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Botox Side Effects: What you Should Know

by Gauri Kolhe

Chronic migraines, limb spasticity, axillary hyperhidrosis, cervical dystonia, strabismus, and blepharospasm can all be treated with Botox, an injectable neurotoxin. Some of the effects of Botox often disappear 12 weeks after the final injection.

This may occasionally cause the disease to recur. When you stop using Botox, your chronic long-term migraine symptoms could become worse than they were before.

Botox prevents nerve signals from reaching muscles. Consequently, injected muscles are unable to contract. While always transient, these Botox side effects can linger for several months.

The muscle that is injected depends on the main problem region. This substance is created by the bacterium Clostridium botulinum. This is a rare but serious medical illness brought on by wound infections and food poisoning.

Muscles and nerves are impacted by botulism. Therefore, if we consume this toxin, we may have difficulty breathing and swallowing. However, medications like Botox can be utilised for both medical and cosmetic reasons when they are administered in small dosages to particular parts of the body.

Additionally, there is a medical form of Botox that can be used to treat a number of ailments, including migraines, overactive bladder, and excessive sweating.

Methods mainly used to treat major problems, such as:

  • treat certain adult cases of overactive bladder.
  • Treat adult patients with severe axillary hyperhidrosis and cervical dystonia.
  • Treat strabismus in both adults and children 12 years of age and older.
  • Treat urine incontinence brought on by a neurological condition in certain people and some kids aged 5 and older.
  • Treat spasticity in both adults and children 2 years of age and older.
  • Avoiding adult headaches brought on by chronic migraine

How often should you get Botox?

The Botox side effects typically last three to four months. At this point, retreat is advised. However, with time, our muscles may learn to contract less. Treatments might be spread out across longer times as a result. Based on our particular requirements, the doctor can advise you on how frequently you should have Botox injections.

Common side effects of Botox depending on different purpose:

There are a few possible adverse effects of botox, some of which are more prevalent than others. These Botox side effects could be brief, lasting a few days or weeks, but if they persist for a longer period of time or get worse. Depending on the disease that the medication is being used to treat, these adverse effects may change.

Chronic migraine: Patients with chronic migraines who experience 15 or more headaches per month that persist for four hours or longer are treated with botox. Botox is injected into the head and neck muscles in seven different locations to treat migraines. Results typically persist for up to 12 weeks, depending on the patient.

Facial wrinkles: Adults can use Botox Cosmetic to temporarily decrease the appearance of facial wrinkles.

Cervical dystonia: There are a few possible adverse effects of botox, some of which are more prevalent than others. These side effects could be brief, lasting a few days or weeks, but if they persist for a longer period of time or get worse. Depending on the disease that the medication is being used to treat, these adverse effects may change.

Muscle stiffness: Botox is also used to treat adults and kids who are at least two years old who have muscle stiffness (spasticity) in their arms, hands, legs, and feet. Spasticity is an unnatural increase in muscle tone or stiffness that can impair movement, create difficulty speaking, or cause discomfort or suffering.

Eye muscle conditions: In adults and children who are at least 12 years old, Botox is used to treat specific eye muscle issues brought on by nervous system abnormalities. This includes irregular eyelid twitching or blinking, as well as an issue with the eyes not pointing in the same direction (strabismus).

Bladder issues: Adults who have hyperactive bladders and incontinence (urinary leakage) that has not responded to other medications are treated with Botox. Incontinence brought on by neurological conditions like multiple sclerosis or spinal cord injury may be treated with botox.

When an anticholinergic medication does not work well enough or cannot be used, Botox is also used to treat overactive bladder in children 5 years of age and older who have a neurologic illness and Botox side effects (such as multiple sclerosis or spinal cord damage).

Excessive sweating: Adults with hyperhidrosis, or severe underarm sweating, can also be treated with botox.

Mild side effects of Botox:

Use of Botox can have mild negative effects. It’s crucial to remember that depending on the disease the medication is being used to treat, these adverse effects may change. Furthermore, it’s unlikely that someone using Botox to treat a persistent migraine will experience adversely by Botox side effects that affect their bladder or their capacity to urinate.

  • cough
  • dry eyes
  • dry mouth
  • drooping eyelids
  • fever
  • muscle aches
  • nausea
  • neck pain
  • excessive sweating in areas other than the underarms
  • discomfort or pain while urinating
  • pain in the extremities, such as the hands or feet
  • muscle weakness near the injection site
  • sore throat
  • upper respiratory tract infection
  • injection site reaction
  • urinary tract infection

Serious side effects of Botox

Serious adverse effects from Botox are possible. The list of potential reported adverse side effects of the medicine may not be complete. You can consult the Botox prescribing information for more details.

