Do Restylane Injections Cause Cold Sores?

Why do I need to tell my doctor that I tend to get cold sores if I want Restylane injections for lip augmentation?

Doctor Answers 13

Restylane and cold sores

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Cold sores are associated with many different potential causes. Trauma to tissue, such as that asssociated with an injection of a filler material, can be associated with the development of cold sores.

If you have a history of cold sores, be sure to tell your doctor before having any procedure performed so an anti-viral medication may be prescribed.

Any injections around the mouth can trigger cold sores

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Cold sores are caused by activation of dormant viruses living in nerve cells. Stress, UV light, and any form of trauma or stimulation can activate them. Restylane injections, laser peels, any procedures around the mouth can trigger them.

If you know you are prone to them, ask for a prescription for antiviral medication and you should be ok.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Dermal fillers and laser treatments may cause cold sores

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It is very important to tell your doctor if you have a prior history of getting cold sores, especially if you are interested in getting a filler (Restylane) injected into your lips.

All dermal fillers in addition to lasers can cause cold sores to appear not only in patients with a history of cold sores but also in patients without a known history of them. Cold sores are more likely to appear if you are being lasered or injected in the lip area, however they can still appear with any dermal filler injection or laser to the the face or neck area.

If you do have a history of cold sores, alert your doctor to this and he/she can prescribe an antiviral medication. A history of cold sores should not preclude you from getting dermal filler injections or laser treatments, and you should do well if treated appropriately.

Jennifer S. Landy MD
Tampa Ophthalmologist

Injections do not cause cold sores per se

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Your doctor is asking because if you have had cold sores before, you already have the virus present in your body. Having injections in the lips can "wake up" the virus, and therefore your doctor may want to write you a prescription to prevent this from happening. If you've never had a cold sore before, there is likely no virus to wake up and therefore no prescription necessary. Hope that helps. 

David P. Rapaport, MD, FACS
Manhattan Plastic Surgeon
4.7 out of 5 stars 47 reviews

Restylane and Cold Sores

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It’s good to tell your physician your entire history. It’s not that Restylane causes cold sores, but anytime there is trauma/injury to the skin you could experience a cold sore. Your physician may prescribe a preventative so you can avoid the possibility.

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 reviews

Cold Sores from Restylane

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Anytime you have an injection procedure there will be some trauma to the area being injected. The reason your physician asked the question was because it's a possibility that after you have your lips injected, you may get a cold sore. There are ways to avoid the possibility of this happening (with a preventative prescription) and he/she may have been trying to determine whether or not to offer you a prescription as a way to prevent a possible cold sore after treatment.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Facial fillers, laser, chemical peels, or surgery can initiate a herpetic attack

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Almost 95% of the population carries the virus associated with Herpes simplex I. All of these patients are at risk for developing a cold sore after surgical or non-invasive manipulation of the skin using chemical peels, laser, or surgery.

If you have a history of cold sores, speak to your physician prior to the procedure in order to avoid postprocedural outbreaks of cold sores.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Restylane may reactivate a cold sore virus

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There is a small risk that a cold sore virus could be reactivated by treatments to the lips, including:

  • Injectables (Restylane, Juvederm, etc.)
  • Chemical peels
  • Dermabrasion

Your physician may elect to provide preventative medicine to reduce the risk of developing a cold sore or delay injection if a cold sore is present.

Mark Codner, MD
Atlanta Plastic Surgeon

Restylane and cold sores

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Thank you for your question. Cold sores are caused when dormant viruses living in nerve cells are activated. This can happen with stress, UV light and trauma, such as injection. Any procedure around the mouth can trigger a cold sore. If you have a history of cold sore, please make sure to notify your doctor before having any procedure done. This is so an anti-viral medication can be prescribed. I hope this helps.



Hardik Soni, MD (not currently practicing)
Summit Emergency Medicine Physician

Restylane Injections and Cold Sores

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Any injectable procedure or similar mild trauma (like wind chapping, sun exposure, or chemical peel) can irritate sensory nerves in the area, enough to create a herpetic outbreak. Doesn’t always happen by any means, but it’s probably a good idea to pre-treat those patients with a strong history of herpetic outbreaks with an anti-viral medication like valcyclovir to prevent an outbreak after treatment.

Bobby Buka, MD
New York Dermatologist
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.