Is it safe to have cosmetic Botox whilst taking Hydrochloroquine (Planequil)?

Thank you for your question sammi72sk. I understand your concern. Botox is a purified protein
used to address wrinkles associated with facial expression. When injected into
the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the
upper face. These include the horizontal lines seen on the upper forehead when
one raises the brows, the vertical lines seen between the brows when one frowns
(frown lines), and the crow's feet seen around the eyes when one smiles.With any injection, there are risks such as
pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take
special precautions to minimize these risks such as using a painless technique.
We also treat bruises with a laser as early as the next day. Bruises usually
resolve within two weeks if untreated. After a laser treatment bruises usually
resolve in 1-3 days, but may still take two weeks for full resolution.While Botox is one of the safest treatments
offered, there are some situation where it is not appropriate. These include
anyone who has an allergy to any of the inactive ingredients or who has had an
allergic reaction to any botulinum product including Botox, Dysport, Xeomin, or
Myobloc. The safety and efficacy of Botox has not been established in women who
are pregnant, trying to become pregnant, or breast feeding. Therefore, women in
these categories are advised to wait until breast feeding is completed prior to
having a Botox treatment. Botox should not be placed in the skin on the site of
an infection. Those who are taking an
aminoglycoside antibiotic, an anesthetic, D-penicillamine, antimalarials, or
immunosuppressants should not be treated, nor should those who have undergone
chemotherapy within the previous six months. It is important to avoid blood
thinners before and after a treatment. These include both prescription and
non-prescription medications such as warfarin (coumadin), aspirin, ibuprofen,
alcohol, fish oil, vitamin E, and ginko biloba. Those with conditions that
affect muscles and nerves such as amyotrophic lateral sclerosis (ALS or Lou
Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome should not
undergo Botox treatments.Specifically, hydroxychloroquine (Plaquenil) is an anti-malarial medication that antagonizes the effects of Botox. Therefore caution is advised for those taking Plaquenil who desire Botox treatments.After a Botox treatment, I recommend that my
patients avoid heat exposure, alcohol consumption, and strenuous exercise for
24 hours and not lie down flat for four hours. This is because all of these
activities may possibly lead to the movement of the product and consequent side
effects such as droopy eyelids as described above. Although there have been no
definitive studies shown that these actually occur and some physicians do not
provide such aftercare instructions, in the absence of data I err on the side
of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific
recommendations. Good luck!

I have not come across or heard of interactions with Plaquenil and Botulinum toxin.  However to be on the safe side you can have a small test dose performed by your doctor to whilst you wait in the office for 30 minutes after the injection to rule out any interactions.  Plaquebil has many possible side effects one which is muscle weakness and you specialist should be assessing you regularly for these.  Please inform the physician that is managing your Plaquenil prior to getting Botulinum toxin treatment.  Hope this is helpful.

Botox goes deep under the skin, and hydroquinone goes more on the surface of the skin. You should be fine to combine them both.
Kristine Brecht, MD
Seattle, WA