From the Guidelines
Botox injections can cause several side effects, though most are temporary and mild, with an overall incidence of allergic reactions reported as 6.5% and anaphylaxis episodes as 1.2% in a systematic review of 687 patients treated with botulinum antitoxin 1.
Common Side Effects
- Pain, swelling, or bruising at the injection site
- Headache
- Flu-like symptoms
- Temporary facial drooping (particularly eyelid drooping when treating the forehead)
- Dry mouth
- Fatigue
- Neck pain
- Vision problems
Rare but Serious Side Effects
- Muscle weakness
- Difficulty swallowing or breathing
- Speech problems These severe reactions require immediate medical attention.
Minimizing Risks
To minimize risks, it is essential to choose an experienced provider, disclose all medications and medical conditions beforehand, and follow post-treatment instructions carefully. Botox works by temporarily blocking nerve signals to muscles, which explains why muscle-related side effects can occur. The safety profile is generally good when administered properly by qualified healthcare professionals, as supported by the recommendation to offer botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia based on RCTs with minor limitations and preponderance of benefit over harm 1.
From the FDA Drug Label
JEUVEAU may cause serious side effects that can be life threatening. Call your healthcare provider or get medical help right away if you have any of these problems after treatment with JEUVEAU: • Problems swallowing, speaking, or breathing • Spread of toxin effects. In some cases, the effect of botulinum toxin may affect areas of the body away from the injection site and cause symptoms of a serious condition called botulism The symptoms of botulism include: o loss of strength and muscle weakness all over the body o blurred vision and drooping eyelids o trouble saying words clearly o trouble breathing o double vision o hoarseness or change or loss of voice o loss of bladder control o trouble swallowing JEUVEAU can cause serious side effects, including: • Allergic reactions. Symptoms of an allergic reaction to JEUVEAU may include: itching, rash, hives, wheezing, trouble breathing, or you may become dizzy or faint • Heart problems. Irregular heartbeat and heart attack that have caused death have happened in some people who received botulinum toxin products. • Eye problems Dry eye, reduced blinking, and corneal problems have happened in some people who receive JEUVEAU to treat glabellar lines.
Botox side effects include:
- Problems swallowing, speaking, or breathing
- Spread of toxin effects, which can cause symptoms of botulism, such as loss of strength and muscle weakness, blurred vision, trouble breathing, and trouble swallowing
- Allergic reactions, such as itching, rash, hives, wheezing, and trouble breathing
- Heart problems, including irregular heartbeat and heart attack
- Eye problems, including dry eye, reduced blinking, and corneal problems The most common side effects of JEUVEAU include:
- Headache
- Eyelid drooping
- Upper respiratory infection
- Increased white blood cell count in your blood 2
From the Research
Botox Side Effects
- Botox injections can cause various side effects, including eyelid/eyebrow ptosis, asthenia, muscular weakness, facial paresis, dysphagia, botulism, and death 3.
- The most common side effects of Botox injections are mild and temporary, such as erythema, oedema, pain, ptosis of eyelid or brow, and ecchymosis 4.
- Serious side effects, such as botulism and death, are rare but can occur due to the systemic spread of the toxin 3, 5.
- Blepharoptosis, or eyelid ptosis, is a reported side effect of Botox injections, which can occur due to local spread of the toxin and is more frequent among inexperienced practitioners 6.
- The onset of blepharoptosis typically occurs 3-14 days after injection and can be treated with medications such as oxymetazoline hydrochloride or apraclonidine hydrochloride eye drops, anticholinesterase agents, or transdermal Botox injections to the pre-tarsal orbicularis 6.
Prevention and Management
- Proper injection techniques, appropriate regional Botox dosing, and a conservative approach to Botox-mediated facial rejuvenation can reduce the risk of complications 7.
- Understanding the anatomy of the supraorbital area and orbital roof is crucial to preventing incorrect injection into "danger zones" that can increase the risk of eyelid ptosis 6.
- Patients should be informed of the potential side effects of Botox injections before undergoing the procedure 4.