Common And Uncommon Side Effects Of Botox

Written by Malini Fowler, MD, Board Certified Dermatologist on January 26, 2021 One Comment

botox side effects

Botox is an injectable drug that’s best known for its wrinkle-reducing powers. In recent years Botox has also been used in a variety of off-label ways like addressing overactive bladder, lazy eye, neck spasms, excessive sweating and migraines.

Botox was first approved by the Food and Drug Administration in 1989 and in the decades since has been extensively studied. A combination of research and over 7 million injections per year confirm that Botox is safe for use.

As with any drug, there are possible unwanted side effects of Botox. Most side effects of Botox injection are harmless and quickly subside without any further intervention, while others may cause more significant problems in a small percentage of cases. Here is a quick rundown on the possible side effects of Botox

What is Botox?

Botox is a neuromodulator made from the onabotulinumtoxinA toxin. This toxin is produced by clostridium botulinum bacteria and is the same toxin that causes botulism, a rare and potentially fatal type of food poisoning.

Therapeutic injections use much less of the toxin, however, making it relatively safe. When used cosmetically, the amount of toxin that enters the body is even less, as are the potential side effects.

Botox works by temporarily paralyzing muscles in the face by blocking certain nerve signals. When the targeted muscles are no longer able to contract, the appearance of wrinkles and fine lines improves.

While Botox is the first drug of its kind to make use of the botulinum toxin, there are now several others on the market, including Dysport and Xeomin.

Common Side Effects of Botox

The vast majority of unwanted side effects from Botox are minor and temporary. Much of these issue stems from the process of injection rather than the neurotoxin itself. Short-lived side effects associated with Botox can include the following:

  • Pain at the injection site
  • Swelling or bruising at the injection site
  • Bleeding at the injection site
  • Redness
  • Headache
  • Fever or chills
  • Injection site infection

These types of side effects should last no longer than 1-3 days. Botox is naturally absorbed by the body over time, and will fade completely within 3-6 months. This is why periodic maintenance treatments are necessary to extend results for a longer term.

Serious Botox-Related Complications

Serious side effects resulting from cosmetic Botox treatment are extremely rare. In its first 14 years of use, studies confirmed only 36 cases of detrimental side effects, 13 of which were related to pre-existing conditions.

If you have been poisoned by Botox, it looks very similar to botulism. If any of the following symptoms are present, call your doctor immediately:

  • Shortness of breath or difficulty breathing
  • Slurred speech or difficulty speaking
  • Difficulty swallowing or swelling of the tongue
  • Drooping eyelids, blurred or double vision, or difficulty seeing
  • Loss of bladder control
  • General muscular weakness

These symptoms are a sign of neurotoxin poisoning. If left untreated, they can cause irreversible damage, including death. The presence of any of the above symptoms are reason to contact your doctor right away, even if you’re unsure of their severity.

How to Minimize Unwanted Side Effects

The best way to ensure the safety of your Botox injections is to see a board certified provider, typically a dermatologist, plastic surgeon, or nurse injector. An experienced injector will ensure your Botox medication is dosed according to FDA standards. There’s no replacement for education and experience.

Do not use Botox if you have an allergy to cow’s milk proteins. It’s also not recommended for those who are pregnant or breastfeeding as no safety studies have been done on these populations.

Preparing for Your Botox Procedure

Tell your doctor ahead of time if you’ve had any injections of neuromodulators in the past. This is especially important if you’ve had your injections within the last 6 months, as re-injecting could lead to a dangerous accumulation of the toxin.

Tell your doctor about any other medications you are currently taking, or have taken in the near past. This includes blood thinners, muscle relaxants, sleeping aids, or allergy medicine.

During Your Botox Procedure

Botox injections take place in your doctor’s office and are relatively quick and painless. Some areas, however, are more sensitive than others, so your doctor may use a numbing agent to reduce pain at the injection site.

After Your Botox Procedure

Immediately after your injections, avoid touching your face to prevent infection. Avoid rubbing or massaging the area for at least 24 hours, even if you are feeling some pain. This prevents toxin from spreading to other areas of the face and body. It is safe to apply ice instead, just be careful not to exert too much pressure on the injection site.

With the correct preparation, administration by a experienced provider, and proper after care Botox injections carry minimal risk. If you have any concerns about how your body might react to Botox, please consult your doctor.

Malini Fowler, MD

Dr. Malini Fowler is a Board Certified Dermatologist that completed her undergraduate studies and graduated summa cum laude from the University of St. Thomas in Houston, Texas. She is a fellow of the American Academy of Dermatology and member of the American Society for Dermatologic Surgery. Dr. Fowler enjoys providing medical, cosmetic and surgical dermatology at our new San Antonio office.

One Response to “Common And Uncommon Side Effects Of Botox”

  1. Avatar Daniel says:

    Hi, I had a chin Botox few days ago. Still waiting for the results. But I was very afraid of this treatment as I thought it might affect the way I smile. So far, its all going good!

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