April 24, 2024

What are the side effects of Botox?

Discover possible side effects and risks of getting Botox injections. Learn about allergic reactions to Botox and who is a good candidate for treatment.

Reviewed by: Karmay Hung, DNP, AGACNP-BC, CEN
Table of Contents

What are the side effects of Botox?

Are you considering Botox treatment? This popular cosmetic treatment is FDA-approved for reducing the appearance of fine lines, and it’s considered very safe when injected by an experienced and qualified provider. With that being said, no treatment is completely free of risks. If you want to get Botox treatment, it’s good to be aware of the potential side effects so you know what to expect. In today’s blog, we’ll cover the 10 Botox side effects you need to know about. Let’s dive in!

Injection site reactions

Injection site reactions are one of the most common side effects of Botox treatment. After treatment, you may experience discomfort, swelling, redness or bruising at the site of injection. These reactions are usually minor and temporary, often resolving within a day or two. If you notice that your injection site is becoming unusually inflamed or your symptoms don’t subside in several days, make sure to let your Botox provider know.

Although it’s less common, an infection can sometimes occur at the injection site. Your Botox injector should make sure the area is properly cleaned before treatment, so this side effect can be mitigated by choosing a quality and experienced provider. Finally, it’s also possible, but rare, to experience an allergic reaction from Botox. Serious allergic reactions are also rare, but you may experience symptoms like itchiness, hives, difficulty breathing or swelling. Make sure to immediately report allergic reaction symptoms and seek emergency medical care if necessary.

Headaches or flu-like symptoms

After Botox treatment, you may experience headaches or flu-like symptoms such as fever, chills, upset stomach and general discomfort. This is another very common side effect after treatment and often subsides within a few days. To mitigate these symptoms, make sure to get enough water and rest and follow any other post-care instructions your provider gives you. 

Over-the-counter medications like Tylenol may also help, but make sure to talk to your provider about what medications you can take following treatment. It’s often recommended to wait at least 24 hours to take pain relievers like ibuprofen, but Tylenol is sometimes ok to take earlier. If your headache or flu-like symptoms become more severe or persist, let your provider know.

Droopy eyelids or crooked eyebrows

Botox can sometimes have an impact on facial symmetry. Commonly, this may cause droopy eyelids or crooked eyebrows. This issue is known as blepharoptosis for droopy eyelids and brow ptosis for droopy eyebrows.  This can cause temporary aesthetic concerns but will subside as Botox’s effects fade over time. Typically, you can expect this side effect to fade within a few weeks, but it can sometimes last as long as three months.

Crooked smile or drooling

Similar to eyelid and eyebrow drooping, Botox injections in certain areas of the face may affect muscles that control your mouth movements and smile. The relaxing of these muscles may lead to a crooked smile or drooling. Again, these side effects are temporary, but it’s important to be aware of the potential aesthetic concerns that come with treatment. While crooked smiles and drooping eyelids aren’t always the fault of the injector, you can minimize the chances by choosing a qualified and experienced provider.

Dry skin

It’s common to sometimes experience dry or flaky skin in the treatment area after Botox injections. While the exact cause of this isn’t clear, it may be due to Botox’s effect on the skin’s sweat and natural oil production. In fact, Botox is sometimes used to alleviate symptoms of excessive sweating. But, if this isn’t an issue for you, then you may experience some dry skin. Make sure to stay hydrated and ask your provider about moisturizers you can use to counter these side effects. Like most side effects, dry skin is likely temporary and will subside over time.

Difficulty swallowing or breathing 

Although rare, difficulty swallowing and breathing is a more serious side effect of Botox. This side effect can occur if the muscles that control swallowing and breathing are weakened from the treatment. If you experience any difficulties swallowing or breathing, you should seek medical attention right away to prevent further complications.

