Does Botox for Migraines Have Long-Term Side Effects?

Botulinum toxin injections have been a popular solution among other cosmetic procedures for reducing the appearance of facial wrinkles and fine lines. They’re also one of the most prescribed preventive treatments for chronic migraines, urinary incontinence, and muscle spasms. This is mostly because the injections serve as muscle relaxants. But despite the positive findings of Botox injections for migraine headaches, some patients still worry about its drawbacks in the long run.

So does Botox for migraine treatment have long-term side effects? Botox has long-term side effects, such as muscle weakness and droopy eyebrows, but they shouldn't be a cause of concern. These symptoms resolve within several weeks, compared to more common side effects that are gone in a day or two. Botox also has risks of more serious effects, such as corneal ulceration, blurry vision, and more. However, these cases are also quite rare and usually only happen at the hands of an inexperienced provider. 

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Are There Long-Term Side Effects From Botox for Migraines?

One of the most common apprehensions of patients about receiving injections of botulinum toxin for chronic migraines is its long-term adverse effects. While the treatment isn’t without long-term and mild side effects, it's safe and has been approved by the FDA. 

With the help of your healthcare provider or an experienced injector, these side effects wouldn’t be that much of a worry and should resolve on their own in days or weeks at most. While there are also risks of severe side effects due to a complication of botulinum toxin injections, these cases are quite rare.

These long-term effects include the following:

  • muscle weakness
  • droopy eyebrows

These are the most common long-term effects of your Botox injections for chronic migraine. While these side effects aren't serious, they should take several weeks to subside. Give them time to heal, and ensure keeping your doctor updated about your bodily reactions to the treatment. Keep in mind to contact them immediately in case they worsen or persist longer than they should.

Mild Side Effects

You may encounter other common side effects throughout your chronic migraine treatment with botulinum toxin – these are usually mild and shouldn't be a cause of your worries. Here are the side effects you’ll most likely have:

  • neck pain
  • injection site pain, soreness, and swelling
  • bruising
  • fatigue
  • chills
  • neck stiffness
  • dry mouth

Neck pain is the most common side effect, according to clinical studies. These effects are only due to your body responding to the Botox injected into you. They also resolve on their own roughly after 1 to 2 days post-treatment.

Serious Side Effects

There are also reports of serious side effects from Botox for chronic migraine, but they rarely happen. When patients experience some of these effects, they usually aren't severe enough to stop them from receiving the treatment. However, they can also be life-threatening, so it's best to keep your doctor updated.

These cases usually happen due to a complication of botulinum toxin injections. Those receiving Botox injections for chronic migraine from an unlicensed practitioner have higher risks of serious side effects – there are risks of giving too many doses of Botox, incorrect injection site, or lack of medical screening.

Here are serious side effects that you should be on the lookout for:

  • swelling of throat or tongue
  • blurry vision
  • difficulty in breathing or swallowing from the spread of toxin effect
  • allergic reaction
  • corneal ulceration

Contact your doctor immediately once you've developed these side effects. Dysphagia after botulinum toxin and other side effects mentioned can be deadly, so call 911 immediately or the emergency number in your area.

Why You Experience Side Effects

Beautiful young woman with clean perfect skin.

You experience these effects of botulinum toxin as the toxins integrate into your body and do their work. The action of botulinum toxin involves temporarily relaxing targeted muscles. Because of this, it's also pretty useful for treating dynamic wrinkles--it controls the muscles from contracting and creating these lines and wrinkles. This is also useful for several medical treatments, such as chronic migraine.

How Botox Helps Your Migraine

Botox (onabotulinumtoxinA) is a brand of botulinum toxin, a poison made by Clostridium botulinum--a type of bacteria. These are the same poison you might find in spoiled food that can cause a disease called botulism and can be deadly once it has reached the stomach. 

This disease paralyzes your muscles and makes it difficult for you to breathe. However, experts have purified this toxin, so it's now safe to administer in controlled amounts into the muscles.

Aside from the positive effects it can do with your glabellar lines and other dynamic wrinkles, clinical evidence has shown its relief for patients with cerebral palsy, lateral sclerosis, and other neuromuscular disorders.

FDA has approved botulinum toxin treatment for chronic migraine in 2010. Chronic migraine is a medical condition where patients experience headaches for 15 days, with 8 days involving migraine headaches. It also includes neck pain, severe throbbing headache, nausea, vomiting, and light and sound sensitivity.

Botulinum toxin treatment for chronic migraine allows the toxin to relax the muscles and interrupt the transmitters that send pain signals between the brain and the nerves from your spinal cord. 

Patients with chronic migraine experience headaches as the body releases pain signals or neurotransmitters from the brain to the nerve endings. As the botulinum toxin product relaxed the muscles around the head, face, and neck, this transmission of migraine pain has been blocked.

Chronic migraine is caused by the following:

  • chemical imbalances
  • disorder of the central nervous system
  • vascular irregularities
  • genetic factors

It may also be a symptom of other underlying medical conditions for the patient. Injections of botulinum toxin for a chronic headache only serve as symptomatic treatment and don’t resolve its root cause. 

However, it drastically improves a patient's quality of life as the frequency of headaches they experience reduces. It becomes easier for them to move forward with other treatments and therapy for their diagnosis.

What’s the Recommended Unit of Botox for Migraine?

The accurate unit of Botox for chronic migraine is crucial in maintaining a more effective and safer procedure with fewer risks of serious side effects. The dose of Botox patients will receive is measured by units – this is the fixed number of Botox molecules to incite a biological activity. 

The unit of Botox for chronic headaches involves 30 to 40 shots of botulinum toxin into 7 key areas of the neck and head, with each shot containing 5 units of botulinum toxin – these numbers may still vary according to what the doctor or headache specialist would prescribe. The treatment cycle is repeated every 12 weeks. Patients can expect results within 2 to 3 weeks after the treatment.

