Lichen Planus on my body - are facial fillers safe?

Question

Hello, Last year I was diagnosed with Lichen Planus. It is under control with medication. I want to have fillers done in my cheek area to help lift my smile lines and lower face slightly. I am worried about the filler making my Lichen Planus react. I have had filler done before, about 2 years ago and prior to my diagnosis. I also do have botox done every few months without an issue. What are your thoughts around filler and lichen planus. Also to add, my lichen planus is on my body and not on my face. thank you for your time.

Anna Chacon, MD, FAAD · Answer

This is a very thoughtful question, and I’m glad you’re asking it before moving forward. When someone has an autoimmune or inflammatory skin condition like lichen planus, it’s always wise to pause and consider how elective cosmetic procedures might interact with the disease.

The reassuring part first: in most cases, facial fillers can be used safely in patients with lichen planus — especially when the condition is well controlled and not active on the face. Your history actually gives us two helpful clues: you’ve previously had filler without issues, and you continue to tolerate Botox well. Both suggest your immune system has not shown a tendency to overreact to injectable aesthetic treatments.

Here’s how I think about it clinically:

✅ Disease control matters most

Risk is lowest when:

Your lichen planus is stable

There are no active flares

No facial involvement

You are not in a high-inflammatory phase

When lichen planus is quiet and controlled with medication, the likelihood of filler triggering a flare is considered low.

⚠️ Theoretical risks to be aware of

Even though risk is low, it’s not zero. With any injectable procedure, there is a small possibility of:

Localized inflammatory reaction

Delayed immune response to filler

Koebner phenomenon (where trauma to the skin can trigger lesions — more common with active disease)

That said, Koebner reactions are far more often seen with active cutaneous disease, not quiet, body-only lichen planus.

✅ Filler type considerations

If proceeding, the most conservative choice is:

Hyaluronic acid filler

Reversible

Lower long-term inflammatory risk

Most studied safety profile

Can be dissolved if needed

I would generally be more cautious with:

Permanent fillers

Strong collagen stimulators

Large-volume biostimulatory products

Those are not necessarily forbidden — just more carefully selected in autoimmune-background patients.

✅ Botox history is reassuring

Your ability to receive Botox regularly without issue is actually encouraging. While Botox and fillers are different substances, tolerance of one injectable often suggests a lower likelihood of exaggerated immune reaction to another.

✅ Practical safety approach

The safest path in situations like yours typically includes:

Treating only when disease is stable

Using conservative amounts

Choosing reversible products

Avoiding treatment directly over any inflamed skin

Spacing treatments rather than doing large volumes at once

Bottom line

With well-controlled, body-only lichen planus, facial hyaluronic acid fillers are generally considered safe, and your prior filler and Botox tolerance are both reassuring signs. The key is thoughtful product choice and conservative technique — not avoidance altogether.

Lichen Planus on my body - are facial fillers safe?

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