Needle-free fillers: The risks you need to know about
Fillers add volume to the face, hands, and lips. This extra volume can give you fuller lips, fewer wrinkles, or younger-looking hands.
To get this extra volume, a filler must be injected into the skin. A needle-free filler uses pressure instead of a needle to inject the filler.
Needle-free fillers can cause serious injuries
Board-certified dermatologists and the Food and Drug Administration (FDA) are warning the public about the serious injuries that needle-free fillers can cause.
While needle-free (aka needle-less) fillers may sound like a welcomed breakthrough for having fuller lips and fewer wrinkles, the risks of needle-free fillers greatly outweigh the benefits.
Serious injuries can occur. After using a needle-free filler, some people have permanent damage to their skin, lips, or eyes.
Reports of serious injuries led the FDA to issue a safety warning. The FDA asks that you:
DO NOT use DIY needle-free devices to inject fillers.
DO NOT get a filler if the person will use a needle-free device.
This FDA safety warning about DIY needle-free devices applies to pens that are sold as a needle-free way to inject fillers at home.
Why do needle-free fillers cause injuries?
Needle-free devices use intense pressure to force a filler into the body. This intense pressure can seriously damage the area being filled. For example, using a needle-free filler to diminish crow’s feet can put too much pressure on the eye, causing permanent eye damage or blindness.
The force used to push the filler into the lips can lead to lumpy, unevenly shaped lips. If the filler blocks a blood vessel in your lips, you can develop necrosis. This means the skin and tissue beneath begin to die. You’ll need immediate medical care to prevent further damage and to heal.
Sometimes, a blocked blood vessel causes a stroke.
People have also developed scarring, discolored skin, an infection, and other unexpected side effects from a needle-free filler.
How do I know I’m getting a needle-free filler?
The terms “needle-free,” “needle-less,” or “needle-free injection” are often used. You’ll find these terms used to describe products like pens and other devices sold online to inject fillers at home. While anyone can buy these devices and the fillers, the FDA has not approved any of the devices or fillers sold online.
If you find anything like this online, resist the temptation to buy it. Even if the product is trending on social media, remember that these devices can cause serious injury.
Some beauty bars, spas, and other businesses that provide beauty services offer needle-free or needle-less fillers. Sometimes, the service is promoted as a needle-free way to have fuller lips or fewer wrinkles. While this may sound like an easy and affordable way to get fillers, remember that it can lead to a serious injury.
When needle-free isn’t mentioned, it can be difficult to know what you’re getting. If you’re wondering, ask. If you still cannot tell, it’s better to say no to a product or service than risk serious injury.
What should I do if I already had a needle-free filler?
If you’ve had a needle-free filler and developed a side effect, it’s best to get checked by a medical doctor like a board-certified dermatologist. You may need medical care. Possible side effects like lumps in your lips, an open sore, or dying skin that’s turning black can be treated. The sooner you get care, the better.
Seeing a dermatologist can be helpful because these doctors are the skin experts. They also know fillers, so they understand what can go wrong when a filler is forced into the skin.
In addition to getting medical care, anyone who has developed a side effect caused by a needle-free filler is asked to report this to the FDA. You can report the problem through the MedWatch Voluntary Reporting Form.
If you had a needle-free filler and didn’t develop a side effect, consider yourself lucky. If you get another needle-free filler, you could develop a serious side effect next time. With needle-free fillers, the person injecting it cannot control where the filler goes. That next needle-free injection could block a blood vessel or leave you with lumpy skin.
Is there a safer way to get fillers?
Yes. See a board-certified dermatologist. Injecting fillers safely requires medical knowledge and experience, which dermatologists have.
Dermatologists use medical-grade, FDA-approved fillers. They inject the filler with a needle, which allows them to place the right amount of filler where it’s needed and without force.
All FDA-approval fillers have been studied and proven safe and effective when injected into specific areas of the face or hands by a licensed medical professional.
Before a dermatologist gives any patient a filler, the patient receives a medical evaluation. Dermatologists do this to find out whether a filler is safe and effective for you. Only patients who can be safely and effectively treated receive a filler, which your dermatologist may call a dermal filler.
While seeing a dermatologist for a filler may cost more than a needle-free filler, it’s well worth the investment. You protect your health and avoid irreversible damage to your skin. A dermatologist will also tell what you can expect from the treatment and give you get better cosmetic results. You won’t get this with a needle-less or needle-free filler.
To speak with a dermatologist about fillers, you can find a dermatologist who offers fillers by going to Find a dermatologist. Then click on Filters. From Any Procedures, select Fillers.
Related AAD resources
Dermatologists warn consumers about the dangers of buying cosmetic injectables — such as fillers — online
U.S. Food and Drug Administration. “Do not use needle-free devices for injection of dermal fillers.” FDA Safety Communication. Content current as of 10/8/2021.
U.S. Food and Drug Administration. “FDA warns public and health care professionals not to use needle-free devices for injection of dermal fillers.” FDA In Brief. Content current as of 10/8/2021.
Voelker R. “Needle-free dermal filler injectors prompt safety warning.” JAMA. 2021;325(19):1899.
Paula Ludmann, MS
Matthew J. Elias DO, FAAD
Amanda Friedrichs, MD, FAAD
Chesahna Kindred MD, MBA, FAAD
Shari Lipner, MD, PhD, FAAD
Last updated: 1/3/22