Serious side effects and their symptoms can include:

  • blurry vision
  • feeling that something is in the eye
  • pain and redness in the eye
  • watery eye
  • A white spot on the cornea

Long-term side effects of Botox

Long-term negative effects with Botox side effects are possible, albeit they are uncommon. Long-lasting negative effects include:

  • corneal soreness (an open sore on the cornea, which is the clear covering over the front of the eye)
  • urinary incontinence (trouble emptying the bladder)
  • existing neurological conditions getting worse

A possible Botox side effects of therapy is headache. In clinical trials, those who used Botox to alleviate headaches had them more frequently:

  • chronic (long-term) migraine, which can also produce other symptoms besides headaches
  • neck stiffness (involuntary tightening of neck muscles)
  • Hyperhidrosis of the axilla (excessive underarm sweating)

Urinary retention

Botox injectable adverse effects include urinary retention. You have problems entirely emptying the bladder if you have urine retention. This may result in signs like:

  • difficulty urinating
  • a burning feeling during urination
  • constantly needing to go to the bathroom

People using Botox to treat urinary retention experienced it more frequently:

  • uncontrollable bladder
  • a neurological condition that causes urine incontinence

Patients with diabetes or multiple sclerosis who are taking Botox for the aforementioned diseases may be more susceptible to urine retention due to  Botox side effects. Within two weeks of beginning Botox treatment, the doctor will evaluate the urine volume to look for urinary retention.

For up to 12 weeks, the urine volume may still be observed. Only those who can have a catheter inserted, if necessary, should use Botox to address bladder issues. In order to temporarily help empty the bladder until you no longer have urine retention, a catheter may be utilised.

Upper respiratory tract infection

Botox frequently causes upper respiratory tract infections as a side effect. An illustration of this kind of illness is the common cold. These infections are usually mild among Botox users.

Symptoms of an upper respiratory tract infection may include:

  • cough
  • pressure behind the face
  • runny nose
  • scratchy or sore throat
  • sneezing

side effect was more common among people taking Botox to treat:

  • neck stiffness (involuntary tightening of neck muscles)
  • spasticity (involuntary muscular spasms)

Injection site reaction

Reactions at the injection site are common with Botox. Whatever the issue you are trying to solve with Botox, this side effect can manifest. During clinical trials, individuals using Botox for reported it.

  • Axial hyperthermia (excessive underarm sweating)
  • long-term, persistent migraine
  • spasticity (involuntary muscular spasms)
  • neck stiffness (involuntary tightening of neck muscles)

Following a Botox injection, symptoms can appear a few hours or days later and include:

  • pain
  • tenderness
  • redness or discoloration
  • bruising
  • bleeding

Spread of toxin effects

Botox comes with a boxed warning, the drug’s toxic effects dispersing from the injection site, according to a reliable source. The Food and Drug Administration’s most severe warning is a boxed warning (FDA).

It warns physicians and patients about potentially harmful drug side effects. Botulism is the medical term for when Botox spreads from the place of injection to other areas of the body. Following a Botox treatment, botulism can develop hours, days, or even weeks later.

Symptoms may include:

  • fatigue (lack of energy)
  • trouble breathing
  • trouble speaking
  • trouble swallowing
  • drooping eyelids
  • double vision
  • hoarse voice
  • loss of control over the bladder
  • muscle weakness

Rarely, life-threatening breathing or swallowing difficulties brought on by botulism can occur. People who currently experience breathing or swallowing issues may be more susceptible to developing these serious symptoms.

Allergic reaction

Like the majority of medications, Botox can give some people an allergic response. However, it’s unclear how frequently this adverse effect showed up in clinical trials.

Symptoms can be mild or serious and can include:

  • rash
  • itching
  • flushing
  • swelling beneath the skin, usually in the hands, feet, or eyelids
  • throat, mouth, or tongue enlargement that may cause difficulty breathing

Boxed warning: Spread of toxin effects

Botox comes with a boxed warning. a reliable source on the possibility of the toxic effects of the medicine spreading to areas of the body other than the injection site.

It’s known as botulism. The Food and Drug Administration’s most severe warning is a boxed warning (FDA). It warns medical professionals and patients of potentially harmful drug side effects.

Neuromuscular disorders Those who have neuromuscular conditions like amyotrophic lateral sclerosis (ALS) may be more susceptible to some of the negative effects of Botox.

