Aftercare, sorted by reason
You will be given a list. Some of it protects you from infection, some of it reduces bruising, some of it exists because the previous clinic's list said so.
The aftercare instructions with the clearest rationale concern infection: keep the area clean, do not apply make up to freshly punctured skin for the rest of the day, and avoid environments with a high organism load such as swimming pools, saunas and steam rooms for a short period. Those follow directly from the fact that the skin barrier has been breached at multiple points.
Instructions about heat, exercise and alcohol are aimed at bruising and swelling and are reasonable precautions rather than established requirements. Instructions about sleeping position, specific skincare exclusions and long lists of forbidden activities vary enormously between clinics, which tells you something about how much of the list is derived from evidence.
3.5.1Sorting the list
Aftercare advice in aesthetics is transmitted between practitioners and between clinic websites more than it is derived from studies. That is not a scandal; the same is true of a good deal of practical clinical advice across medicine, and much of it is sensible. But it means the list you are handed contains items of very different weight, presented identically, and a patient cannot tell which is which.
This article sorts them into three groups: rationale that is clear, rationale that is reasonable, and rationale that is convention. That is a judgement about the reasoning behind each instruction, not a licence to ignore what your own practitioner has told you.
| Instruction | Aimed at | Strength of rationale |
|---|---|---|
| Keep clean, do not touch | Infection | Clear |
| No make up on the area that day | Infection | Clear |
| No pools, saunas, steam rooms for a few days | Infection | Clear |
| Know the warning signs and how to reach someone | Safety | Clear |
| Avoid strenuous exercise briefly | Bruising and swelling | Reasonable |
| Avoid alcohol briefly | Bruising | Reasonable |
| Sleep with head elevated | Swelling | Reasonable |
| Avoid direct heat and sun | Swelling, and general skin protection | Reasonable |
| Specific skincare exclusion periods | Irritation | Convention, and highly variable |
| Drink extra water | Nothing specific | Convention |
| Do not fly for a set period | Nothing specific | Convention, and highly variable |
| Massage, or do not massage | Contradictory between clinics | Convention |
A framework written by this publication to organise a decision. It is not a measurement, it is not drawn from any study, and no figure in it should be quoted as a finding.
3.5.2Instructions with a clear rationale
Keep the area clean and do not touch it
Multiple punctures through the skin barrier is exactly the condition under which organisms from the surface get into the dermis. Clean hands, clean pillowcase, and leaving the area alone are the sensible measures. This is the single most defensible item on any aftercare list.
No make up on the treated area for the rest of the day
Cosmetic products are not sterile, brushes and sponges carry an organism load, and the puncture sites are open for a period. Waiting is straightforward and low cost.
Avoid pools, hot tubs, saunas and steam rooms for a few days
These combine a high organism load with heat and moisture. The infection argument here is direct.
Watch for the signs that are not normal
Increasing pain, spreading redness with warmth, fever, discharge, blanching or mottling, or visual change. Knowing what to look for, and having a route to reach someone, is aftercare rather than an optional extra.
3.5.3Instructions with a reasonable rationale
Avoid strenuous exercise for a day or two
Raised blood pressure and heat plausibly increase bruising and swelling immediately after injection. The reasoning is sound, the evidence specific to this treatment is not something we can point you to, and the cost of following it is low.
Avoid alcohol for a day or two
Alcohol affects vasodilation and platelet function. The reasoning is sound. The same caveat about specific evidence applies.
Sleep with your head elevated for a night or two
For facial and particularly periorbital treatment, gravity is on your side. This costs nothing and has a plausible mechanical rationale.
Avoid direct heat and prolonged sun
Heat increases local blood flow and swelling in the short term. Sun protection is good advice generally and better advice on skin that has just been treated. The general advice on sun protection from the NHS applies here as it does otherwise.
3.5.4Instructions that are convention
These appear on many lists and vary greatly between clinics, which is itself informative. They are not wrong and following them costs little. They should not be presented as established.
- Specific durations for avoiding particular skincare actives, which differ from clinic to clinic by factors of several.
- Long lists of forbidden facial treatments for extended periods.
- Instructions to drink a specified amount of water, on the basis that the treatment is hydrating.
- Instructions to massage, or not to massage, which point in opposite directions depending on which clinic you ask.
- Prohibitions on flying, which vary from a day to weeks with no discernible basis.
If an instruction matters, your practitioner should be able to say why in one sentence. That is a fair test and a good practitioner will pass it without irritation.
3.5.5What aftercare should include beyond a list
A written copy, so that you are not relying on memory after an appointment. A named contact and a route to reach someone including out of hours. A clear statement of what would count as a problem. A review appointment or at least an invitation to make contact if you are concerned. And a record of what was done, including the product and ideally the batch number.
Aftercare that consists only of a list of prohibitions, with no contact route and no statement of what a problem looks like, is incomplete. The Joint Council for Cosmetic Practitioners and the professional regulators all publish standards that contemplate follow up as part of the treatment rather than as an optional courtesy.
3.5.6Skincare afterwards
The general position is to keep it simple for a few days: cleanse gently, moisturise, protect from sun, and reintroduce anything active once the skin is settled. Retinoids, exfoliating acids and abrasive treatments on skin that has just been punctured multiple times are worth pausing.
Beyond that, this document is not going to recommend products, and a clinic that follows the treatment with a strong recommendation to buy its own skincare range is doing something that is worth noticing. It may be good advice. It is also a second sale, and the two are difficult for a patient to separate in the room.
Questions
Which aftercare instructions really matter?
The ones aimed at infection: keep the area clean, leave it alone, no make up on it that day, and avoid pools, saunas and steam rooms for a few days. Those follow directly from having breached the skin barrier at multiple points.
Can I exercise afterwards?
The customary advice is to wait a day or two, on the reasoning that raised blood pressure and heat increase bruising and swelling. The reasoning is sound and the cost of following it is low, but we cannot point you to evidence specific to this treatment.
Why do clinics give such different aftercare advice?
Because much of it is transmitted between practitioners rather than derived from studies, and some of it is copied from one website to another. The variation itself is informative: instructions that differ by a factor of several between clinics are not resting on a common evidence base.
Should I put anything on the area?
Keep it simple for a few days: gentle cleansing, moisturiser, sun protection, and pause retinoids, acids and anything abrasive until the skin has settled. If you are given a strong recommendation to buy a particular range, notice that it is also a second sale.
What should I have been given before I left?
Written aftercare, a named contact and a route to reach someone out of hours, a clear statement of what would count as a problem, and a record of what was done including the product. A list of prohibitions with no contact route is incomplete aftercare.
- NHS, Cellulitis
- NHS, Plastic surgery
- Joint Council for Cosmetic Practitioners
- NHS 111 online
- British Association of Dermatologists
Links to regulators, professional bodies, legislation and research indexes. They are cited because they are public and checkable, not as endorsement of this publication. No source listed here has any commercial relationship with us.
Revisions to this document
This reference is revised when the evidence changes. Subscribe and you will be told what was revised, what the verdict was before, and what it is now.
One email when this document is revised, with what changed and why. Any sponsor line is labelled as such and can never influence an evidence verdict. Rates are published on the newsletter page. We do not sell, share or rent the list. Unsubscribe from any email.