Yes, People Can Tell If You’ve Used Injectables. Here’s How Cosmetic Nurses Know.

One time, while getting Botox from a new provider, the injector smiled as she stuck the needle into my forehead.

“I can tell you’re good about using sunscreen,” she said. “The needle is going in smooth as butter.”

She was right. I diligently apply SPF 30 or higher every day. And the insight made me wonder what else a cosmetic injector or aesthetic nurse could assess just by looking at or touching a patient’s face.

We interviewed three cosmetic injectors who revealed what they could tell about a person’s skin care and lifestyle habits from a single visit.

They can see your dedication (or not) to sun protection

Skin and health experts agree that protecting your skin from the sun with SPF on a regular basis is vital for maintaining healthy skin and decreasing your risk of skin cancer — and if you’re not keeping up with your sun protection, a cosmetic nurse can tell.

“Patients that are using sunscreen and retinoid diligently typically have very clear skin,” said Ginille Brown, a registered aesthetic nurse and the founder of Ginille Beauty Aesthetics in Los Angeles.

Meanwhile, if a patient has “copious amounts of fine lines, [it] usually means they do not use a retinol or sunscreen,” added Denisse M. Serrano, an aesthetic physician’s assistant with SkinSpirit in Park Ridge, New Jersey.

If a patient’s skin has a “leathery” look to it, that could be a sign that they’ve made a habit of using UV tanning beds or tobacco, noted Serrano.

They can tell if you’re using the correct skin care ingredients for your skin type

If you’re slacking on your skin care practices or if your skin care routine isn’t well-suited for your skin’s particular needs, there are signs a cosmetic nurse can spot.

A patient with “very dry, flaky skin” may not “adequately moisturize and hydrate their skin,” said Marina Sominsky, a registered nurse and owner of Capital Aesthetics in Ottawa, Ontario. “Additionally, someone with dehydrated skin may be moisturizing, just with a product that does not have the right ingredients.”

“If someone is peeling a lot on their face, looks inflamed, or has redness, they may be using too many active or harsh ingredients, which is drying them out,” Brown added.

However, it’s important to note that these signs are clues and not definitive answers. “Skin appearance is also genetic,” Sominsky said, adding that “it is hard to say if a person’s skin condition is directly related to their skin care practices” or if it’s a result of their genetic predispositions.

They can tell if your skin is aging well

Looking at a patient’s skin can give a cosmetic injector a good idea of how old that patient is. “Usually in the late 20s and early 30s, people start seeing early signs of aging, where fat pads on the face start separating and sinking,” Brown said. “Quite often, people start noticing a line from their under-eyes that extends through their cheeks, smile lines or nasal labial folds.”

And if a patient’s age doesn’t match the visible aging signs on their face, it may be an indicator of lifestyle habits, including exercise and cosmetic treatments.

“If a patient looks a lot older than their age, they may have had recent significant weight loss or a very active lifestyle. When we lose weight, we also lose fat in our face. A fuller face typically shows signs of youth,” Brown said. “Usually, if a person 30-plus years old has no etched forehead lines and their forehead looks relatively smooth when they are talking and animating, that is a good sign that they’ve had Botox injected.”

They know about your history with injectables, such as filler or Botox

Though Botox and fillers can get a bad rep for making it look like a person has had “work done,” well-placed Botox and fillers by a skilled, licensed professional can actually be quite tough to spot with the untrained eye. A cosmetic nurse, however, knows exactly what to look for.

“A person who has little expressive facial movement in the forehead and around the eyes when talking may be suggestive that they have had Botox treatment to combat fine lines,” Sominsky said, adding that “this is not necessarily a bad thing and is usually undetectable to the untrained eye if the treatment is well done.”

She also noted that because neither of these treatments is permanent, “if a patient had the treatment many years ago, it would be much more difficult to detect at first glance.”

Bad Botox or bad fillers, on the other hand, stand out like a sore thumb. “With filler specifically, someone’s face may look ‘blown up’ while the rest of their body is more thin,” Serrano said. “Someone who is using filler may have overfilled lips or under-eye troughs, both of which are things I see daily.”

“If just the cheeks and lips are more youthful than the lower face, that discrepancy can be a sign that someone has done injectables on just a certain part of the face,” Brown added. “It’s for this reason that I tell patients to consider their entire face when getting cosmetic treatments. If we just spot treat areas, things can look ‘done’ or a little off.”

Even if fillers can’t be seen, they can be felt in the form of nodules or lumps under the surface of the skin. “Sometimes, patients have filler in their face that was done several years prior. I am not always able to see that, but if I touch certain areas of the face, sometimes I can feel it,” Brown said.

Lip filler is the easiest injectable to spot

“Filled lips are easier to spot [than other injectables], as it is common for the cupid’s bow to flatten out when the upper lip is filled,” Sominsky said. “Additionally, the lips will appear closer to the same size when, naturally, our bottom lip is more prominent.”

Brown even said she’s often able to guess the specific brand of lip filler a person has been injected with based on the texture and hydration of their lips. (She declined to provide further details as to which brands coincide with which visible features.)

Even if a cosmetic nurse can’t see well-placed lip filler with the naked eye, they can typically detect its presence through touch. “When done properly, [lip filler] may not be visibly detected, but I may be able to feel it with my fingers,” Serrano noted.

Injecting a needle into someone’s skin also gives hints about their skin habits

Along with feeling a patient’s skin for signs of lifestyle habits, cosmetic nurses say that the ease with which a needle enters a person’s skin is another giveaway.

“I can also tell if someone has acne scarring if I am having trouble introducing the needle,” Serrano said. “If you don’t have scarring on your face, that means your skin is supple, hydrated and healthy.”

“If there is difficulty putting the needle in a patient’s skin, it may be due to scar tissue or previous filler in an area,” Brown added.