Botox Side Effects: How to Prevent Them and When to See a Doctor

Botox is one the most sought-after skin rejuvenating procedures. It is FDA-approved, so it’s effective and safe. However, as with any other injectable, it has risks and side effects you should be aware of before booking an appointment. 

Botox injections are pretty low-risk, especially when performed by qualified skin care specialists like those of BHSkin Dermatology. Below you’ll learn more about the short-term and long-term Botox side effects, tips on preventing them, and when to see a doctor. 

Overview of Botox and How it Works

Botox is among the popular brands of neurotoxins, best known for its use in cosmetic settings. It temporarily reduces the appearance of dynamic wrinkles arising from repetitive facial movements like smiling, frowning, squinting, or laughing. 

When injected into the targeted area, Botox blocks the nerve signals to the muscles preventing them from contracting. It improves the creases arising from the muscles of facial expression. The most common treatment areas are crow’s feet, forehead lines, and frown lines. 

Botox isn’t just for aesthetics. It has been used for decades in the medical industry to treat chronic migraines, excessive sweating, specific bladder issues, and other muscle movement-related conditions. Our focus will be more on cosmetic Botox. 

How Is Botox Administered?

A trained skin specialist performs Botox injections after taking your medical history and the results you want to achieve. The health provider uses a fine hypodermic needle to inject tiny amounts of Botulinum toxin into the targeted muscles. 

There are specific injection patterns for each treatment site. How often you have Botox injections and the number of injections needed per section will depend on the treatment site and the severity of your wrinkles. 

Your doctor might numb your skin beforehand using ice or topical anesthesia to reduce discomfort during the procedure. You may begin to see the results after a few days, but full effects may only be visible by the end of the second week. The treatment results can last between three to six months, after which the muscles’ mobility returns gradually. Regular follow-up injections are necessary to maintain this effect. 

Botox Side Effects

Botox injections are safe when prepared according to FDA standards and administered by a licensed skin specialist. Nonetheless, the treatment can cause side effects.

The most common Botox side effects are mild, occurring close to the injection site due to needle trauma to the skin. They include: 

• Localized pain
• Swelling 
• Tenderness
• Bruising and/or minimal bleeding at the injection site

In rare cases, the following complications can occur:

• Blurred vision
• Trouble breathing
• Allergic reactions like itching or rash
• Muscle weakness all over the body
• Severe headache
• Antibody formation
• Infection

These rare complications occur usually when the Botox provider is unlicensed. We recommend against having the procedure done at a spa or salon to protect your health and safety. 

Who Should Not Get Botox Injections?

Although Botox is considered safe for general use, not everyone is a good candidate for this cosmetic treatment. People with the following situations are at a higher risk for complications when getting the injections. 

• Pregnant or breastfeeding women
• People with neurological disorders
• Those who are allergic to Botulinum toxin
• People who are unwell and currently under other medications

Patients can consider a few viable alternatives to Botox, including cosmetic acupuncture, chemical peels, laser treatment, and dermal fillers.

• Cosmetic Acupuncture: A treatment that aims to increase circulation and blood flow to improve the skin’s appearance and stimulate the creation of stronger elastic fibers and collagen. The doctor uses ultra-fine acupuncture needles to inject the medicine into the targeted areas, including the eyes, forehead, jawline, cheeks, and around the eyes. The procedure reduces the appearance of wrinkles and fine lines, resulting in an overall healthier complexion.
• Laser treatment: Also known as laser skin resurfacing, this treatment works by directing an intense beam of light energy to the skin. Doing this stimulates collagen production, resulting in better skin texture and tone. 
• Chemical peels: A standard acne treatment that also helps reduce aging signs. Glycolic acid is the most commonly used chemical peel—the skin blisters and peels upon application, leaving a fresh and radiant appearance.
• Dermal fillers: If allergic to Botox, consider getting dermal fillers. These minimally invasive injectables use ingredients such as collagen or hyaluronic acid to address facial wrinkles resulting from loss of skin elasticity. You still can’t use dermal fillers if you are pregnant or have a neurological disease. Check out our Botox vs. fillers comparison article to learn more.
  

How to Minimize the Risk of Side Effects From Botox Injections

The most important thing you can do to minimize the risk of side effects from Botox treatment is to entrust it to a qualified medical professional. Individuals without formal training in cosmetic procedures can expose you to life-threatening Botox side effects. Before going under the needle, ask about training and experience in performing Botox injections to ensure your safety. 

It’s also necessary to disclose all pre-existing medical conditions, allergies, or medications to your Botox provider before receiving the treatment. They will review your medical history to determine whether you are a good candidate for the procedure. 

We recommend avoiding the following activities to prevent the common side effects of Botox injections.

• Strenuous exercises for up to two days after injections
• Rubbing the treatment area for 24 hours
• Going to the sauna, excess sun exposure, or other activities that may cause flushing
• Applying heat on the injection site
• Lying on your back 
• Blood thinners, alcohol, and some herbal supplements can increase the risk of bruising
• Facial treatments such as hair laser removal and injectables for a few weeks. They can further traumatize your skin, causing severe effects.

If you are the kind that bruises easily, consider taking anti-bruising supplements such as Arnica Montana and Bromelain before and after your appointment. 

What to Do If You Experience Serious Botox Side Effects

You should never hesitate to contact your dermatologist if you experience any side effects after a Botox treatment. Some symptoms like severe pain, profuse bleeding, fever, pus, difficulty breathing and speaking, chest pains, and vision problems are red flags and require immediate attention. 

Trust BHSkin Dermatology to Receive Safe Botox Injections

Botox isn’t without the risk of developing Botox side effects like any cosmetic treatment, and worrying about them is completely normal. However, you can avoid or easily manage some of these effects by entrusting the procedure to a board-certified dermatologist. 

At BHSkin Dermatology, we care about our patients and want you to feel confident after every procedure. Our skincare specialists take enough time to examine your skin and learn your medical history to ensure you’re safe for Botox injections. 

Book an appointment today and allow us to develop a beauty plan that meets your goals and expectations.

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