These might include breathing difficulties and muscle weakness. The doctor will constantly watch you for these adverse effects if they determine that Botox is safe.

Active urinary tract infection We shouldn’t receive Botox injections until the infection has cleared up if you have an active urinary tract infection. Before beginning to use Botox, discuss how to treat the infection with the doctor.

Active infection at a Botox injection site You shouldn’t receive Botox injections if you currently have an infection at the site of a Botox injection until the infection has cleared up. Before beginning Botox treatment, discuss the treatment of the infection with the doctor.

Trouble emptying the bladder If you can’t completely empty the bladder on your own, you shouldn’t use Botox to treat urinary incontinence. However, you might be able to treat urinary incontinence with Botox if you use a catheter to empty your bladder. Before using Botox for this reason, discuss any issues with bladder emptying with the doctor.

Upcoming surgical procedures Before receiving Botox injections, be sure to tell the doctor about any planned surgical treatments you have.

It’s possible that certain anaesthetic drugs used during surgery will interact with Botox and reduce its effectiveness. The physician can assist in coordinating the Botox injections with any forthcoming operations you have.

Allergic reaction If you’ve ever experienced an allergic response to Botox or any of its components, you shouldn’t undergo Botox injections. Ask your doctor what alternative therapies might be the best ones for you.

Alcohol with Botox

Botox injections and alcohol use don’t appear to interact with one another. Alcohol use may increase the likelihood of some Botox side effects, such as:

  • blurry vision
  • dizziness
  • headache
  • tiredness

Pregnancy and breastfeeding while taking Botox

Getting Botox injections during pregnancy may not be safe. Pregnant women have not been studied with the medication. Botox was administered to pregnant women in animal studies without any negative effects. But research on animals does not necessarily foretell human outcomes.

Side effects in children

Some of the certain case where botox is used in certain children to:

  • treatment for blepharospasm (uncontrollable eyelid twitching or blinking)
  • strabismus treatment
  • treat spasticity in the upper or lower limbs
  • Treating an excessively active bladder brought on by a nerve issue neurogenic detrusor overactivity.

Children with strabismus or blepharospasm experienced Botox side effects that were comparable to those experienced by adults with these illnesses. Drooping eyelids are the most frequent adverse effect.

Children with limb stiffness or an overactive bladder may experience Botox adverse effects that differ slightly from those seen by adults with same diseases.

Compared to adults who used Botox for limb stiffness, children were more likely to get an upper respiratory infection like the common cold. The most frequent adverse reaction in children treated with Botox for this illness is upper respiratory infections.

Urinary tract infection was the most frequent adverse reaction in both children and adults who used Botox for bladder issues. Adults receiving Botox for bladder issues frequently had urinary retention, which is the inability to empty your bladder on your own.

Children who used Botox for bladder issues didn’t experience urinary retention. However, in these studies, youngsters with this problem who were getting Botox were already regularly utilising a catheter to empty their bladder.


Inform the doctor or pharmacist if you have any allergies before to using this drug to prevent from Botox side effects, including any to it or other medications. The inactive substances in this product, including the cow’s milk protein included in some products, may contribute to allergic reactions or other issues.

Before using this medication also be sure to let the doctor know if we have ever had bleeding issues, eye surgery, certain eye problems like glaucoma, heart disease, diabetes, signs of infection close to the injection site, urinary tract infections, inability to urinate, muscle/nerve disorders like ALS, myasthenia gravis, seizures, difficulty swallowing, dysphagia, or breathing issues like asthma, emphysema.

This medication may result in impaired vision, droopy eyelids, or muscle weakness. Until we are certain that can perform such activities safely, avoid driving, using machinery, or engaging in any other activity that calls for attention or sharp vision.

Limit the alcohol consumption and to inform the surgeon or dentist that we are taking his medication before to the procedure. This drug’s albumin is manufactured from human blood in some brands.

There is a very small chance that we could contract a serious Botox side effects and infection from the medication, even though the blood is thoroughly checked and this medication goes through a specific manufacturing process.

The adverse effects of this medication, particularly those affecting the urinary system, may be more noticeable in older persons using it to treat overactive bladder. Children taking this medication for muscle spasms may be more sensitive to its side effects, which include breathing or swallowing difficulties.

Only usage of this drug during pregnancy should be obviously necessary. Using it to address wrinkles cosmetically is not advised during pregnancy. It’s unknown if this medicine enters breast milk.

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