Risks
By Mayo Clinic staffBotox injections are relatively safe when performed by an experienced doctor. The most common side effects include swelling or bruising at the injection site, headache or flu-like symptoms. If the injections aren't placed correctly, the medication may spread into adjacent tissues and cause problems such as:
- Eyelid droop
- Cockeyed eyebrows
- Crooked smile
- Dry eye or excessive tearing
Although very unlikely, there is a possibility that the effect of botulinum toxin may spread to other parts of the body and cause botulism-like signs and symptoms. Call your doctor right away if you notice any of these effects hours to weeks after receiving Botox:
- Muscle weakness all over the body
- Vision problems
- Trouble speaking or swallowing
- Trouble breathing
- Loss of bladder control
Doctors generally recommend against using Botox when you're pregnant or breast-feeding, since the effects on the baby aren't known.
Select your doctor carefully
Botox must be used only under a doctor's care. It can be dangerous if it's administered incorrectly. Ask for a referral from your primary care doctor or look for a doctor who specializes in your condition and who has experience in administering Botox treatments. A skilled and properly certified doctor can advise you on the procedure and can help determine if it suits your needs and health.
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- Botox medication guide. Food and Drug Administration. http://www.fda.gov/downloads/Drugs/DrugSafety/UCM176360.pdf. Accessed Dec. 14, 2012.
- AskMayoExpert. Botulinum toxin. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- OnabotulinumtoxinA (botulinum toxin type A, Botox): Drug information. http://www.uptodate.com/index. Accessed Dec. 14, 2012.
- FDA approves Botox to treat overactive bladder. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm336101.htm. Jan. 18, 2013.
- OnabotulinumtoxinA (marketed as Botox/Botox Cosmetic), AbobotulinumtoxinA (marketed as Dysport) and RimabotulinumtoxinB (marketed as Myobloc) information. U.S. Food and Drug Administration. FDA boxed warning alert: August 2009. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm174949.htm. Accessed Dec. 17, 2012.
- Barbara Woodward Lips Patient Education Center. Botulinum toxin treatment. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Barbara Woodward Lips Patient Education Center. Managing pain for your child's Botox injection. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.


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