ACE Group releases guidance on dermal fillers and COVID-19

10 Mar 2021

The Aesthetic Complications Expert (ACE) Group World has released new guidance on dermal filler delayed onset reactions following COVID-19 infection and vaccination.

The six-page paper, titled ‘The Impact of SARS-CoV-2 Vaccination and Infection on Soft Tissue Fillers’ was written by aesthetic practitioner Dr Martyn King.

The paper explains that although there are currently few published cases that demonstrate delayed onset nodules (DONs) or delayed onset reactions (DORs) following either the COVID-19 vaccination or infection, it is a cause of concern to aesthetic practitioners.

The paper therefore covers the mechanism of action, incidence, signs and symptoms, areas of caution and how to minimise the risk, consent considerations, and treatment of DONs and DORs caused by COVID-19 vaccination and infection.

Dr King said, “Delayed onset nodules or reactions occur weeks, months or even years after receiving a soft tissue filler treatment when the immune system is challenged. Potential triggers include viral illnesses, bacterial infections, dental procedures, excessive UV exposure, subsequent minimally invasive aesthetic treatments, and vaccinations. Thereby, it is essential that all practitioners are mindful of this risk.”

Dr King emphasised that practitioners should consent their patients appropriately, risk assess their patients, time their treatments around their expected vaccination date and are knowledgeable on how and when to intervene if a complication does occur.

He added, “To minimise the risk, the practitioner must take a full medical history, including previous and recent COVID-19 infection and vaccination schedule. Although current evidence is limited, for reasons described in our paper, the ACE Group recommends that practitioners should not be performing soft tissue filler treatments either two weeks before or three weeks after COVID-19 vaccination. This guidance would apply to all current COVID-19 vaccinations.”

There is currently no evidence that COVID-19 vaccination or infection has effects on other aesthetic procedures, including botulinum toxin. However, the ACE Group recommends avoiding treatments for one week post vaccine, due to some patients becoming unwell and experiencing flu-like symptoms following vaccination.

The new ACE Group Guidelines are available via the link:  


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