Botox Injections: A Guide to Cosmetic and Medical Botox

Medically Reviewed By Angelica Balingit, MD

Botox injections are a popular cosmetic treatment to help smooth wrinkles. However, they can also be used for medical reasons, such as chronic migraine and overactive bladder. This article defines Botox injections. It also explains both their cosmetic and medical uses. Finally, it goes over how Botox injections are given and the risks and complications of using them.

What are Botox injections?

Doctor preparing to give an injection in a person's forehead
Liliya Rodnikova/Stocksy United

A Botox injection is a minor procedure that treats lines and wrinkles on the face and neck. A Botox injection contains botulinum toxin, a neurotoxin that relaxes muscles to smooth out lines and wrinkles. Botox temporarily creates a more youthful appearance. You must repeat Botox injections every 3–6 months to maintain results.

A Botox injection is only one method to treat wrinkles and aging skin. Discuss all of your treatment choices with your doctor to understand which option would be the most effective for you.  

Botox can also be used to treat certain medical conditions and issues. For instance, your doctor may recommend Botox injections as treatment if you experience chronic migraine or excessive sweating.

Many types of doctors and other professionals perform Botox injections. It’s important to find the right professional to give you a Botox injection. Choose a professional who is licensed and specializes in facial aesthetics (cosmetics) and has experience in injecting Botox, such as a dermatologist or plastic surgeon

What are cosmetic uses for Botox injections? 

Injectable treatments like Botox are the most popular cosmetic procedure in the United States, according to the American Board of Cosmetic Surgery. This board states that more than 3.6 million people in the United States had treatments like Botox injections in 2021.

Botox-type injections can help adults of any age have a refreshed and more youthful look. These injections are typically used to smooth lines and wrinkles on your face. Some of the most common areas for Botox injections include:

  • glabellar lines or frown lines
  • crow’s feet or wrinkles around your eyes
  • corners of your mouth
  • forehead creases
  • skin dimpling on your chin

What are medical uses for Botox injections?

The U.S. Food and Drug Administration (FDA) Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source has approved Botox injections for cosmetic use, as well as to treat certain medical conditions and issues.

The medical conditions Botox can be used to treat include:

  • overactive bladder
  • bladder leakage issues due to neurologic disease
  • headache prevention in adults with chronic migraine
  • increased muscle stiffness in adults with limb spasticity
  • cervical dystonia (CD) which causes severe muscle contractions in the neck and shoulders
  • issues with the muscles in the eye or strabismus
  • eyelid spasms or blepharospasm

How is a Botox injection given?

Botox injections are typically performed in a clinical setting. The procedure usually includes the following steps:

  1. Your doctor will determine if you are a candidate for Botox injections. This includes performing an exam, taking a medical history, and asking about your goals and expectations for Botox injections.
  2. Your doctor will develop a personalized treatment plan and discuss it with you.
  3. Your doctor may numb your skin in the injection area with a cold pack or anesthetic cream.
  4. Your doctor will use a tiny needle to inject Botox into the muscles that cause lines and wrinkles or into the site that requires treatment. Each injection takes a few seconds.

Will I feel pain with a Botox injection?

Your comfort and relaxation are important to both you and your doctor. You may feel a brief pinch or prick during the needle insertion. Take a few long, deep breaths to help yourself relax. Tell your doctor if any discomfort does not pass quickly.

A Botox injection causes minimal, brief discomfort and does not generally require anesthesia. Tell your doctor if injections make you nervous or anxious and ask about numbing the area with a cold pack or anesthetic cream before the injection. 

What are the risks and potential complications of a Botox injection?  

Potential complications and side effects of Botox injections include Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source

  • allergic reaction
  • discomfort or pain at the injection site
  • dry mouth
  • eyelid problems including drooping or swelling of the eyelids
  • facial asymmetry
  • fatigue
  • headache
  • infection
  • neck pain
  • pain or swelling
  • redness or discoloration, bruising, or bleeding at the injection site
  • vision and eye problems including dry eyes, double vision, blurred vision, and decreased eyesight

People who receive Botox injections to treat an overactive bladder may also experience the following side effects:

Tell your doctor about any side effects you may experience.

The botulinum toxin that makes up Botox can spread to other areas in rare cases. This can cause a serious disease called botulism

Botulism can cause Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source weakness in other muscles, including muscles that control swallowing and breathing. The spread of the botulinum toxin can be fatal in extreme cases. However, it has not occurred in properly selected patients who receive the recommended dose of Botox. Generally, botulism is only a risk Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source to those who receive improper dosage or too frequent injections of Botox.

Read about the importance of proper injection techniques in facial rejuvenation.

Reducing your risk of complications

The risk of serious complications with a Botox injection is greater in people with certain conditions. Tell your doctor if you have any of the following: 

  • breathing problems or diseases including asthma or emphysema
  • difficulty swallowing
  • history of bleeding problems
  • taking blood thinner medications
  • pregnancy or nursing, or plan to become pregnant or nurse
  • recent surgery or plan to have surgery in the near future
  • side effects from a botulinum toxin product in the past
  • weakness of facial muscles, such as trouble raising your eyebrows

You can reduce the risk of some complications by: 

  • Consulting with your doctor before taking any prescriptions, over-the-counter medications, supplements, or herbal preparations. Certain medications can interact with Botox injections and cause serious side effects.
  • Notifying your doctor immediately of any concerns, such as:
  • Telling all members of your care team if you have any allergies
  • Telling your healthcare team, including your dentist, that you have had Botox injections.

What can I expect after my Botox injection?

Knowing what to expect after a Botox injection can help you get back to your everyday life as soon as possible.

The results of a Botox injection will vary from person to person and typically do not occur immediately. Generally, results can take up to 14 days to be fully noticeable. However, you may notice a difference in your wrinkles in as little as 3 days after the injections.

Your results should last anywhere from 3–6 months. At that point, your lines and wrinkles may gradually return to their normal state. Talk with your doctor about a regular treatment plan to provide continuous results. Your doctor may change the dose of Botox to achieve the best results for you.   

Most patients go home and return to their daily activities right after the procedure. For mild discomfort, you can take over-the-counter pain medications.

Read more about what to expect from cosmetic injections.

When should I call my doctor?

It is important to keep your follow-up appointments after a Botox injection. Contact your doctor for questions and concerns between appointments.

Call your doctor immediately if you have:

  • bleeding
  • fatigue, weakness, or loss of strength
  • fever
  • new or unexplained symptoms
  • pain including neck pain or headache
  • redness or discoloration and swelling
  • bruising or bleeding at the injection site
  • rash, hives, or itching
  • vision and eye problems including dry eyes, drooping eyelids, and decreased eyesight

If you have difficulty breathing after receiving Botox injections, seek immediate medical care or call 911.


Botox injections are a popular cosmetic treatment for lines and wrinkles on the face and neck. They can also be used to treat medical conditions like chronic migraine and overactive bladder.

Overall, Botox injections are considered a safe treatment when administered properly. Severe side effects are rare.

Contact your doctor if you experience side effects such as vision issues, weakness, and itching.

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Medical Reviewer: Angelica Balingit, MD
Last Review Date: 2022 Nov 22
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.