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Botulinum toxin injections, such as Botox

Botulinum toxin injections, such as Botox, relax the muscles in your face to smooth out lines and wrinkles, such as crow's feet and frown lines.

It's not permanent – it usually lasts for around 3 or 4 months.

In the UK, the cost of botulinum toxin injections can vary from about £100 to £350 for each treatment, depending on the clinic and the area being treated.

Botulinum toxin injections for cosmetic reasons are not available on the NHS.

What to think about before having botulinum toxin injections

If you're thinking about having botulinum toxin injections, be clear about why you want them.

Read more about whether a cosmetic procedure is right for you.

Make sure the person doing your injections is suitably qualified and experienced.

They should be a medical practitioner and on a register to show they meet set standards in training, skill and insurance.

Avoid practitioners who have no training or have only completed a short training course.

When you meet the practitioner, ask about:

  • their training, qualifications and experience
  • the name of the product, if it's licensed, and how and where it's made
  • any risks or possible side effects
  • what will happen if things go wrong
  • what insurance cover they have

Read more about choosing who will do your cosmetic procedure.

Botulinum toxin can only be prescribed in a face-to-face meeting by a qualified medical practitioner, such as a doctor, dentist, pharmacist prescriber or nurse prescriber.

The person prescribing botulinum toxin is responsible for making sure it's given safely. They might not give the injections, but they should make sure it's done by a qualified and experienced practitioner.

When you cannot have botulinum toxin injections

In certain circumstances, botulinum toxin injections are not recommended, including if:

  • you have a skin infection
  • you're unwell in any way
  • you have a neuromuscular condition like myasthenia gravis
  • you're taking certain medicines
  • you're pregnant or breastfeeding

What having botulinum toxin injections involves

Your face will be cleaned and botulinum toxin will be injected into muscles in your face using a very fine needle.

You will need injections in different places, depending on the area being treated. The practitioner will ask you to move the muscles in your face to help find the best place for the injections.

It usually takes about 10 minutes.

Afterwards

You will not see a change straight away. It takes about 2 or 3 days to start working, and 2 to 3 weeks to see the full effect.

Do not massage or rub your face for 3 days. Also, avoid vigorous exercise, sunbathing (including using sunbeds), and the sauna for 2 days. Your practitioner should be able to give you more advice about what you should and should not do.

The effects usually last for about 3 or 4 months. If you have botulinum toxin injections again, you should wait at least 3 months. It might stop working if you have it too often.

Risks

The risks of botulinum toxin injections are small if it's done correctly by a suitably qualified practitioner. Speak to your practitioner about the risks.

After treatment you may have:

  • a headache and flu-like symptoms for the first 24 hours
  • bruising, swelling and redness where the needles went in the skin
  • a frozen look – you might not be able to move the muscles in your face if too much botulinum toxin is injected
  • temporary weakness and droopiness in your face – for example, your eyelids or eyebrows may droop if the botulinum toxin moves into these areas

Very rarely, serious problems such as blurred or double vision can happen if the area around the eyes is treated, or breathing difficulties if the neck area is injected.

What to do if you have problems

Talk to your practitioner if you've had botulinum toxin injections and you're not happy with the results.

If you have a serious problem, such as difficulty breathing, dial 999 to ask for an ambulance or go straight to your nearest accident and emergency (A&E).

You can also report any side effects directly through the Yellow Card Scheme website. By reporting side effects, you're providing valuable information about the safety of the product used.

Page last reviewed: 9 July 2019
Next review due: 9 July 2022