According to the American Society of Plastic Surgeons (ASPS), more than 7 million Botox (botulinum toxin) injections were given in the U.S. in 2020 to treat wrinkles and medical problems. In comparison, only a little over two million injections using dermal fillers (Juvederm, Restylane, etc.) were given in 2018. So it’s not hard to determine which non-invasive, skin-rejuvenating injectable is the most popular among people who want to turn back their “skin clock” – Botox!

Dermatology experts have also learned how to optimize the amazing results of Botox injections by analyzing the effectiveness of different methods of Botox aftercare. Here are the top 10 Botox aftercare recommendations that Botox injection specialists highly recommend to their patients to enjoy younger, smoother-looking facial skin.

Ten things to know about Botox aftercare

Your skincare professional will provide detailed instructions on Botox follow-up care so that you can feel the full effect and benefit from your treatment. Here are a few things to remember before returning to your normal activities.

Ice is in order

Some people experience swelling and discomfort at injection sites. You can safely apply a cold compress to the treated areas to reduce discomfort and minimize swelling. However, do not put pressure on the cold compress. Instead, gently place the compress over the swelling. Minor bruising and swelling near the injection sites are usually reported and will decrease within 48 hours of treatment. Taking NSAIDs or applying heat to swollen injection sites will not only make the discomfort worse but may also cause migration. This is strongly discouraged.

Train your face

Approximately one hour after a Botox injection, do a facial muscle workout: frown, squint, smile, and raise your eyebrows for 30 seconds. Repeat these exercises several times throughout the day to help the Botox solution penetrate the targeted muscles. However, remember that you don’t need to train your face to get the same great results from Botox. Moving your facial muscles and doing the recommended facial exercises may just speed up the reduction of wrinkles and fine lines by about one day.

Botox aftercare and the gym

Intense activity increases heart rate and blood flow. Although you can take a leisurely walk after Botox injections, don’t walk on ellipticals or Nordic Walking Treadmills for at least 24 hours. Heavy physical activity can unintentionally spread Botox to other areas, which can reduce the effectiveness of Botox and cause unintended side effects. Intense activity after the treatment can also increase the risk of swelling and bruising surrounding the treated areas.

Botox aftercare and makeup

Do not wear makeup the entire day. Using a liquid foundation, as well as blush, powder, eyeliner, and even an eyebrow pencil, can stimulate the skin enough for the Botox to disperse in unwanted areas. Those who receive Botox injections for medical reasons should also avoid exposure to the injection sites and the skin around them. Then, the next day, you can apply makeup.

Do not lie down or lean forward for 4 hours.

Lying down or bending over for more than a few minutes after a Botox treatment can disperse the Botox solution over the targeted area. If you are the type of person who bruises easily, sitting up straight can also help reduce bruising by preventing increased blood flow to the face.

Try to sleep on your back.

The first night in Botox aftercare, sleep on your back for as long as possible to minimize strain on your facial muscles. Of course, if your injections were designed to reduce forehead wrinkles or frowning eyebrows, you won’t have to worry about the pressure of your face on the pillow. However, Botox injections for goosefoot treatment are usually injected near or on the side of your face. So even if you are used to sleeping on your side, put pillows along your body so you don’t find yourself lying in your usual sleeping position.

Botox aftercare and alcohol

Beer, wine, and spirits contain ethanol, dilating blood vessels and increasing blood pressure. When blood vessels dilate, it allows more blood to flow quickly throughout the body. Increased blood flow may increase swelling and bruising in and around injection sites. A good rule of thumb for alcohol and Botox follow-up care: avoid drinking alcohol 48 hours before and after Botox treatment.

Postpone other skin treatments in Botox aftercare

Wait at least 24-48 hours before doing facials, microdermabrasion, laser skin treatments, and massages. This gives Botox time to work its magic on the muscles responsible for wrinkles.

Botox aftercare and sun

Avoid full sun exposure after your Botox injections for the rest of the day. Any kind of heat (including hot showers) will raise your blood pressure and cause bruising. If possible, avoid being in the sun for a day or two to completely reduce the chance of migration due to sunlight and heat. Also, avoid tanning beds, saunas, and hot tubs for at least 24 hours. (When it is safe to return to the sun, be sure to use high-quality sunscreen.)