Eye and vision problems

Eye and vision problems are another uncommon, but potentially serious side effect of Botox. You may notice you have trouble focusing, or you’re seeing double if you experience these side effects. Botox injections may also cause less blinking, which can lead to dry eye and irritation. If you’re experiencing eye and vision problems, it’s best to reach out to a provider right away to prevent the condition from progressing.

Botox toxin spreading

In rare cases, the Botox toxin may spread to other parts of the body. This can cause serious issues and should be addressed immediately. It’s also possible to develop botulism if Botox spreads to other parts of the body. With that being, botulism is exceedingly rare if Botox is properly administered to approved treatment areas. Botulism is more likely if Botox is misused or if the medication is contaminated. This also underlines the importance of getting Botox treatment from a licensed professional.

Nerve or muscle problems

Botox may sometimes cause symptoms of muscle weakness in the treatment area and surrounding muscles. The risk for nerve or muscle side effects increases if you already have nerve or muscle problems. Make sure to report any muscle weakness to your provider.

Heart problems

Though rare, Botox can potentially cause heart rhythm problems and sometimes even heart attacks. The risk of these complications is greater if you already have an existing heart condition. Always make sure to disclose any heart condition to your Botox provider to ensure you’re a good candidate for treatment. Also, make sure to seek immediate medical care if you experience any symptoms related to heart conditions or heart attack.

Frequently Asked Questions About Botox Risks

With the above side effects in mind, it’s important to remember that Botox is generally considered a safe treatment and it has been approved by the FDA for cosmetic purposes. You can minimize the risk of Botox complications by choosing a licensed, qualified and reputable Botox provider.

Have more questions about the risks of Botox? Check out our FAQ below.

What are the long-term side effects of Botox?

For the most part, Botox side effects aren’t serious and they are usually temporary. Studies indicate that there are no long-term, life-threatening side effects of properly administered cosmetic Botox. However, long-term use may cause permanent changes in facial expressions, making you more expressionless over time. These effects vary among individuals, so make sure to consult with your Botox provider to determine what is the best treatment path for you.

When do Botox side effects go away?

Most Botox side effects are mild and tend to dissipate on their own within a week of treatment. Certain side effects, like drooping eyelids and crooked smiles, may last a few months after treatment as the Botox begins to wear off. If you experience severe or lasting symptoms, you should speak with your health care provider right away.

Who should not get Botox?

While Botox is a common and generally safe treatment, it’s not right for everyone. To get Botox treatment, you need to be 18 or older. Botox also is not recommended for those who:

  • Are pregnant or nursing
  • Have a neuromuscular condition
  • Have a skin condition near the site of injection
  • Have certain facial features that would affect treatment, like deep scarring
  • Are taking certain medications

Always speak to your Botox provider or health care provider to determine if Botox treatment is safe for you.

Compare Botox providers in NYC 

Now that you know what to expect from Botox treatment, you may be wondering where you should find your provider. If you live in New York City, Certainly can help. There are a lot of Botox providers in NYC, and it can be hard to compare your options and choose one that is right for you. With Certainly, comparing providers is easy and convenient.

To find your Botox provider on Certainly, just enter your location and your desired treatment. You’ll get a list of providers in your area so you can take your time comparing options to find the most qualified provider for your needs. Once you find your provider, you can book your appointment directly online.

Get Upfront Costs with Certainly Health 

Certainly does more than just help you find your Botox provider. With the Certainly platform, you can also compare prices for cosmetic treatments. Transparent pricing can be hard to find, and no one likes getting hit with a surprise bill that is more than you expected. With Certainly, you can leave surprise bills behind. Find your provider and compare upfront Botox costs on the Certainly platform today!


  1. https://www.accessdata.fda.gov/spl/data/b0bf872a-b136-435f-af20-46a9b3e02f2b/b0bf872a-b136-435f-af20-46a9b3e02f2b.xml
  2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/103000s5322lbl.pdf
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112997/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874868/
  5. https://www.aao.org/eye-health/treatments/how-does-botulinum-toxin-botox-work

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