Cold Sores After Juvederm

I had Juvederm a week ago last Wednesday and have developed cold sores on lips.  My doctor called in Valtrex but it hasn't seemed to work.

Doctor Answers 9

Cold sores and fillers

Yes, sometimes patients develop cold sores after filler placement in the lips.  This can happen in patients that have a history of cold sores in the past. The valtrex will help the cold sores heal quicker and minimize the risk of worsening.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews



Thank you for your question.  I usually prescribe Valtrex to my patients a week prior to doing fillers and also have them continue for at least a week after if they have a history of outbreaks. This usually prevents them from getting the outbreak. It is not the actual product that is causing the cold sore but the trauma to the lip. Let your plastic surgeon know if you have a history of outbreaks.

N. Bill Aydin, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 60 reviews

Cold Sores After Juvederm

Cold sores usually appear after Juvederm because of the stress or trauma to the lip, not the actual Juvederm. If someone has had an outbreak in the past of cold sores then sometimes an anti-viral medication is prescribed. We recommend Valtrex, if taken before an injection to the lips and sometimes after, can help significantly with this.  It is hard to predict if the client will develop a cold sore.


Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 120 reviews

Generally Juvederm does not cause cold sores

If you’re prone to getting cold sores, Juvederm might stimulate them. But, generally Juvederm does not cause cold sores.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

Cold sores after Juvederm injection.

I have to assume that the Juvederm injections you received were in your lips, since that is where you developed cold sores.

It is not unheard of to experience an outbreak of cold sores after perioral treatments especially if you have a previous history of cold sores. With a declared previous history of cold sores, it is best to have you start an antiviral like Valtrex beginning 24 hours before your treatment and continuing for 7 days.

Once you have a cold sore outbreak, the use of an antiviral like Valtrex helps shorten the course of the of the infection.

Make sure to inform your cosmetic surgeon about a history of cold sore outbreaks when you are having facial treatments such as microdermabrasion, peels, laser resurfacing, laser hair reduction around the lips and lip fillers.

Anifat Balogun, MD
Seattle Otolaryngologist

Cold sores occur after perioral injections

Even a gentle injection around the mouth with fillers can stimulate the virus responsible for cold sores. Treatment number one is prevention, which means next time you consider soft tissue fillers, take a med like valtrex at least 24 hours prior, and continue for 5-7 days minimum.

Since that is not an option now, you have to wait it out.  Studies have shown that meds like valtrex work best if started within 24 hours of your outbreak.  Was that the case?  Second issue is that the meds work by shortening the pain and the duration of the open sore, and therefore hopefully decrease the chance of scarring.  It's not like some meds where hours after starting them you see results.  It is important that you remain patient, assume the med is helping, and provide local care to the sores without drying or disruption.  Don't pick them!

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 14 reviews

Cold sore

Great your doctor did the right and only treatment available for Herpes infection. It has nothing to do with the injection of juvederm.

The Valtrex will shorten the course of the infection but will take time

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Cold sores after Juvederm

It is very important to take preventative antivirals with a true history of HSV.  If this outbreak is in fact HSV, then you will probably have to let it run its course.  You have about 48 hours to make a change in the course of an outbreak with oral antivirals, like valtrex.

Peter Malouf, DO
Dallas Dermatologist
4.7 out of 5 stars 87 reviews

Cold Sores

Have you had cold sores in the past?  Juvederm and other injections do not cause cold sores.  You may want to make an appointment to see your doctor for an evaluation.  Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 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.