Botox Recovery and Aftercare

Botox Recovery and Aftercare: What You Should Do to Ensure the Best Results 

Updated on April 30, 2021, by Don Mehrabi

Botox treatment is one of the fastest ways to get rid of wrinkles and other skin flaws. Patient recovery is also quick, requiring little by way of aftercare. Here, we explain the pain-free recovery process after a Botox procedure and what you can do to enhance its effectiveness and safety.

What Is Botox Treatment?

“Botox” is short for “botulinum toxin,” a nerve poison produced by the bacterial canned food contaminant Clostridium botulinum. Technically, “Botox” is also the brand name of a drug derived from this toxin.

Botulinum toxin stops the release of the chemical acetylcholine in the nerve endings. Acetylcholine has many roles in the body, including the control of voluntary muscles, such as those in the face.

At large doses, the toxin causes potentially fatal botulism, which presents with profound muscle weakness in the head and neck areas. However, it can remedy various medical conditions when delivered in much smaller quantities. This is what we know today as “Botox treatment.”

Since the 1990s, Botox injection has been used to treat conditions caused by disordered muscle contraction. They include the following:

  • Involuntary eyelid twitching
  • Some cases of crossed eyes
  • Neck muscle spasms
  • Chronic migraine
  • Urinary incontinence from an overactive bladder

The FDA approved Botox injection for cosmetic use in 2002. Compared to a facelift, it offered similar cosmetic results but was proven to be safer, more cost-effective and led to shorter recovery periods. Since then, it has become the treatment of choice for facial wrinkles, and its dermatologic applications continue to grow today.

  • In the treatment of fine lines and coarse wrinkles, Botox paralyzes facial muscles that fold the skin and help form these blemishes.
  • Acetylcholine regulates sweat gland activity, so Botox may also be used to stop excessive sweating.
  • Botox injection can combine with other treatments for some chronic skin conditions that produce severe itchiness.
  • Botox likewise curbs oil gland activity, so it is also indicated for acne treatment.

Dysport is an alternative botulinum toxin formulation that BHSkin Dermatology specialists sometimes use in place of the Botox brand. It works faster but may only be injected in specific areas of the face. Read our guide for more information on botox vs dysport.

What Happens During a Botox Procedure?

At the start of your session, your cosmetic dermatologist will clean the injection site. Botox will then be delivered using a very fine needlepoint. You may need more than a single injection depending on your facial muscle arrangement or the complexity of your skin condition.

The procedure takes only a few minutes. Patients usually do not require numbing medication. The injections may cause some discomfort, but this is tolerable.

How Long Does It Take for Botox to Work?

The timeline of Botox’s clinical effects is different for every patient. However, most will observe smoothening of the treated skin by the 3rd day after the injection. The maximal effects will appear around the 2nd week. The recovery of muscle function is gradual, and facial lines may become noticeable again 3-4 months after your treatment. You may schedule your next Botox appointment by then to keep the skin from going back to its previous condition.

After several treatments, the target facial muscles become increasingly weaker and take more time to recover their strength. Your sessions may become fewer over time, as maintenance treatments tend to have effects longer than 4 months.

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What Should I Watch Out for After My Botox Treatment Session?

The toxin is injected in very small doses and in limited areas of the skin, so the procedure is generally safe. The most common side effects of a Botox cosmetic treatment are swelling, redness and pain at the injection site. Vulnerable individuals may also notice some bruising and pinpoint bleeding. All of these are usually mild and resolve quickly, so most patients can tolerate them.

Localized botulinum toxin injection does not cause drowsiness or whole-body paralysis. You may leave the clinic and drive home as soon as your session is done.

On its own, the complications of this cosmetic procedure are rare. They include the following:

  • Severe pain on the injection site
  • Hypersensitivity to the toxin
  • Mild to moderate headache
  • Altered sensation on the treated area, e. g. pins-and-needles sensation, numbness, etc.
  • Infection on the injection site
  • Developing antibodies against the toxin, which can make repeat treatments ineffective
  • Sudden blood pressure drop and fainting (vasovagal episode)

Nearby muscles may also grow weak, but this happens even more rarely. It can manifest anytime within the first few weeks of a Botox procedure and last for a few months if left untreated. It may present as any of the following:

  • Eyelid drooping
  • Eyebrow drooping
  • Double vision
  • Stroke-like facial weakness
  • Paralysis of other head and neck muscles

Inadvertent toxin spread in the eye areas produces unsatisfactory cosmetic results. Ophthalmic apraclonidine and similar drugs can reverse the side effects. However, it may still convince patients to get their Botox injections elsewhere.

