Does a patient need to discontinue Clopidogrel (Plavix) prior to receiving microneedling or dermal fillers?

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Last updated: May 9, 2025View editorial policy

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From the Guidelines

Patients undergoing minor dermatologic procedures such as micro needling or derma fillers should continue taking Plavix (clopidogrel) as the risks associated with stopping the medication may outweigh the benefits of discontinuation. The American College of Chest Physicians suggests continuing antiplatelet drugs, including P2Y12 inhibitors like Plavix, for patients undergoing minor dermatologic procedures, based on a conditional recommendation with very low certainty of evidence [ 1 ]. This approach prioritizes minimizing the risk of thrombotic events, which could have significant morbidity and mortality implications, over the potential for increased bleeding risk associated with these cosmetic procedures.

  • The decision to continue or stop Plavix should be made in consultation with the patient's healthcare provider, taking into account their individual cardiovascular risk profile and the potential consequences of altering their antithrombotic regimen.
  • It is essential to weigh the risks of bleeding and bruising against the cardiovascular risks of stopping Plavix, considering the patient's specific medical history and current health status.
  • Cosmetic practitioners should be informed about the patient's continued use of Plavix to take appropriate precautions and manage potential bleeding complications during and after the procedure [ 1 ].

From the Research

Patient Preparation for Microneedling and Derma Fillers

  • There is no direct evidence in the provided studies that suggests a patient must stop taking Plavix to receive microneedling or derma fillers 2, 3, 4, 5, 6.
  • Microneedling is a minimally invasive procedure with a low risk of adverse events, including transient erythema and postinflammatory hyperpigmentation 2, 3.
  • Derma fillers are also considered safe, with rare but possible complications such as vascular occlusion, which can be minimized with proper technique and choice of instrument (e.g., cannulas vs. needles) 4, 5, 6.

Considerations for Patients Taking Plavix

  • While the provided studies do not specifically address the interaction between Plavix and microneedling or derma fillers, it is essential to consider the potential risks of bleeding or bruising associated with Plavix use 2, 3, 4, 5, 6.
  • Patients taking Plavix should consult their healthcare provider or dermatologist to discuss the potential risks and benefits of microneedling or derma fillers and determine the best course of action 2, 3, 4, 5, 6.

Procedure-Specific Considerations

  • Microneedling and derma fillers are generally considered safe procedures, but it is crucial to follow proper protocols and guidelines to minimize the risk of complications 2, 3, 4, 5, 6.
  • The choice of instrument (e.g., needles vs. cannulas) and technique can impact the risk of complications, such as vascular occlusion 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Microneedling: A Comprehensive Review.

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2017

Research

A Systematic Review Examining the Potential Adverse Effects of Microneedling.

The Journal of clinical and aesthetic dermatology, 2021

Research

Dermal fillers: an update.

American journal of clinical dermatology, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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