Botulinum Toxin Injections—Medical Side Effects and Warnings

Possible Complications

Complications are rare. When they occur, they are temporary and mild. Side effects are related to the site of injection. For example, if injections take place near the eyes, there may be complications with eyelids or brow line.

Temporary issues may include:

• Redness
• Bruising
• Stinging around the injection sites

The following are less common reactions. They are generally mild and do not last long.

• Nausea
• Fatigue
• Flu -like symptoms
• Headache

Other complications that may occur include:

• Excessive weakness of the muscle around the eyes—can cause drooping of the eyelids or obstruction of vision
• Difficulty swallowing—can occur in patients receiving injections in their neck
• Compensatory hyperhidrosis—people being treated for hyperhidrosis may develop increased sweat production at another area of the body
• Excessive weakness or atrophy (wasting) in chosen muscles—the injection may slow any improvement in the muscle
• Neck weakness in people with long, thin necks
• Risk of the botulinum toxin spreading beyond the injection area—may cause botulism symptoms, including difficulty breathing and death in severe cases (Children with cerebral palsy may be at a higher risk for this side effect.)

• This procedure may worsen nerve or muscle disorders, such as:

• Amyotrophic lateral sclerosis (ALS)
• Myasthenia gravis

The toxin can also interact with medicines, such as antibiotics. Tell your doctor about all of the medicines that you are taking.

You should not have botox if you:

• Have an infection or inflammation in the area where botox will be injected
• Are sensitive to the ingredients in botox
• Are pregnant or breastfeeding

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

• Difficulty breathing
• Difficulty swallowing
• Difficulty speaking
• Severe lower eyelid droop or obstructed vision
• Excessive weakness around the injection site
• Rash or any other sign of an allergic reaction

In case of an emergency, CALL 911.