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

Botox is one the most sought-after skin rejuvenating procedures used to address static and dynamic wrinkles for people of all ages. This minimally-invasive treatment is FDA-approved and considered very safe to use. However, as with any other injectable, there are risks and side effects of Botox that you should know before going under the needle. 

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 is a skin-rejuvenating injectable that temporarily reduces the appearance of static 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 weakens the facial muscles, causing your facial expression to tighten and create smoother and more youthful skin. 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 muscle-related conditions. Our focus will be more on cosmetic Botox. 

How Is Botox Administered?

A trained skin specialist performs Botox injections after consulting 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 after a 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. 

Common Botox Side Effects

Botox injections are safe when prepared to FDA standards and administered by a licensed skin specialist. Nonetheless, the treatment can cause some side effects, most of which are temporary and resolve within a few days or weeks.

If they last longer or become more severe, you’ll want to talk to your doctor or pharmacist for further guidance immediately. The most common Botox side effects often occur close to the injection site due to needle trauma to the skin. They include: 

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

In rare cases, Botulinum toxin may spread to other parts of the body where it’s not needed, causing further effects like:

• Blurred vision
• Trouble breathing
• Allergic reactions like itching or rash
• Muscle weakness all over the body
• Severe headache
• Loss of bladder control
• Neck pain

We recommend against having the procedure done at a spa or salon to protect your health and safety. 

Short-term Side Effects of Botox

Here’s a detailed overview of the short-term effects of Botox.

1. Bruising

All injections can lead to bruising at the insertion site, so it’s only natural that Botox can cause the same effect. The needle causes bruising, which has to pierce through the targeted muscle to ensure that the treatment reaches the required depth. 

It’s more apparent on the forehead, especially when treating a frown line or getting a brow lift. While it’s easy to panic, this effect is extremely normal and should be gone within a few days.

2. Headache

Some patients report headaches following Botox injections, but researchers have no consensus regarding the cause. Some theories blame potential impurities in some batches of Botox, over-contraction of certain facial muscles, and accidental bumping of the needle on the frontal forehead bone. 

Luckily, it’s simple to treat headaches with OTC medications like acetaminophen and get relief after a few hours. Be sure to discuss your symptoms with your doctor or dermatologist for the best recommendations based on individual circumstances.

3. Dry Mouth

You may experience a dry mouth after your Botox treatment. It is a common side effect that disappears within a few days. Some of the symptoms that indicate you have a dry mouth include:

• Sticky mouth
• Thick or stringy saliva
• Dry or hoarse throat
• Having trouble swallowing

If you experience this, you can take small seeps of water, chew sugarless gum, suck sugarless candy, and avoid breathing through your mouth.

4. Eyelid Drooping

Botox injections between the eyes or into the forehead muscles can cause droopy or irritated eyelids. It occurs mainly when some medicine seeps into the upper eyelids, paralyzing the muscle that holds them up. 

While this is slightly alarming, the effect disappears within a few weeks. You can avoid this by not rubbing the treatment site after the injections to ensure the Botox stays in place until it’s fully absorbed. 

5. Dysphagia

Dysphagia or difficulty swallowing can occur after Botox treatment, even when administered by an expert. Remember, the response to these injections varies among patients. While a given dose may not be sufficient for someone, it can be too much for another. Dysphagia can result from the spread of toxins to the nearby muscles, especially when the treatment is in excess. It’s temporary and resolves within 2-10 days. 

Always inform your doctor about your symptoms to adjust your doses in the subsequent treatments. Meanwhile, you can use a straw to swallow fluids and eat soft foods before the botox side effect resolves. 

6. Muscle Weakness

Another common short-term effect of Botox treatment is muscle weakness, often caused by restricted communication of nerves and muscles. It eliminates the muscle’s tension-generating capacity, causing weakness. The effect may also result from too much toxin on the treatment site. 

It’s usually expected in first-time patients before their bodies get used to the treatment, especially those treating limb spasticity and muscle spasm. Muscle weakness may feel strange, but it disappears within a week. Your Botox provider should continue to monitor you for any additional symptoms.

7. Allergic Reactions

Hives, swelling, itching, and redness after Botox injections may indicate that you are allergic to the treatment. Most cases of allergic reactions occur in patients with underlying conditions. It’s best to consult your doctor immediately to avoid adverse reactions, no matter how mild the symptoms are.

Long-Term Side Effects of Botox

Although uncommon, Botox injections can result in long-lasting side effects. A study by Karger International reveals the presence of long-term effects such as:

• Respiratory compromise
• Sarcoidal granuloma is the growth of granulomas (small collections of inflammatory cells) around the eyes or other body parts. It may result from a hypersensitivity reaction to Botox. 
• Cervical kyphosis is exaggerated neck curvature.
• Drooping eyelids (marked bilateral ptosis) may also be persistent.
• Necrotizing fasciitis is the death of soft tissues in the body.

According to the study, these Botox side effects commonly occur after therapeutic use. Still, you could occasionally notice them in cosmetic uses.

Other possible long-term Botox side effects of this treatment include

• Skin discoloration and wavy texture due to uneven distribution of the neurotoxin
• Visible thinning of the skin
• Difficulty emptying the bladder or urinary retention
• Worsening of a pre-existing neurological disorder
• Corneal ulcers- a painful open sore on the cornea

An overdose or misuse of Botox may cause permanent muscle paralysis over time. Even worse, contaminated or counterfeit products can lead to life-threatening effects like botulism. Most of these issues happen when you go to a clinic with no license and unqualified physicians.

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 identify a qualified medical professional. Physicians without formal training in cosmetic procedures can expose you to life-threatening Botox side effects which you could have otherwise avoided. 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 difficulty breathing and speaking, chest pains, vision problems, and inability to control your bladder are red flags and require immediate attention. In most cases, they indicate that the neurotoxin has spread to other parts and can appear hours to weeks after the treatment. 

Keeping note of what you should expect after the injections or otherwise can greatly help. Some effects like swelling, bruising, tenderness, dry mouth and mild headaches may not be an emergency. But you should always report them to your provider regardless of how mild they are. 

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 finding a certified plastic surgeon or 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.