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Managing Botox Side Effects for the Eyes

Botox is widely-known as a treatment for facial rejuvenation. Since 2002, it has been FDA-approved for addressing certain types of wrinkles like crow’s feet, frown lines, and forehead wrinkles. The Botox cosmetic is also an FDA-approved treatment for a number of eye problems, such as strabismus and blepharospasm, which concern the eye muscles. As effective as Botox is, however, patients may experience an adverse reaction when injected with Botox around the eyes. 

So how do you manage Botox side effects for the eyes? It depends on the symptoms you have, as most of the common Botox side effects tend to disappear on their own. For example, in mild cases of dry eye or droopy eyelids, you may need to apply eye drops or ointments for relief. On the other hand, if you’re experiencing a severe allergic reaction, it’s best to call your doctor immediately or seek urgent care. 

Are Botox Injections Around The Eyes Safe? 

The Botox cosmetic is primarily used for its ability to reduce the appearance of facial wrinkles -- specifically deep, dynamic wrinkles and folds, rather than fine lines. Botox cosmetic injections do this through its primary ingredient, botulinum toxin, which is produced by the microbe responsible for botulism. In small doses, cosmetic Botox can temporarily relax your facial muscles and keep the skin smooth. 

Botox treatment prevents the muscle from moving by blocking the chemical nerve signals from the brain to the muscles, preventing the muscles from contracting. In terms of eye wrinkles, the Botox neurotoxin can keep the orbicularis muscle from folding or furrowing, reducing the severity of crow’s feet and frown lines. And because it can keep muscles relaxed, Botox injections work well to relieve other problems with the body: 

  • Chronic migraine: When a patient has a headache or migraine from more than 15 days a month, it is considered to be a chronic migraine already. A Botox injection in the forehead muscle can help relieve pain. 
  • Cervical dystonia: Cervical dystonia, or neck spasms, is a painful condition where the neck muscles involuntarily contract and cause the head to twist or turn into an awkward position, triggering neck pain. 
  • Hyperhidrosis: Hyperhidrosis, also known as excessive sweating, is defined as abnormal sweating -- even when the temperature isn’t hot or you didn’t physically exert yourself. Injecting botulinum toxin can temporarily stop the brain from sending signals to the sweat glands. 
  • Overactive bladder: Bladder dysfunction and urinary incontinence caused by detrusor overactivity can be fixed with a few shots of Botox, which can control involuntary contractions of the bladder walls for increased urinary retention. 
  • Eye issues: Lazy eye (amblyopia), crossed eyes (strabismus), and eyelid spasms (blepharospasm) may occur if there is an imbalance or lack of control over the six muscles positioning the eyes.
  • Muscle contractions: Neurological conditions like cerebral palsy and upper limb spasticity may cause you to pull your limbs towards your center or become tense and overactive, limiting your ability to perform basic tasks. 

Generally, Botox is a very safe treatment. It has been used by countless people worldwide; in 2016, 7 million people received Botox -- and serious adverse events are rare among treated patients. Botox use for medical conditions is FDA-approved for men and women who are aged 18 years old and above, although there are some exceptions. You shouldn’t get Botox if you:

  • Are allergic to any ingredients in Botox
  • Are allergic to cow’s milk protein 
  • Are allergic to other botulinum toxin brands like Xeomin, Dysport, or Myobloc 
  • Are planning to conceive a child 
  • Are currently pregnant or breastfeeding
  • Have a skin infection in the injection site 
  • Have ALS (Lou Gehrig’s disease), myasthenia gravis, Lambert-Eaton syndrome, or other neuromuscular diseases 
  • Have difficulty swallowing
  • Have bleeding issues
  • Have breathing problems or asthma symptoms

Side Effects and Risks of Botulinum Toxin Injection for the Eyes

As long as Botox injections are performed by an experienced, board-certified doctor, they are a safe treatment to undergo. A qualified doctor will consult with you to determine if the procedure best suits your needs and your health condition. They’ll instruct you on how to prepare for the treatment, check your medical history, and address your questions or concerns. 

It’s also crucial to find an expert injector who knows the correct treatment sites and inject the Botox precisely so the small, highly concentrated dose of Botox won’t spread outside the intended area. For cosmetic Botox procedures to address frown lines around or under the eyes, your provider should be able to match their injection techniques according to your unique facial anatomy for good results. 

