Cold Sores After Juvederm

Question

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.

N. Bill Aydin, MD · Answer

Hi, 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.

Kevin M. Robertson, MD, FACS · Answer

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!

David Shafer, MD, FACS · Answer

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.

Milan Shah, MD · Answer

Cold sores, also known as fever blisters, are caused by the herpes simplex virus (HSV). Although the injection of dermal fillers like Juvederm typically doesn't cause cold sores directly, certain factors associated with the procedure may trigger a cold sore outbreak in individuals who are already infected with the herpes simplex virus. Here's how it can happen:1. Stress: Undergoing a cosmetic procedure such as Juvederm injections can be stressful for some individuals. Stress is a known trigger for cold sore outbreaks in people who are already infected with HSV.2. Immune Response: The body's immune response to the Juvederm injection may temporarily weaken the immune system in the treated area. This temporary suppression of the immune system can allow the herpes simplex virus to reactivate, leading to a cold sore outbreak.3. Trauma to the Skin: The injection process itself can cause minor trauma to the skin, which may serve as a trigger for cold sore recurrence in individuals who are prone to outbreaks.To minimize the risk of cold sore outbreaks after Juvederm injections or any other cosmetic procedure, consider the following preventive measures:1. Antiviral Medication: If you have a history of cold sores, consider taking antiviral medication prescribed by your healthcare provider before and after the Juvederm procedure to reduce the risk of an outbreak.2. Stress Management: Practice stress-reduction techniques such as deep breathing, meditation, yoga, or mindfulness to help manage stress levels before and after the procedure.3. Topical Treatments: Apply topical antiviral creams or ointments to the lips or areas prone to cold sore outbreaks as directed by your healthcare provider.4. Avoidance of Triggers: Identify and avoid triggers that are known to induce cold sore outbreaks, such as excessive sun exposure, fatigue, illness, and certain foods.5. Good Hygiene Practices: Maintain good hygiene practices, including washing your hands frequently and avoiding touching your face, lips, or mouth to reduce the risk of spreading the herpes simplex virus.If you experience a cold sore outbreak after Juvederm injections or any other cosmetic procedure, inform your healthcare provider promptly. They can provide guidance on managing the outbreak and may recommend postponing further treatments until the cold sore has healed completely.

Edward E. Dickerson, IV, MD · Answer

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.

	"Dr.Dr"

Joseph A. Eviatar, MD, FACS · Answer

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

Samir Shureih, MD · Answer

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

Steven Wallach, MD · Answer

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.

Peter J. Malouf, DO · Answer

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.

Anifat Balogun, MD - Account Suspended · Answer

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.

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