How to Manage Side Effects from Botox for Chronic Migraines

Woman applying ice pack as cold compress on forehead due to headache

Your side effects will depend on how your body reacts to the botulinum toxin. These side effects are usually mild and shouldn't be worried about. However, it can be really uncomfortable, especially for long-term side effects that take a few weeks to subside.i

In fact, it can even make patients want to stay in bed even if the procedure itself has little downtime. The good thing is that with the guidance of your doctor, these long-term side effects are pretty manageable.

1) Take Eye Drops for Droopy Eyelids

Droopy eyelids are one of the long-term side effects of receiving Botox injections for chronic migraine. This side effect will have risks for dry eyes, making them prone to corneal laceration. Maintain the hydration of your eyes and take apraclonidine eye drops. Consult your doctor about seeking more Botox shots that can counteract the droopy muscle, but this usually resolves within 4 to 6 weeks.

2) Avoid Blood Thinners

If you experience bruising, pain, and swelling, you should avoid blood-thinning medications. These side effects are caused by the small trauma from the injections. The needle from your Botox injections may have left a damaged blood vessel, causing it to bleed.

Your platelets need to cover up the wound in the blood vessel with its coagulation factors to stop the bleeding. Taking blood-thinning medications will interfere with this because it prevents blood clots – this includes aspirin, ibuprofen, and other NSAIDs, so it’s best to avoid these types of over-the-counter medications.

3) Apply a Cold Compress

Applying ice at the injected site will help with the swelling, bruising, and pain. This contracts the blood vessels, which would cover up the wound from the needle. It also reduces blood circulation.

4) Keep the Head Elevated Above the Heart

Keep your head elevated above your heart to keep the blood from flowing to the injected sites. This will help reduce swelling, bruising, and pain from Botox injections. Wounded blood vessels will receive more pressure if more blood flows through them, causing more pain.

5) Take Recommended Over-The-Counter Medications

We've mentioned that patients must avoid NSAIDs for the pain from their Botox injectables. Some of them experience flu-like symptoms from Botox, but this rarely happens for those taking the treatment for chronic migraine. 

But if you find yourself needing medications, you can take acetaminophen, such as Tylenol, for the pain, fever, headache, and others. You may also take an expectorant for coughs.

6) Call Your Doctor for A Temporary Catheter

Urinary retention is one of the rare and serious side effects of receiving Botox injections for chronic migraine headaches. Patients experiencing this symptom must contact their doctor immediately because they might need to have a temporary catheter attached. 

Be sure to inform your healthcare provider if you have bladder problems before receiving the injections. Botox may not be the best treatment for you.

A Smoother, Younger You Today

Wrinkles and fine lines are a thing of the past with a single Botox treatment. Book your first session of Botox today.

How to Know if Botox is the Best Treatment for Your Migraine

While injections of botulinum toxin have been effective for reducing pain from your chronic migraine, it might not be the best treatment for every patient. Patients must receive a full screening from their healthcare provider to assure effectiveness from the treatment with fewer instances of grave side effects.

You can receive Botox injections for your migraine if you have:

  • a history of headaches
  • headaches for 15 days or more in a month, with each attack lasting 4 hours or longer.

If you get 14 days or fewer headaches, Botox may not be the best treatment for you – the same goes with patients experiencing cluster types of headaches.

Other Treatments for Your Migraine

Young White Woman at home Holding Two Pain Killer Pills in Her Hand

Patients not eligible for receiving Botox injections for their migraine may benefit from other treatments. These include antidepressants, NSAIDs, beta-blockers, and anti-seizure medications.

1) Antidepressants

Your doctor may also prescribe antidepressants as a preventive treatment for your migraines, such as nortriptyline or Pamelor. This medication helps treat your chronic headaches with sleep disturbances, anxiety, and depression that usually come with chronic headaches.

Other types of antidepressants can also be prescribed by your doctor, like the selective serotonin reuptake inhibitor (SSRI). An example of this is fluoxetine or Prozac, Sarafem, and other brands. While these drugs primarily help with anxiety and depression, they can also be effective for addressing headaches.


NSAIDs are recommended preventive treatments. These drugs are helpful for patients withdrawing from pain relievers. They can use this when their headaches are becoming less tolerable.

3) Beta-Blockers

Patients with high blood pressure take beta-blockers--these drugs are also ideal for prophylaxis for migraines. The examples of these drugs are the following:

  • atenolol (Tenormin)
  • metoprolol (Lopressor or Toprol-XL)
  • propranolol (Innopran XL or Inderal)

Consult your doctor about the proper dosage of these medications.

4) Anti-Seizure Medications

Reducing brain activity that causes seizures, anti-seizure medications  may also work for limiting the pain signals that cause chronic headaches. Some of these drugs have been proven to prevent migraine and may even serve as a daily medication. 

Consult Rejuvenation Center for Mind and Body About the Best Treatment for Your Migraine

Botox treatment for chronic migraine may come with mild and long-term side effects – it even comes with risks of serious side effects. However, the positive results of this treatment bring hope to patients living in pain because of their migraine. While these side effects are uncomfortable, they’re manageable and shouldn't be a cause of concern. With the help of the right healthcare providers and highly-trained injectors, patients can return to normal and get back the comfort of being headache-free.

For migraine treatment, consult with reliable clinics such as Rejuvenation Center for Mind and Body. With our roster of licensed physicians, we provide care with credibility, compassion, and promote holistic wellness as well. Find out the best treatment options for your migraine by booking an appointment with us today.

A Smoother, Younger You Today

Wrinkles and fine lines are a thing of the past with a single Botox treatment. Book your first session of Botox today.



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