Botox aftercare and medications

Most people do not need to take any pain medication, such as acetaminophen or ibuprofen, after Botox injections because discomfort is almost always minimal and temporary. Although rarely reported, some people may experience headaches after Botox treatment, in which case you can take acetaminophen or ibuprofen. However, if you are taking prescription blood thinners, such as warfarin, do not stop taking them until you have consulted your doctor.

What does the research say about the safety of Botox?

Over the past 30 years, hundreds of peer-reviewed studies of Botox show Botox to be the safest and most effective cosmetic neuroparalytic injectable. A comprehensive placebo-controlled study of 537 people who underwent Botox injections found that:

Improvement in glabellar lines (interbrow furrows) was superior to the results seen in the placebo group.
Peak results were noticeable 30 days after treatment. Eight out of 10 study participants reported significant reductions in glabellar lines, and some reported complete elimination of the wrinkles above the eyebrows.
Headache was the most common side effect (13 percent). In addition, approximately 3% reported temporary blepharoptosis (drooping eyelid).
Those who chose the second and third Botox treatment sessions reported fewer side effects.

A recent National Institutes of Health (NIH) clinical study on the safety of Botox states that Botox is “relatively effective and safe for the treatment of expression lines.” In addition, the study authors report that Botox “does not cause permanent changes in target muscles or nerve endings, and Botox does not cause any long-term dermatologic side effects.”

Botox Aftercare: When to see your doctor

Following all the recommendations for Botox aftercare is the best way to get optimal results without unwanted side effects. For people who only receive Botox injections for cosmetic purposes, the U.S. Food and Drug Administration cites the following symptoms as an indication that you should see a doctor as soon as possible:

Swallowing, breathing, or speech difficulties;
Decreased muscle tone/general weakness of muscles throughout the body;
Blurred or double vision;
Dysphonia (voice change/loss or hoarseness that is not related to other conditions);
Decreased bladder control;
Shortness of breath, itching, rashes, and other signs of an allergic reaction.

These side effects of Botox are extremely rare. However, it should be remembered that they can occur a couple of days or even a few weeks after the Botox procedure. Your doctor will be ready to discuss any concerns you may have during your consultation.

Misconceptions about Botox and Botox aftercare

Botox injections are very toxic.

Botox has been used for cosmetic purposes for over 20 years and is absolutely safe. Almost every worthwhile medication in medicine is a diluted toxin solution. Most drugs that can save a person’s life in serious heart disease- digoxin, atropine, lidocaine, or adrenaline- are chemicals extracted from microbes, animals or plants that are used under the supervision of a physician. Some drugs, such as digoxin extracted from the foxglove plant, can stop the heartbeat if used in a strong enough dose. If we dilute them, they will have less effect, but they can stop the uncontrolled heartbeat and allow it to beat normally.

Botox is a weak dilution of botulinum toxin, which can cause a serious form of food poisoning.

The safety of Botox is also ensured by its selective injection into a particular muscle or muscle group, making it largely incapable of acting outside of that area.

People suffering from cerebral palsy or muscle spasms receive much larger doses of the drug each day without any sign of problems.

Most doctors admit that aspirin and antibiotics are potentially more harmful than Botox. However, as with the introduction of any medication, anaphylactic reactions can occur, and therefore procedures with Botox should be performed by competent professionals.

Botox injections are a painful experience.

On the contrary, Botox injections are usually relatively painless. The needle that is used to inject Botox is tiny; in fact, it is smaller than the ones that people with diabetes use every day to inject insulin. People who have received Botox injections compare the sensation to the feeling of being stung by an insect. Some clients prefer to apply an anesthetic cream to their face about fifteen minutes before the procedure, and this completely eliminates any possibility of pain. There is no pain after a Botox injection.

Botox injections can sometimes cause headaches.

