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Botulinum toxin therapy: FAQs

Botulinum toxin therapy is one of the most popular cosmetic treatments available. To help you decide whether this treatment is right for you and to have the treatment performed safely, the AAD provides the following facts.


Buying botulinum toxin online jeopardizes your health. This product should require a medical license to purchase. If you do not need to show proof of a medical license, the product differs greatly from what a dermatologist uses. 

Injecting a product that you can buy without showing a medical license can cause serious complications. Cases of long-term muscle paralysis, Bell’s palsy, and permanent eye damage have occurred.

Getting botulinum toxin injections in a non-medical setting also can be extremely dangerous. To protect your health, you should never get botulinum toxin injections at a:

  • Non-medical spa.

  • Party.

  • Salon.

  • Someone's home.

What happens during this procedure?

A dermatologist injects very small amounts of purified botulinum toxin. 

When treating fine lines and wrinkles, the dermatologist injects botulinum toxin into targeted muscles on the face or neck. This temporarily relaxes the targeted muscles, causing fine lines and wrinkles to diminish. The effect lasts about 3 to 4 months — and sometimes longer.

When treating excessive sweating, a dermatologist injects directly into the skin on the underarm. A single treatment can provide up to 6 months of relief from excessive sweating. 

Will I lack facial expressions after treatment? 

Dermatologists want their patients to look natural. To do this, they inject just enough to weaken and relax the targeted muscles without affecting other muscles. This allows patients to maintain their natural facial expressions.

Will I lose my sense of feeling where I have the injections? 

No. This treatment does not affect your ability to feel. 

When is it safe to have another treatment? 

You can have another treatment when the excessive sweating or lines and wrinkles return. With repeat treatment for lines and wrinkles, the muscle may thin, leading to longer-lasting results.

Is there downtime?

Most people return to the everyday activities immediately. As soon as you leave the treatment room, you can apply makeup.

What must I do after the procedure?

To prevent the injected substance from spreading to areas where you do not want it, you’ll need to take a few precautions:

  • Do not rub or massage the areas where you received the injections. 

  • If you apply makeup, take care not to press or rub it in.

  • Wait two hours before you engage in strenuous physical activity. This includes lifting heavy items, working out, and any other physical activity that raises your heart rate. 

What are the possible side effects?

If a patient develops side effects, these tend to be mild and temporary. The injections, rather than the botulinum toxin itself, cause most mild side effects. For example, a patient may occasionally bruise. If this happens, the bruising lasts about 1 week.

After receiving injections, people have experienced:

  • Swelling

  • Redness

  • Soreness

  • Bruising

  • Mild headache (uncommon)

  • Weakness in a neighboring muscle, leading to a temporarily droopy brow or eyelid (rare)

  • Signs and symptoms of botulism, including problems breathing, swallowing, or speaking (very rare)

What is the safety record for this procedure?

More than 20 years ago, a dermatologist and his wife, an ophthalmologist, began using botulinum toxin therapy to treat signs of aging. Today, medical professionals inject millions of patients each year.

When used by a dermatologist to treat signs of aging or excessive sweating, no serious side effects like problems breathing or swallowing have ever been reported.

Dermatologists continue to make patient safety their No. 1 priority. Each year, the AAD offers continuing medical education sessions that include best practices for treating patients with this treatment. Dermatologists continue to make new research breakthroughs in the use of botulinum toxin therapy.

Dermatologists have millions of satisfied patients. They treat people of all colors and skin types with botulinum toxin therapy.

If you are interested in this treatment, you should consult a dermatologist.

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