If you start having trouble speaking, swallowing, or breathing, these are signs that the toxin has spread to the more distant head and neck muscles. The risk of these side effects happening after a cosmetic Botox injection is insignificant, though they are life-threatening. Seek medical help right away if you notice these changes.

You can avoid unwanted side effects by choosing the best Los Angeles dermatologist with extensive cosmetic Botox experience. At BHSkin Dermatology, our award-winning skincare specialists are some of the best in the field. Once they treat you, you will never look for another dermatologist again!

Botox Aftercare and Recovery: What You Should and Should Not Do After the Procedure

There is no surgical wound to care for after a Botox procedure, unlike when you have facial plastic surgery. However, you must avoid the following activities in the first 4 hours after your treatment as they may spread the toxin out to other areas:

  • Lying on your back
  • Scratching the site
  • Applying pressure or heat on the treatment area
  • Exercising, going to the sauna, sun exposure and other activities that cause flushing

You may go back to your normal activities after this period. You can even wear makeup and resume your skincare regimen as soon as it is over.

If you’re the kind of patient that bruises easily, you may benefit from the following treatments:

  • Put an ice pack on the site before and after the procedure, letting it stay on for 15 minutes each time. You may do it again every 2-4 hours after the injection or as long as you feel pain in the area. Icing is most effective within the first 24 hours of Botox treatment.
  • Avoid vigorous exercise for up to 2 days after Botox injection. Exercise increases blood flow to the skin, and consequently, the risk of bruising.
  • Take supplements with anti-bruising properties, such as Bromelain and Arnica montana, days before and after your Botox appointment.
  • Use extra pillows under your head at bedtime to avoid pressure and control blood flow in the injection site.
  • Continue to avoid facial treatments, especially injectables like hyaluronic acid, for a few more days. Such treatments may traumatize the skin further.

Your dermatologist will also advise you to avoid alcohol, blood thinners and some herbal supplements for a while as they can also cause bruising.

Who Should Not Get Botox?

The treatment has a wide margin of safety, but it is not for people with the following conditions:

  • History of an allergic reaction to botulinum toxin
  • Localized or systemic infection
  • Pregnancy and breastfeeding
  • Disorders that affect muscle function, such as myasthenia gravis, multiple sclerosis and Lou Gehrig’s disease (ALS)
  • Intake of drugs that affect muscle movement or acetylcholine activity. They include medications for certain infections, heart disease, glaucoma, Parkinson’s disease, Alzheimer’s disease, bladder muscle dysfunction, etc.
  • Blood clotting problems or intake of a blood thinner like aspirin

Your dermatologist will determine your fitness for the procedure based on your medical examination.


Botox treatment is a facial rejuvenation procedure that involves paralyzing target facial muscles with the botulinum toxin. It can get rid of most wrinkles as effectively as a facelift, though it is safer and more cost-effective. Its side effects are typically minor, and it requires minimal to no downtime.

To guarantee the success of your Botox treatment, your dermatologist will give you a full medical examination, making sure that it is the right procedure for you. Adherence to the aftercare regimen is likewise crucial. Lastly, to get the best cosmetic results and avoid unwanted side effects, you must entrust your Botox injections only to highly experienced skincare professionals.

Filters Are Awesome… Until They Want to Meet You Face-to-Face

Looking fabulous at any age is a gift. Some people can fake it by using filters. But what if that hot prospect wants to meet you in person? Wouldn’t it be nice to have gorgeous, blemish-free skin for real?

At BHSkin Dermatology, our board-certified dermatologists specialize in a wide range of facial rejuvenation treatments. Consider them the Great Houdinis of skin flaws! Visit our Glendale or Encino clinic or use our telederm portal so they can start working their magic on you.

Time waits for no one. Book your appointment now!


Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online

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