After Botox, your body is likely to react to this foreign substance temporarily. Common side effects experienced by patients include: 

  • Mild pain, swelling, or bruising in the injection site
  • Headache, dizziness, or flu-like symptoms
  • Crooked smile, drooling, or dry mouth 
  • Fat bulges near the injected area 
  • Eye dryness, excessive tearing, or hollowness under the eyes
  • Puffy eyelids, eyelid ptosis, or droopy eyelid
  • Brow ptosis or cockeyed eyebrows 

If Botox is administered incorrectly, it can be dangerous and cause potentially life-threatening complications. Usually, these unlikely instances occur due to a wrong placement of the injection -- causing the toxin to spread throughout the body. Some patients experience a severe reaction like an allergy -- rash, hives, wheezing, itching, feeling faint, or swelling in the face, lips, tongue, and throat. You should also call your doctor immediately if at least one symptom appears hours or days after receiving Botox: 

  • Nausea 
  • Diarrhea 
  • Urinary tract infection 
  • Pain or burning when urinating 
  • Crusting or draining from the eyes 
  • Eyelid swelling 
  • Stomach pain 
  • Irregular heartbeats
  • Sore throat or cough 
  • Chest tightness, pain, or pressure
  • Facial asymmetry 
  • Muscle weakness or stiffness
  • Blurred vision or double vision
  • Breathing problems or shortness of breath
  • Incontinence (loss of bladder control) 
  • Trouble speaking or swallowing
  • Eye pain or sensitivity of eyes to light
  • Inflammation of cornea (keratitis) 
  • Hoarseness or changes in the voice

Dealing With Unwanted Side Effects of a Botox Treatment 

Closeup shot of a young woman looking stressed out

In general, common side effects of Botox last a few days or weeks at most. Unwanted side effects tend to vary from person-to-person; reactions are often different depending on the condition you’re trying to treat. While the amount of Botox in the body eventually decreases and wears off, it’s best to talk to your doctor if the side effects bother you. Here are some things you can do to relieve discomfort at home: 

Headaches

It’s unclear why a Botox shot to the forehead can cause headaches, but it happens. When this occurs, you may take over-the-counter medication for relief. It’s best to call your doctor as well so you can discuss how you’re feeling before they make an appropriate recommendation. 

Urinary retention 

Sometimes, trying to treat an overactive bladder may make it more difficult to urinate at all, especially if you have diabetes or multiple sclerosis. In cases like this, a doctor should monitor your urine volume constantly. A catheter may also be used to temporarily help you empty your bladder until the symptom disappears. 

Upper respiratory tract infection 

Common flu-like symptoms such as a cold, cough, runny nose, sneezing, fever, fatigue, or a sore throat may occur as a mild infection from the injection. Aside from calling your doctor to ask for medication or treatment, it’s recommended to treat this as an ordinary flu. Get more rest, drink plenty of fluids, and use a humidifier or a steamy bath for relief. You may also try an expectorant or acetaminophen to relieve aches and fever. 

Injection site reactions 

Pain, tenderness, redness, bruising, or bleeding in the area you were injected are among the most common symptoms of Botox injections. These are usually caused by damaged blood vessels bleeding into the surrounding areas, although this effect doesn’t last for more than a few days. Avoid drinking alcohol, taking blood thinning medications, or engaging in vigorous activities if this happens. Keep your head elevated above your heart and apply ice at regular intervals to soothe discomfort. 

Dry eyes or droopy eyelids 

When the orbicularis muscle is treated with Botox, it may be difficult to open and close the eyelids completely. Eye drops (apraclonidine) or ointments would help, while a severe droop can be counteracted by additional Botox injections between the eyebrows. 

To prevent unwanted side effects, it’s best to find a practitioner with the proper medical qualifications. Someone like a salon stylist would not be an appropriate provider, because they won’t have the emergency equipment or sufficient medical knowledge to treat you in case something goes wrong. 

For eye treatment, it’s best to find an oculoplastic surgeon -- trained and board-certified ophthalmologists who have also completed highly-specialized courses in plastic surgery. Sensitive eyelids, tear ducts, and eye orbits should be handled by someone familiar with cosmetic, corrective, and reconstructive procedures for these eye structures. 

Learn more: What are the causes of droopy eyes and how to treat them?

Safe and Effective Botox at Evolve Med Spa 

At Evolve Med Spa, we understand that no two clients are alike. Rather than a one-size-fits-all approach, we prepare customized treatment plans to accomplish your aesthetic goals. 

Our expert medical staff stay updated with the rapid changes in the cosmetic industry, so we’re always equipped with the latest technologies and advanced techniques to perform safe and effective skin, body, and hair procedures. Schedule a consultation with Evolve Med Spa today to learn more about our custom treatments. 

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