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Finding the Right Chronic Migraine Treatment

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Botox for Medical Reasons: 8+ Uses

Medically Reviewed By Megan Soliman, MD

Botulinum toxin (Botox) can be used for medical conditions and cosmetic procedures. Medical reasons for Botox include migraine, overactive bladder, and strabismus. It also has off-label uses for hair loss, plaque psoriasis, and other conditions. Many types of Botox exist, including type A (BoNT-A), type B (BoNT-B), and a type A subtype called onabotulinumtoxinA.

Botox works by temporarily paralyzing targeted muscles. This means it’s an effective treatment for many conditions that cause muscular problems. It can also help with other conditions by affecting the release of chemicals that control body functions.

Read on to learn more about using Botox for medical reasons, its effectiveness, and the possible side effects.

1. Chronic migraine

Someone prepares a needle and vial of medication with gloved hands.
Photography by Catherine Falls/Getty Images

Chronic migraine involves having headache symptoms on 15 days per month for at least 3 months.

Research, including reviews from 2019 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source and 2022 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , suggests that onabotulinumtoxinA injections may reduce:

  • pain and inflammation from migraine
  • migraine frequency
  • migraine severity

Botox may help with migraine by stopping the release of brain chemicals that transmit pain signals and relaxing muscle contractions in your head. However, more research is necessary to confirm the reviews’ results.

Doctors may provide a course of 31–39 small injections Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , with a few given at a time every 12 weeks or so.

Learn more about chronic migraine and its treatment.

2. Overactive bladder

An overactive bladder causes a sudden urge to pass urine. 

A 2020 review Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source reports that BoNT-A may help reduce urgency and incontinence by:

  • temporarily stopping your bladder muscles from contracting too strongly
  • blocking the release of the brain chemicals acetylcholine and ATP, which prompt muscle contractions in your bladder
  • increasing the release of nitric oxide, which helps relax your bladder

Read more about overactive bladder, including its causes and treatment.

3. Hyperhidrosis

Hyperhidrosis is excessive sweating.

Botox injections may help with this condition by blocking brain chemicals that activate sweat glands, according to a 2023 review Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source

The effects of Botox injections for hyperhidrosis may last 6–12 months.

4. Strabismus

If you have strabismus (also known as crossed eyes or squint), your eyes do not align with each other while looking at an object.

Doctors can use Botox to temporarily paralyze Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source targeted muscles around your eye, improving its alignment.

Sometimes, the muscles necessary to properly align your eye gain better control while the targeted muscles are paralyzed, leading to lasting improvements even after the Botox has worn off. However, in most cases, the effects of Botox wear off after a few months.

5. Hemifacial spasms

Hemifacial spasms are involuntary muscle contractions on one side of your face, mostly involving your eyelid. Botox can treat hemifacial spasms by temporarily paralyzing the muscles responsible.

While there are many other treatment options, Botox injections may be the most effective, and doctors may prefer them.

Some research has reported long-term improvements Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source in hemifacial spasms after Botox, but many people may need repeat injections.

6. Cervical dystonia

Cervical dystonia involves involuntary contractions in your neck muscles, which cause involuntary head movement and pain.

Doctors can treat cervical dystonia by injecting Botox into the affected muscles to relax them. This may reduce pain and involuntary head movement, according to a 2020 review of studies Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . However, further evidence is necessary to confirm this finding. 

How often you need injections can vary. Participants in the 2020 review needed further treatment after 1–11 months.

7. Upper limb spasticity

With upper limb spasticity, your arms become tense and stiff, which leads to spasms and limited movement.

The authors of a 2020 review of studies Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source investigated the effects of Botox on children with upper limb spasticity due to cerebral palsy. They suggested that combining Botox with physical therapy temporarily reduced muscle tightness. However, there wasn’t enough evidence to determine whether Botox can improve arm movement.

You may need injections every 3–4 months Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , but this can vary.

8. Depression 

Studies suggest that getting Botox injections around or between your eyebrows may help improve Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source depression and is relatively safe.

Some researchers suggest that Botox may limit frowning and other facial expressions linked to negative moods, reducing the perception of negative thoughts. However, this theory has not been confirmed, and more research is needed to support the effectiveness of Botox for depression.

Read more about how to treat depression.

Off-label uses

Off-label use is when doctors prescribe a drug for a purpose other than what it is approved for.

Possible off-label uses of Botox include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • Rosacea: Rosacea happens when blood vessels in your face enlarge, causing flushing or discoloration. Botox may block chemicals that cause flushing and swelling in rosacea.
  • Androgenetic alopecia or male pattern baldness: Health experts do not know exactly how Botox may help stop hair loss, but some theories Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source suggest that it may be due to relaxing the scalp muscles and reducing the activity of a protein linked to hair loss.
  • Plaque psoriasis: Plaque psoriasis causes dry, raised, itchy patches of skin. Botox may help improve psoriasis and reduce itching.

The Food and Drug Administration (FDA) Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source recommends approaching off-label uses with extra care. Ask your doctor about the following information before going ahead with off-label Botox treatment:

  • the potential benefits and risks of using Botox to treat your condition
  • whether an approved medication could work better than Botox to treat your condition
  • the qualifications of the doctor giving you the medication

Other medical uses 

Botox injections may be helpful for many other medical conditions, including Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

Talk with a doctor if you have questions about using Botox or feel you need further treatment for a condition.

Side effects 

Serious side effects may be more likely Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source with medical uses of Botox since the doses tend to be higher. However, doctors generally consider Botox safe.

Possible complications and side effects of Botox include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • swelling
  • skin discoloration
  • bruising
  • asymmetry (if you receive Botox injections in your face)
  • allergic reactions
  • botulism, an infection with the same bacteria and neurotoxin Botox is made from (in rare cases Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source )

What else to know about Botox for medical reasons

  • The effects of botulinum toxin are temporary. You will likely need follow-up or supportive treatment to improve your condition.
  • Botox treatments may not be safe or effective for all cases of these conditions, so doctors may not recommend them to everyone.
  • More research is needed to confirm the effectiveness, long-term safety, and best dosage of Botox for each condition.
  • How often you need Botox injections can vary by person and condition.

Talk with a doctor if you have any questions about Botox for medical conditions.

Learn more about Botox injections, including their procedure, benefits, and safety.

Summary 

Botulinum toxin (Botox) can help treat many health conditions, including migraine, overactive bladder, and strabismus. Botox may also have off-label uses for conditions such as rosacea and erectile dysfunction.

Botox is generally safe and effective, but it can cause side effects for some people.

Talk with a doctor about using Botox for medical conditions.

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Medical Reviewer: Megan Soliman, MD
Last Review Date: 2024 Apr 17
View All Finding the Right Chronic Migraine Treatment Articles
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