Key takeaways
- Botox for chronic migraine prevention is given as 155 units across 31 injection sites in seven muscle areas, including your forehead, temples, behind your ears, and the back of your neck and shoulders.
- You’ll likely receive these injections every 12 weeks. Some people notice a reduction in migraine headaches 2 to 4 weeks after the first series, but it may take up to 6 months to feel the full benefits.
- Botox injections for migraine aren’t likely to reduce wrinkles or significantly change your face, though your forehead may look slightly smoother due to injection sites in that area.
Botox is a prescription drug used to help prevent headaches in adults with chronic migraine. It works by blocking pain signals and relaxing overactive muscles.
For migraine, you’ll likely receive Botox injections every 3 months.
Botox comes as a powder in single-use vials that’s mixed with liquid to make a solution. This solution is given as injections into seven different muscle areas of your neck and head by a healthcare professional. They’ll inject 155 units into 31 sites in your neck and head.
The healthcare professional will inject the medication into multiple sites in each muscle area. These sites include:
- above your ear, behind each temple
- behind each ear
- in your lower forehead near the inner edge of each eyebrow
- in your lower forehead just above your nose
- above each eye, in the middle of your forehead
- between your neck and shoulder on both sides
- near the back base of your skull on both sides
You’ll likely receive these injections every 12 weeks. Some people begin to notice a reduction in migraine headaches 2 to 4 weeks after their first series of Botox injections. However, it may take two series of injections and up to 6 months before you feel the full benefits.
While Botox may decrease the number and duration of migraine attacks you experience, it will not stop them entirely.
The Food and Drug Administration (FDA) has not approved Botox to help prevent chronic (long-term) tension headaches (also called stress headaches). But healthcare professionals sometimes prescribe Botox off-label to help with this condition. “Off-label” means a drug is prescribed for a condition it hasn’t been approved to treat.
Chronic migraine — which Botox is approved to treat — is defined by headaches that last at least 4 hours and occur 15 or more days per month. Botox is not prescribed to help prevent symptoms of episodic migraine, which happen 14 or fewer days each month.
Tension headaches are considered chronic if they occur 15 or more days per month for 3 or more months in a row.
Unlike migraine headaches, tension headaches tend to affect both sides of your head and can occur with neck or shoulder stiffness. Tension headaches don’t usually cause nausea, while migraine headaches do. And people experiencing tension headaches may be more sensitive to sound and light.
Botox injections for migraine headaches are unlikely to affect your facial appearance or reduce wrinkles. Botox only relieves pain in the nerves of the muscle groups where it’s injected. But it’s possible that your forehead could look a little smoother after Botox injections for migraine treatment, considering the location of certain injection sites.
It’s also possible for Botox to cause unwanted facial side effects, such as drooping eyelids, but these are usually temporary.
If you’d like to temporarily reduce lines and wrinkles on your face, ask a healthcare professional about Botox Cosmetic. It contains the same active ingredient (onabotulinumtoxinA) as Botox, but it’s given in lower doses and injected into different sites.
Botox treats chronic migraine by blocking pain signals and calming overactive muscles. For this purpose, a healthcare professional typically injects the drug into 31 sites on the neck and head.
The drug wears off after 3 months, but can be used long-term to prevent chronic migraine.
If you have questions about Botox for headache prevention or wrinkle reduction, talk with your doctor.
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