Botulinum Toxin Injections


What are botulinum toxins?

Botulinum toxins are neurotoxins that affect nerves and cause muscle paralysis. A bacterium called Clostridium botulinum makes these neurotoxins. Healthcare providers use a specific type of the bacteria (type A) for medical injections.

Botulinum toxins occur in soil and contaminated foods. If you consume large amounts of botulinum toxins or the bacteria get into a wound, you can develop botulism. This serious nervous system disorder affects breathing.

What are botulinum toxin (Botox®) injections?

Botox® is one of the most widely known brands of botulinum toxin injections. Healthcare providers inject small amounts of Botox or another type of botulinum toxins into specific muscles. This procedure can smooth wrinkles, prevent migraine headaches and treat other health problems.

Technicians develop botulinum toxins for cosmetic and medical procedures in a lab. Technicians dilute and sterilize the toxins so they won’t cause botulism.

What are the types of botulinum toxin injections?

There are different brand names for botulinum toxin injections. Not all products treat the same problems. Your healthcare provider can discuss the best option for your unique situation. Options include:

  • Botox® (OnabotulinumtoxinA).
  • Dysport® (AbobotulinumtoxinA).
  • Xeomin® (IncobotulinumtoxinA).
  • Jeauveau® (PrabotulinumtoxinA).

How do botulinum toxin injections work?

Repeated muscle contractions are one of the causes of wrinkles in the face. Botulinum toxins like Botox temporarily block nerve signals to muscles. As a result, injected muscles can’t contract (tense). They become weak or paralyzed. These effects can last for several months. The muscle injected is dependent on the area(s) of concern that you have. Several areas can be treated in one session.

What do botulinum toxin injections treat?

Providers use botulinum toxin injections cosmetically to improve appearance. Medical Botox injections treat health problems. These conditions include:

Procedure Details

How should I prepare for botulin toxin injections?

Make sure your healthcare provider has a current list of the medications and supplements you take. Certain medications increase the risk of bruising at the injection site. These include anticoagulants or blood thinners (Warfarin®) and nonsteroidal anti-inflammatory drugs (NSAIDs). Alcohol also makes you more prone to redness and bruising. Don’t drink for 24 hours before a procedure.

How are botulinum toxin injections performed?

Your healthcare provider uses a fine needle to inject small amounts of botulinum toxins into the treatment area. Depending on the problem, you may receive several injections in different spots. Here’s what else you need to know about the procedure:

  • Outpatient procedure: Treatment takes place as an outpatient procedure. You go home the same day.
  • Discomfort: The injections may sting and feel uncomfortable, but the procedure is over quickly. Some providers apply a topical numbing agent to the skin before giving injections.
  • Anesthesia: If you’re receiving injections for an overactive bladder, you may receive local or regional anesthesia.

What should I do after getting botulinum toxin injections?

Unless your healthcare provider says otherwise, you can return to work or most activities after treatment. To reduce redness, swelling or bruising:

  • Don’t rub or put pressure on the area for 12 hours.
  • Stay upright (don’t lie down) for three to four hours.
  • Avoid physical exertion for 24 hours.

Risks / Benefits

What are the potential risks or complications of botulinum toxin injections?

Side effects from botulinum toxin injections vary depending on the area receiving treatment. Most problems improve in a day or two. They include:

Who should not get botulinum toxin injections?

Botulinum toxin injections are relatively safe. Still, you shouldn’t get this treatment if you have:

Recovery and Outlook

What should I expect after treatment?

Treatment requires minimal downtime, you can return to your daily routine after treatment.

How long do botulinum toxin injections last?

It can take several days for botulinum toxin injections to take effect. Within three to six months, toxins wear off, and muscles regain movement. As a result, wrinkles come back, and problems like migraines and sweating may resume. You may choose to get more botulinum toxin injections.

When to Call the Doctor

When should I call the doctor?

You should call your healthcare provider if you experience:

Additional Details

Does insurance cover botulinum toxin injections?

Health insurance policies vary, so always check with your provider. Most health insurers cover treatments for migraines, urinary incontinence or other medical conditions. Insurers don’t typically cover injections for cosmetic purposes.

A note from Cleveland Clinic

Botulin toxin injections like Botox and Dysport offer temporary relief from migraines, excessive sweating, certain eye problems and other health problems. As a cosmetic procedure, these injections smooth wrinkles by preventing muscles from contracting. Treatment effects don’t last forever, which means you’ll need more injections in three to six months. It is safe to get repeated botulinum toxin injections.

Last reviewed by a Cleveland Clinic medical professional on 09/29/2020.


  • American Society of Plastic Surgeons. Botulinum Toxin. ( Accessed 9/15/2020.
  • American Academy of Dermatology. Botulinum Toxin Therapy: Overview. ( Accessed 9/15/2020.
  • American Academy of Facial Plastic and Reconstructive Surgery. Injectables and Wrinkle Treatment. ( Accessed 9/15/2020.
  • American Academy of Ophthalmology. Botulinum Toxin (Botox) for Facial Wrinkles. ( Accessed 9/15/2020.
  • American Osteopathic College of Dermatology. Botox. ( Accessed 9/15/2020.

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