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Are White Patch Spots Under the Eyes Normal After Years of Getting Botox Injection Treatment?

Beautiful middle-aged blonde woman shows off her perfectly well-groomed face

Botox has earned a name for itself as a safe cosmetic injectable that improves the appearance of most forehead wrinkles, Crow’s Feet, Bunny Lines, Smoker’s linesand glabellar lines among men and women of all ages. However, both on and off-label uses of Botox cosmetics such as for treatment around the eyes and brow lifts need to be administered by a trained injector to minimize side effects and serious complications.

So what causes white patch spots to appear under the eyes after Botox? Are white patch spots under eyes years after Botox injection treatment normal? Small whiteheads or patches, known as milia, rarely appear as a side effect of Botox. Milia can be caused by skin damage from a poorly done injection. The spots don’t pose any negative health risk but there’s a chance that they are permanent which can affect your overall look. Treatments and topical products are available to minimize their appearance.

Why Do White Spots Appear After Botox?

Botulinum toxin, commercially known as Botox, is a strong nerve toxin. It has various uses in the field of cosmetic surgery and medicine including the treatment of migraines, lazy eye, excessive sweating, and cervical dystonia. High doses of Botox injection can be harmful which is why it’s carefully regulated when used for cosmetic purposes.

Most of the time, Botox injections are given in tiny amounts depending on the area of treatment. The toxin works by weakening the facial muscle and limiting their movement so they won’t contract. In turn, the skin smoothes out and the appearance of creases and fine lines are reduced.

It’s imperative that Botox injections are performed by a highly skilled and certified medical professional to avoid complications. If the botulinum toxin treatment for the eyes is poorly injected, it can cause unwanted side effects which may include dry eyes, inflammation of the cornea, eyelid swelling, and vision problems such as blurred vision and double vision.

The white spots that appear under the eyes may be caused by an irritation or allergic reaction. Milia present as tiny white bumps, similar to whiteheads, and they’re not necessarily a cause for medical concern. There are two kinds of milia:

  • Primary milia: They show up when dead skin cells are trapped beneath the skin. They’re common among children and young adults and are typically found on the eyelids, forehead, and cheeks.
  • Secondary milia: These kinds of spots appear when the skin becomes damaged from irritation, inflamed skin condition, sun exposure, rash, or abrasion. Botox can cause a localized skin infection when done poorly and can lead to rare sightings of milia in the injection site.

There’s a clinical trial conducted by the FDA where they analyzed 49,763 people who were getting Botox injections. The study closely examined the side effects they experienced while getting injections for wrinkles and acne treatment. It showed that within one month of having Botox administered, only 5 people reported having milia. Other reactions experienced by those with milia included swelling, rashes, and itchiness.

Intramuscular injections of Botox can also affect sebum production and sometimes lead to clogged pores, triggering whiteheads and acne spots to appear after the treatment. Primary milia can often go away on its own, while secondary milia may be permanent. Luckily, there are available exfoliating products, topical Retinoid prescriptions, and eye creams that can improve their appearance.

In some cases, the white or pale patches can be characterized as facial blanching. Blanching is another unusual side effect of Botox treatment. It occurs when the injection is applied close to a blood vessel which leads to vascular occlusion. With an occlusion, the circulation of blood is disrupted and white spots can appear on the skin. 

The appearance of white spots may also look similar to a type of skin cancer known as basal cell carcinoma (BCC). This skin disease can start as an acne scar or patches of discolored skin but can grow to the size of a small bump. Often, BCC may be caused by years of sun damage or exposure to UV lights. There hasn’t been a reported case where Botox has resulted in cancer of the skin.

Lastly, people of color who get Botox treatments may also be prone to spotting or pigmentation of the skin. People with dark skin are more likely to develop pigmentation which can happen as a result of a poorly administered cosmetic injection.

Understanding the Side Effects of Long-Term Botox Treatment

cosmetic injection of botox to the pretty female face

Many people prefer Botox since it’s a minimally invasive and low-risk procedure. Long-term treatment of botulinum toxin is usually performed to remedy medical conditions such as overactive bladder, hyperhidrosis, and muscle spasms among others.

A 2005 study shows that adverse effects are more common for therapeutic uses of Botox than cosmetic. This can be because certain conditions require higher doses of Botox compared to Botox aesthetic treatments that only need small amounts. Risks are also greater in clients with pre-existing conditions that can have a negative reaction to the toxin.

These symptoms are related to botulism poisoning which can happen when the toxin has spread and attacked various nerves in the body. You should seek immediate medical attention from a doctor if you begin experiencing these effects.

Is It Safe to Get Long-Term Botox Cosmetic Treatments?

One catch that Botox injections have is that they’re only a temporary solution to cosmetic problems. While it’s effective in reducing the prominence of wrinkles and lines in the face, it can only take effect for up to 3 to 6 months. After which, the relaxed muscles will contract again.

To maintain their wrinkle-free look, many people get Botox treatments at least three times a year depending on their provider’s advice. Consistent injections can help maintain the effectiveness of the toxin and let you enjoy smooth-looking skin for a long time. As long as the procedure is done by a qualified medical injector with proper training and experience, there are generally no issues or complications from frequent Botox sessions.

