worsening bruises

• Swelling that gets worse instead of better

• Signs of infection (redness, warmth, pus)

• Hard lumps or unusual discoloration lasting more than two weeks

• Drooping or facial asymmetry

• Hives, rash, or allergic reactions

• Worsening pain or redness over time

Final Thoughts

Bruising after Botox is common, but it’s nothing to fear. With the right preparation, a gentle technique, and proper aftercare, you can minimize your risk and heal quickly. And remember, a little patience goes a long way: bruises are temporary, but your smooth, refreshed results can last for months.

At Aesthetx, we will help guide you with aftercare to ensure the best results. Our providers are each renowned for highly informative and in-depth consultations. Whether you're interested in BOTOX in Marin County, Menlo Park, or Los Gatos, we offer expert care tailored to your aesthetic goals. 

To schedule your private BOTOX consultation and learn more about the procedure, contact Aesthetx by visiting our contact page or calling (408) 412-5909.