Can You Get Dermatology Treatment After a COVID Vaccine? Clots and Side Effects

As COVID-19 vaccination rates have recently increased, inquiries about vaccination and dermatological procedures and medication use have significantly risen. Many people are curious whether dermatological treatments can be safely received after vaccination, and what precautions should be taken. Today, we would like to address your questions about dermatological treatments related to COVID-19 vaccination with a dermatologist.

During COVID-19 vaccine clinical trials, some patients reported side effects such as inflammation or swelling in areas where filler procedures had been performed. This also occurred in patients who had received injections a long time ago. These side effects were mainly reported with specific mRNA vaccines not yet introduced in Korea.

In the United States, such inflammatory or swelling reactions are considered immune responses that occur as the immune system is activated by the vaccine. When symptoms are severe, they can be treated with steroids and antihistamines, and in some patients, symptoms may naturally disappear over time.

Among vaccine side effects, there is particular interest in blood clots. If medications containing Tranexamic Acid, which is widely used as a hemostatic agent, are taken before or after vaccination, the possibility of blood clot side effects may increase, requiring caution.

Therefore, those who are taking Tranexamic Acid-based medications should consider discontinuing them for about one week before vaccination and for at least 30 days after vaccination.

Among the medications commonly prescribed in dermatology, antibiotics such as Minocin and Zithromax, and antifungals such as Fluconazole, Sporanox, and Lamisil used for nail fungus treatment, are known not to affect COVID-19 vaccination.

Furthermore, there have been no reported effects of isotretinoin-containing sebum regulators, commonly used for acne treatment, on COVID-19 vaccination. As far as is currently known, these medications can be taken regardless of vaccination.

One of the most common questions related to vaccines was about adrenocortical steroids. Since our bodies continuously produce these components, it is not true that 'not even a speck should be used'.

Low-dose steroids and topical treatments

• In the case of low-dose steroids, some people get vaccinated without discontinuing their medication.
• Acne inflammatory injections or topical application of steroid ointments are generally considered not to reduce vaccine efficacy.

Long-term steroid use

For continuous daily intake of multiple tablets of methylprednisolone, prednisone, etc., there is expert opinion that it may reduce antibody formation, but there is no clear evidence yet that it directly suppresses immunity.

Important point: Patients on long-term steroid therapy often have underlying conditions such as immunosuppressive diseases, thrombocytopenia, rheumatoid arthritis, other autoimmune diseases, or are organ transplant recipients, making them a high-risk group for whom COVID-19 vaccination is even more necessary.

Therefore, patients taking steroids should not arbitrarily stop or discontinue their medication before vaccination, but must consult their primary physician first to receive personalized guidance. Please remember that even if antibody formation is somewhat reduced, the risks of not getting vaccinated or suddenly stopping medication are greater.

There have been no reports in Korea of dermatological procedures that would pose significant problems after vaccination. No side effects have been reported for Botulinum Toxin or laser procedures, and these can be performed regardless of vaccination.

However, since cosmetic procedures are not urgent treatments, if you had planned a procedure 1-2 weeks before vaccination, it is recommended to postpone it for a while. Muscle pain or fever may occur after vaccination, so it would be best to receive the procedure when your body is in good condition after these symptoms have passed.

Allergic hives or red spots at the vaccination site or other areas are common reactions and usually improve within a few days to several weeks.

However, if severe hives or allergic reactions accompanied by difficulty breathing occur, it is best to seek emergency treatment immediately. Anaphylaxis, one of the adverse reactions to vaccines, occurs very rarely, but a drop in blood pressure or difficulty breathing can occur immediately after vaccination, which can be life-threatening in severe cases.

Especially with Janssen or AstraZeneca vaccines, if bruising or petechiae suggesting thrombocytopenia are observed, internal medicine examination and treatment may be necessary rather than dermatological care.

So far, we have examined the interactions between dermatological treatments and COVID-19 vaccines, focusing on facts and medical evidence known as of February 2021. Since the vaccine is still being administered under emergency use authorization, there may be changes or additions to the information provided in the long term.

Rather than avoiding necessary treatments based solely on a few reported side effects, we recommend continuing treatment with appropriate measures after consulting with a specialist.