Read more: A Guide to Botox for Eyes Lift Treatments

Things to Do to Avoid Botox Complications

After getting the Botox injectable, clients are generally advised to take it easy to achieve optimal results without any complications. To optimize results, the client should follow these aftercare reminders:

  • Avoid participating in strenuous activities or physical exercise for a day after getting Botox. This can increase blood flow which in turn causes the toxin to migrate to other areas, and it can also promote bruising at the injection site.
  • Don’t touch the face or the treated area after getting the injection. Applying pressure can unintentionally spread the toxin to other areas and increase the risks of negative side effects.
  • You can use a cold compress or ice pack to control swelling and bruising at the treatment site.
  • Stay away from alcoholic drinks before and after the Botox procedure. Alcoholic beverages have blood-thinning properties which stimulate blood flow in the injected area and increase the risk of bruising.
  • Minimize the application of make-up and skin care products for the first 24 hours after the treatment.
  • Limit exposure to the sun and other sources of high temperature such as tanning beds, hot tubs, and saunas. The heat can promote bruising, flushing, and increased blood circulation.
  • Botox cosmetic treatments should also be avoided by women who are pregnant or are breastfeeding.

Other Complications That May Arise From Cosmetic Procedures

Woman talking to professional botox injector

These days, there are a variety of options for facial rejuvenation treatments. Each cosmetic procedure comes with its own set of side effects and possible complications. The best way to minimize these risks is to ensure that they’re administered by an experienced provider. Here are some popular cosmetic treatments and their possible complications:

1. Dermal Filler

Dermal filler, or hyaluronic acid filler, is a common facial and lip augmentation method. It involves injections of a gel-like substance that contains hyaluronic acid, which fill in the hollowing parts of the skin rather than paralyzing the muscles like Botox. Complications from a filler injection usually happen due to poor application or low quality of filler material.

People who get dermal filler injections may experience side effects such as swelling, bruising, and pain. Vascular occlusion is one of the rare adverse consequences of filler treatment and it can often cause pain, skin blanching, tissue necrosis (death of tissue), and permanent scarring. Granuloma formulation may also happen as an inflammatory reaction to improper injectable filler placement.

2. Chemical Peel

This treatment uses chemical substances to help reduce the appearance of  wrinkles, scars, pigmentation and lines on the skin. The chemical solution is applied to the top layers of the skin (dermis), and after some time, the old skin will be peeled off. This procedure greatly improves the texture and look of the skin, as well as enhances any uneven skin tone or discoloration.

Possible complications from chemical peels can include redness and scabbing of the skin, scarring, delayed wound healing, pigmentation changes, bacterial or viral infection, and the appearance of acne or milia.

3. Laser Treatment

Laser resurfacing is a technique that uses either ablative or non-ablative laser devices to treat skin and facial problems. It works by heating the dermis to stimulate the production of new collagen in the affected area. With a new batch of collagen, the skin will improve its appearance and reduce wrinkles, blemishes, and even acne scars.

Swelling, itching, scarring, and changes in skin color are some of the common side effects of laser treatments. In some cases, serious conditions such as keloid, contact dermatitis, erythema, and wound infection may occur from treating the skin with lasers.

How Does Botox for Eyes Work? 

Botox for under the eyes has yet to receive approval from the FDA. Injecting them to treat eyebags and dark circles in this area is still considered off-label use and requires a skilled provider to minimize its risks. Even so, Botox is deemed effective to address certain wrinkles in the eye area and correct issues that can affect normal vision such as:

  • Crow’s feet — These are expression lines that form at the corner of the eyes. Using Botox for the treatment of crow’s feet will relax the muscles surrounding the eye area, allowing the skin at the edges of the eyes to look smoother. Twenty-four Botox units is the average dose needed for the treatment of crow’s feet.
  • Droopy eyelids — Sagging skin on the eyelids due to lost elasticity can be augmented by Botox. Botox simultaneously relaxes the eyelids and tightens up the muscles in the eyelid area, making the injectable a non-invasive alternative to having eyelid augmentation. 
  • Hooded eyes — People with hooded eyes have excess skin that protrudes on their upper eyelids, and they tend to look distinctly tired all the time. The Botox brow lift is usually done to remedy this condition and it uses 4-6 units per side.

Results of injecting Botox around and under the eye area may take three days to a week to be fully visible. During the recovery, you may feel side effects such as bruising, swelling, headaches, rashes, and temporary muscle weakness. Afterward, the treated areas will start to look smoother, clearer, and show less wrinkling, and these effects of Botox can last for 3 to 4 months.

Learn more: How Many Units of Botox Do You Need for Eyes?

Choosing a Botox Provider

While they’re a cosmetic treatment, Botox injections will only be successful if they’re given by a practitioner who’s had proper training and is equipped with knowledge on the procedure. You’ll want a medical professional who has undergone specific training on administering neurotoxin injectables. They should also have complete mastery of the facial anatomy and know how to precisely inject needles to the desired treatment area.

When selecting a specialized provider or medical spa, you should check out their online reviews and read through client testimonials to see how well they serve their clients. You can also ask about their history of doing Botox treatments so you have an idea of what to expect when you choose to get the injection from them.

Evolve Med Spa: Your Trusted Partner for Safe Botox Cosmetic

White spots after Botox injections are a rare complication that may occur when the cosmetic procedure is done incorrectly. To be on the safe side, you should only receive Botox from a licensed medical provider who has the suitable skills to properly administer the treatment. Our medical and cosmetic staff at Evolve Med Spa can help you.

Here at Evolve Med Spa, our Botox providers are all trained experts who are qualified to perform safe and quality cosmetic injections. We’re committed to offering the best products and services for any of your facial concerns and anti-wrinkle needs. Call us today so we can discuss how we can help meet your aesthetic goals.

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Chemical Peel vs. Microneedling: A Comparative Guide 

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