On average, although Botox can cause headaches in about 2-3% of people, it relieves them in most patients receiving the treatment. It has been known for some time that Botox can help prevent and cure migraine sufferers. To do this, doctors usually inject it into different trigger points, which can vary from patient to patient. In migraine prophylaxis, Botox lasts for 10-13 weeks, but it may take more than one week for the desired effect to set in. Therefore, the drug should not be injected more often than once every 3-4 months.

Botox injections should only be administered to people over the age of 40.

It is difficult to understand where this misconception comes from and whether it really still exists among young people in the most developed parts of the world. Perhaps this sentiment exists among the older generation, which is less susceptible to media and peer pressure. These people often consider it an important event to see a doctor who does Botox and wants to keep it a secret is known only to themselves.

In fact, the average age for starting Botox in the U.S. has now dropped to 19 because young people now realize that it’s much easier to address the problem early, and if they start early, they won’t get wrinkles at all. In addition, if you start early, you will probably get better results and will require less to continue in later life.

Botox will be less effective if used frequently.

There is evidence that about 5% of patients who are continuously injected with Botox may produce neutralizing antibodies that can cause the injections to stop working. The likelihood of this occurring depends on administering high doses or repeated injections within four weeks of treatment.

Patients are not allowed to fly in Botox aftercare.

This may also be a misconception, but many doctors still continue to impose this instruction on patients. The perceived logic comes from the fact that different cabin pressures can promote the migration of toxins through the orbital septum. Thus, patients are instructed not to fly after the injection. However, the cabin pressure is generally the same as the air pressure on the ground. The pressure of the air outside the cabin is different. In general, I treat many patients from overseas, and if they are flying for a long time, I tell them to wait one day.

Botox injections are only suitable for expression lines.

This is a complete misconception that few people still adhere to. In fact, many people are astonished to learn that children with muscle spasm syndrome and cerebral palsy get even higher concentrations of Botox. They are also surprised to learn that, in fact, doctors who have treated muscle spasms have found that it has anti-wrinkle effects as a beneficial side effect. In fact, Botox is now used to treat sweating, migraines, urinary incontinence, spasms, strokes, multiple sclerosis, cerebral palsy, and chronic back and neck pain.

Botox has little effect on underarm sweating.

On the contrary, Botox has an almost 100% effect on excessive sweating, which can last up to a year. The condition, known as hyperhidrosis, is caused by autonomic nerve overstimulation of the sweat glands. A study at the University of California, San Francisco (2002) involved twelve patients who received Botox injections directly into their armpits. The amount of drug used was the same as for the treatment of lines and wrinkles. All patients reported a reduction in underarm sweating within 48 hours of the procedure. Further follow-up showed that the treatment was effective for five to twelve months.

Botox works immediately

Unfortunately, Botox does not produce immediate results. The effect is gradual and imperceptible, with results usually becoming apparent within the first 3-5 days. Full results are usually visible after seven to ten days. This is because Botox helps relax and suppress muscle movement to reduce the appearance of wrinkles and fine lines. In some cases, it may take one or two injections to see full results and complete relaxation.

Botox is permanent

The use of Botox is not a permanent way to reduce the appearance of fine lines and wrinkles. This treatment provides only temporary results, usually for 3 to 6 months. The length of time Botox lasts on the patient and how many times he or she has received Botox. After this time, the movement in your muscles will begin to return, so wrinkles and fine lines will gradually start to appear.

Botox is only for women.

This is one of the most common misconceptions about most cosmetic procedures. Men and women get older and want to look younger. Fortunately, more and more men are leaning toward the idea of cosmetic enhancements and are getting new treatments every year. Both men and women can benefit from the results that Botox provides. Many men who use Botox seek to soften their wrinkles to appear more approachable, as some feel that their wrinkles not only make them look older but also meaner. Because men’s facial muscles are stronger, a higher dose of Botox must be used to get the desired changes.

Botox can make you look frozen.

A major misconception in pop culture is the joke that Botox can make you look frozen or emotionless. This is only true if it is injected by someone who does not use the proper technique. Botox seems natural when properly injected, giving the patient a more youthful and renewed appearance. The goal is not to look full or frozen but to look rejuvenated and young.