Herpes Zoster Occurring After Injection of Botulinum Toxin and Hyaluronic Acid

J Craniofac Surg. 2025 Sep 1;36(6):e677-e678. doi: 10.1097/SCS.0000000000011239. Epub 2025 Apr 1.

Abstract

Botulinum toxin, as a common facial wrinkle removal product, can be used for facial rejuvenation or improvement of skin texture, which is a commonly used cosmetic injectable product. However, botulinum toxin may lead to decreased immune function, causing a series of subsequent complications. This case report describes a 32-year-old female patient who developed herpes zoster after receiving injections of semaglutide, botulinum toxin, and hyaluronic acid. Viral infection and decreased immune function are common triggers of herpes zoster. After injection of botulinum toxin, the local immune response may be affected, which may activate the latent varicella-zoster virus or lead to decreased immune function that causes herpes zoster.

Keywords: Botulinum toxin; complications; herpes zoster; semaglutide.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Botulinum Toxins, Type A* / administration & dosage
  • Botulinum Toxins, Type A* / adverse effects
  • Cosmetic Techniques* / adverse effects
  • Dermal Fillers* / administration & dosage
  • Dermal Fillers* / adverse effects
  • Female
  • Herpes Zoster* / chemically induced
  • Herpes Zoster* / diagnosis
  • Herpes Zoster* / drug therapy
  • Humans
  • Hyaluronic Acid* / administration & dosage
  • Hyaluronic Acid* / adverse effects

Substances

  • Hyaluronic Acid
  • Botulinum Toxins, Type A
  • Dermal Fillers