Nexplanon is a small, flexible contraceptive implant placed just beneath the skin on the inner side of your upper arm. It continuously releases the hormone etonogestrel to prevent pregnancy for up to three years. For removal, a healthcare provider makes a small incision, typically 2 to 3 millimeters, to extract the implant. Proper post-removal care is important for preventing infection, minimizing scarring, and ensuring the wound heals cleanly.
The 24-Hour Rule: Showering and Water Exposure
The immediate concern after Nexplanon removal is keeping the site dry for the first 24 hours. Following the procedure, your healthcare provider covers the incision with steri-strips, an absorbent pad, and a large pressure bandage wrapped around your arm. This outer compression bandage must remain completely dry and in place for a full day.
The 24-hour waiting period allows the incision site to begin the initial stages of clotting and tissue repair. The pressure bandage helps to minimize bruising and swelling, which is common after any minor surgical procedure. Exposing the wound to water during this time can compromise the bandage’s integrity and increase the risk of bacteria entering the fresh wound.
After the initial 24 hours have passed, you can safely remove the outer pressure bandage and take a quick shower. While a shower is acceptable, soaking the area is not. You must avoid submerging your arm in a bathtub, hot tub, or swimming pool for at least the next few days. Soaking the wound site can soften the remaining steri-strips and introduce bacteria, potentially delaying the healing process.
Managing the Removal Site and Healing Timeline
Once the outer pressure bandage is removed at the 24-hour mark, you will notice the smaller steri-strips or butterfly bandages directly over the incision. These strips act as sutures for the small wound, pulling the edges of the skin together for neat healing. They should be left alone and kept as dry as possible to allow them to work effectively.
The steri-strips are designed to fall off naturally, typically between three and seven days after the procedure. Do not pick at, peel, or forcibly remove them, as this could reopen the incision or interfere with scar formation. If they remain firmly in place after seven days, you may gently soak them in the shower and peel them off.
The removal site will likely show bruising, slight swelling, and tenderness, which are normal side effects. Bruising can be quite noticeable, ranging in color from purple to yellow, and generally resolving within two weeks. Applying an ice pack wrapped in a cloth to the site for short periods during the first 48 hours can help reduce swelling and discomfort.
Limit strenuous activity or heavy lifting with the affected arm for at least 48 hours following the removal. Intense exercise, especially movements that strain the upper arm like weightlifting, could put excessive tension on the incision site. Most providers recommend avoiding such vigorous activity for up to one week to ensure the wound remains securely closed and heals without complication.
Signs of Complication and When to Contact a Doctor
While Nexplanon removal is generally straightforward and complications are rare, monitor the site for signs of infection or abnormal healing. Mild pain and tenderness are expected, but pain that significantly worsens or spreads beyond the immediate area after the first two days is a concern. Local redness and warmth common immediately after the procedure should begin to diminish, not increase.
Specific visual signs that warrant contacting your healthcare provider include:
- Excessive or spreading redness on the skin.
- Pus or foul-smelling discharge from the incision site.
- A fever (100.4°F or higher), which signals a systemic infection requiring prompt medical attention.
Contact a doctor if the incision site opens before the steri-strips have fallen off naturally. While minor bruising and slight itching are common, rapidly expanding swelling or a sudden change in sensation, such as numbness or tingling in the forearm or hand, should be reported immediately. These symptoms help distinguish normal post-operative discomfort from a developing complication.