Immunosuppression and rheumatoid arthritis; is it safe to use Botox and dermal fillers.

Hi Dr Irwin, Please could you help me? I have Rheumatoid Arthritis and take Methotrexate 10mg also Hydrocloquire The Methotrexate suppress my immune system, I have lost a lot of weight in my face and would like to have Botox and Dermal fillers and am wondering if they will be safe for me and also would it be possible to have them anyway.

Good questions! There is no known contraindication with Botox and those medications and patients with RA generally have no problem. With hyaluronic acid fillers of good quality like Juvederm or Restylane, there is no contraindication as long as the skin is sterilized well just prior to injection (as it should always be anyway).


Sculptra should NOT be used in RA and some other rheumatologic conditions, in my opinion, and this is supported by data, because it works by stimulating a mild immune response which is how it builds collagen. In patients who have an immune system problem, that response can be excessive and cause bumps that are difficult to treat. Silicone and Artefill should never be used in my opinion, for the same reason.


Hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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