What to Know About BOTOX Cosmetic

BOTOX Cosmetic is a purified and safe form of botulinum toxin A, which is produced by a microbe and causes botulism. When injected, BOTOX will temporarily paralyze the facial muscles preventing them from creating deep wrinkles, crow’s feet, and furrows in the skin.

Woman getting a Botox treatment
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Wrinkles are caused by a combination of the lack of collagen in the skin, cellular changes in the body, changes in the environment and exposure to the sun. Manufactured by Allergan, Inc., BOTOX is used to treat other medical conditions, including:

  • Overactive bladder
  • Chronic migraine
  • Chronic pain
  • Neck spasms
  • Strabismus
  • Blepharospasm
  • Cervical Dystonia
  • Upper limb spasticity
  • Muscle twitching


Originally approved by the U.S. Food and Drug Administration (FDA) for the treatment of blepharospasm, eye and muscle spasms, BOTOX Cosmetic came to be recognized for the cosmetic value it supplies. With injections placed properly, BOTOX Cosmetic can block nerve impulses from being sent to muscles. It weakens them so that they cannot contract. This results in temporarily eliminating moderately severe furrows and lines.

There are three other brands of botulinum toxin Type A: Dysport, Xeomin, and Reujuveau.

Procedure and Results

With a very fine needle, BOTOX Cosmetic is injected into the facial muscles that cause furrows and lines.

For patients who want to lessen the appearance of crow’s feet or frown lines, the physician will inject BOTOX Cosmetic into the following facial areas:

  • Crow’s feet: BOTOX will be injected into three areas of the orbicularis oculi, the muscle that frames the side of the eye.
  • Frown lines: BOTOX will be injected into two of the muscles in the forehead—the procerus and corrugator muscles.
  • Horizontal forehead lines: BOTOX will be injected into the frontal muscle in the forehead.
  • Vertical lip lines: BOTOX will be injected into the upper lip.

Doctors may choose to numb the area with ice packs or a topical numbing cream prior to being injected with BOTOX Cosmetic. Within a few days of treatment, patients will begin to see results and they can last up to four months, although areas that are treated regularly may have longer-lasting results. Injections of BOTOX Cosmetic should be given only by qualified medical professionals.

Side Effects

Patients have reported that the injection of BOTOX Cosmetic feels like a pinch. Some of the side effects of a BOTOX Cosmetic injection are usually mild and temporary, and include the following:

  • Headache
  • Neck pain
  • Difficulty with vision
  • Localized pain at the injection site
  • Infection
  • Inflammation
  • Tenderness
  • Swelling
  • Redness
  • Bleeding
  • Bruising

Patients can resume normal activities after receiving BOTOX Cosmetic injections.


Patients who are contemplating BOTOX Cosmetic injections should alert their doctor to any of the following conditions:

  • An allergy to the ingredients in Botox Cosmetic
  • An allergic reaction to any other botulinum toxin product
  • A skin infection at the planned injection site
  • A muscle or nerve condition that may result in difficulty swallowing or breathing
  • Spread of the toxin effects to areas away from the injection site.

The doctor should be made aware of all medical conditions and all medications taken, including prescription and nonprescription medicines, prior to injection with BOTOX Cosmetic.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Accessdata.fda.gov. BOTOX® (onabotulinumtoxinA) for injection, for intramuscular, intradetrusor, or intradermal use.

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  4. American Board of Cosmetic Surgery. Learn more about Botox, Dysport, Xeomin & Jeuveau.

  5. Alsantali A. A comparative trial of ice application versus EMLA cream in alleviation of pain during botulinum toxin injections for palmar hyperhidrosis. CCID. 2018;11:137-140. doi. 10.2147/CCID.S155023

  6. American Society of Plastic Surgeons. How long does Botox last?

  7. Witmanowski H, Błochowiak K. The whole truth about botulinum toxin – a review. Adv Dermatol Allergol. 2019;37(6):853-861. doi. 10.5114/ada.2019.82795