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Botox Side Effects

Kristina Cadwell  
March 9, 2023  

Botox ranks high among popular, nonsurgical cosmetic procedures. Its safety and effectiveness are well established, with millions of people getting a Botox treatment each year and reporting few serious adverse reactions.

This article explains what side effects can potentially occur after Botox and what you can do to alleviate uncomfortable symptoms.

Botox side effects to know about before undergoing treatment

12 Botox Side Effects

The following Botox side effects range from mild to severe. Severe side effects from the cosmetic use of Botox are rare. Their frequency is 33 times lower than from the therapeutic use of botulinum toxin.

The severity of Botox side effects depends on the dosage and the location of the treatment area. The medical provider's expertise and technique also play a role in the type and extent of potential adverse effects.

The risk of severe symptoms is significantly reduced in the hands of a skilled medical professional.

Note: Learn about common Botox treatment areas and the dosage of Botox required to treat them.

1. Bruising

Bruising after Botox is a common side effect. It occurs when the medical provider accidentally injures a blood vessel and the blood leaks into the surrounding tissue. It can happen to experienced and inexperienced providers because of the multitude of blood vessels.

Bruising is a mild side effect and doesn’t require treatment. It typically disappears after several days, but if you want to speed up recovery, apply ice packs on the treated area several times a day for 10-15 minutes.

Exercising after botox increases the risk of bruising. Other common risk factors include blood-thinning medications and supplements as well as alcohol consumption before and after the treatment.

Note: Bruising is not the only Botox side effect that is more likely to appear after alcohol consumption. Learn more about the potential consequences of drinking alcohol after botox.

2. Swelling

Swelling commonly accompanies bruising after a Botox treatment. The needle used for Botox administration can cause mild trauma to the skin and underlying tissue. The trauma causes a localized inflammatory response, leading to swelling and redness around the injection site. This side effect is usually mild and resolves on its own within a few days, but you can apply ice packs to mitigate the symptoms.

3. Numbness

Numbness is a common mild symptom after Botox. When injected into the muscle, Botox prevents the release of the neurotransmitter acetylcholine that signals the muscles to contract. This causes temporary muscular relaxation, which can lead to a loss of feeling or numbness in the treated area. It typically lasts several hours.

4. Infection

When the needle penetrates the skin and enters the muscle, there is a chance that bacteria can enter as well. To minimize the risk of infection, medical providers must clean the treatment area before every injection. Bacterial infections after Botox are more common when untrained cosmetic providers administer the shot and don’t follow the standard preparatory procedures.

5. Bumps

Bumps after Botox are a common reaction to the micro-injury from the injection. They can also occur if the patient is allergic to the ingredients in the injection, or if the provider doesn’t inject Botox properly (using inadequate dosage or missing the target location). Botox bumps are usually mild and painless, disappearing after several hours.

6. Headache

A headache is a common short-term Botox side effect due to the muscle spasm that sometimes precedes muscle paralysis. Other possible causes of headaches after Botox are the needle hitting deep muscle hematomas or worry about undergoing the procedure.

The headaches usually stop after a few days, but in rare cases, they last up to four weeks. Patients can use anti-inflammatory drugs to manage the pain.

7. Droopy Eyelids

A droopy eyelid or ptosis can occur with forehead botox treatment and frown lines Botox treatment.

When too much Botox is injected into the frontalis muscle to erase forehead wrinkles, it can result in an eyelid or eyebrow droop.

When Botox is injected to smooth glabellar lines, droopy eyelids occur if the neurotoxin migrates from the injected area into the levator muscle responsible for keeping the upper eyelids open.

Untrained providers cause this undesired symptom by injecting Botox in the wrong location or exceeding the correct dosage. A skilled injector may be able to correct the issue by performing a botox eyebrow lift.

Note: Find out how to minimize the appearance of side effects after getting forehead botox.

