Patient education: Botulinum toxin injections (The Basics)

What is botulinum toxin? — This is a medicine made from a type of bacteria. It is often called "Botox," which is the brand name of 1 of these medicines. It is given as 1 or more shots. It blocks or calms the nerve signals to the muscles where it is injected. This helps the muscles relax.

The effects of the shots are temporary. They often start working within a few days to a week or so. Most shots work for 3 to 4 months. Some conditions might be treated only once. For other conditions, the shots are given on a regular schedule.

What conditions might be treated with botulinum toxin? — In many cases, it is used to help reduce frown lines and wrinkles on the face. However, it can also be used to treat some medical conditions. Examples include:

●Muscle spasms

●Abnormal movements

●Crossed eyes, or "strabismus"

●Sweating more than normal, or "hyperhidrosis"

●Drooling more than normal, or "sialorrhea"

●Migraine

●Anal fissures, or tears in the lining of the anus

●Overactive bladder or trouble controlling the flow of urine

●Trouble with the voice

How do I prepare for botulinum toxin shots? — The doctor or nurse will tell you if you need to do anything special to prepare. Before your procedure, your doctor will do an exam.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In many cases you do not need to stop eating or drinking before the procedure. In other cases, you might need to "fast" before the procedure. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during botulinum toxin shots? — When it is time for the procedure:

●The doctor will inject the medicine right into the treatment area. In some cases, they might use ultrasound or small needles (called "electromyography") to target the right muscles. To inject the medicine into the bladder, the doctor will insert a thin tube with a camera, called a "cystoscope."

●In most cases, this takes between 10 and 20 minutes.

What happens after botulinum toxin shots? — Most people can go home and return to their normal activities right after.

For the next day or so, do not rub or massage where you got the shot. In some cases, you might need to avoid lying down for a few hours.

What are the risks of botulinum toxin shots? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Pain, swelling, or bruising where shot was given

●Infection

●The medicine spreading to other parts of the body

●Muscle weakness

●Trouble breathing, swallowing, or talking

●Droopy eyelids

What else should I know? — Before you go home, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Muscle spasms (muscle cramps) (The Basics)
Patient education: Bladder spasm (The Basics)
Patient education: Crossed eyes and lazy eye (The Basics)
Patient education: Migraine in adults (The Basics)
Patient education: Migraine in children (The Basics)
Patient education: Anal fissure (The Basics)
Patient education: Treatments for urgency incontinence in females (The Basics)
Patient education: Dystonia (The Basics)
Patient education: Cerebral palsy (The Basics)
Patient education: Raynaud phenomenon (The Basics)
Patient education: Achalasia (The Basics)

Patient education: Migraine in adults (Beyond the Basics)
Patient education: Anal fissure (Beyond the Basics)
Patient education: Urinary incontinence treatments for women (Beyond the Basics)
Patient education: Raynaud phenomenon (Beyond the Basics)
Patient education: Achalasia (Beyond the Basics)