8. Muscle Weakness

Muscle weakness is a rare, severe adverse effect of botulism (botulinum toxin poisoning) and is the result of the diffusion of the toxin from the target muscle into adjacent muscles. It can start with muscles that control the face and throat and spread to the entire body. In the case of cosmetic Botox administration, muscle weakness is more likely to occur after neck Botox treatment because, compared to other treatment areas, a larger dosage is used.

Contact your medical provider right away if you experience this symptom.

9. Swallowing Difficulties

Dysphagia or trouble swallowing is another result of botulism and appears when Botox paralyzes the wrong muscles. The symptom is rare and typically occurs nine or ten days after the injection, lasting approximately three weeks. Like muscle weakness, it is more common after the treatment of neck lines.

Patients may need to switch to a temporary soft diet until symptoms subside. Patients with severe dysphagia require nasal feeding or nutritional IV therapy.

10. Blurred Vision

Eye side effects, such as blurred vision, are rare after Botox. The symptom may occur because the toxin blocks the function of the neurotransmitter which helps the normal functioning of the parasympathetic nervous system. Eye problems can last up to three months, after which the patient’s vision returns to normal.

11. Allergic Reactions

In rare cases, botulinum toxin can cause allergic reactions. They can be mild, including redness, swelling, and rashes at the injection site, and severe and manifest as a potentially life-threatening anaphylactic shock.

Mild symptoms can be treated with antihistamines. Severe symptoms require immediate medical attention and treatments such as adrenalin injections.

Note: Consider these pros and cons of getting Botox before you book the treatment.

12. Botox Resistance

Patients may develop an immunity to Botox and stop responding to the treatment. Botox resistance is a very rare side effect that occurs when the body synthesizes antibodies to botulinum toxin. The condition is more common when the neurotransmitter is used for medical purposes, but studies and clinical experience show it can also happen with cosmetic Botox. Higher doses and repeated injections increase the risk of developing resistance to Botox. Patients who experience it can try any of the FDA-approved Botox alternatives.   

When Do Botox Side Effects Go Away?

The duration of a Botox side effect depends on its severity and the patient’s behavior after the treatment. Bruising typically resolves on its own within two weeks, headaches disappear in 24-48 hours, and drooping eyelids last approximately three weeks. Some symptoms, such as blurred vision, can last for months.

Does Botox Have Long-Term Side Effects?

Clinical practice shows Botox for cosmetic purposes isn’t associated with negative long-term effects. Trained medical professionals significantly reduce the risk of potential complications by carefully examining the patient’s medical history and using adequate dosing and technique for the Botox injection.

When Should You See a Doctor?

If you experience severe symptoms that are interfering with your daily activities after a Botox treatment, seek medical help right away. Examples of such symptoms include trouble swallowing or breathing, excessive swelling, general muscle weakness, and anaphylactic shock.


Botox provides impressive wrinkle-erasing results, but like every procedure can also cause undesired side effects. Always choose a reputable Botox provider to ensure a safe and favorable outcome.

Contact the professionals at Vibrant Skin Bar if you are looking for a Botox treatment in Phoenix.

Are you considering undergoing multiple cosmetic treatments, including Botox? Some cosmetic treatments can be combined for optimal results and maximum efficiency, a common example being Botox and microneedling. Learn more about how these treatments complement each other.

If you are discouraged to try Botox because of its potential side effects, consider Botox alternatives, such as other neurotoxin injectables (Dysport), dermal fillers (Restylane), and chemical peels, that can help you achieve the aesthetic results you desire.

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About the Author:
Kristina Cadwell
PA Kristina Cadwell graduated from Arizona State University with a Bachelor of Science degree in Biology. She then completed the Physician Assistant program at A.T. Still University graduating with a Masters of Medical Science degree. Kristina has been working in the Aesthetic Medical field for over 10 years. She is certified in neurotoxin cosmetic injection, dermal fillers, Plasma Pen skin tightening, chemical peels, and laser therapy. She is known for producing natural results and has extensive knowledge in diet and exercise allowing her to help you achieve vibrant skin from the inside out.
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