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After Botox, when Can I Touch the Treated Area?

I have had botox injected into my brow. When can I actually continue excercise, or even touch my brow to cleanse, use cosmetics, etc.?

Looking at various websites, some are saying don't rub/massage/touch your brow for 4 hours, 24 hours, 48 hours, 72 hours, 4 days, 2 weeks. I am confused, as you have to rub your brow to cleanse, moisturise, foundation, etc.

Doctor Answers 11

Skin manipulation after botox

Two general thoughts, since you have a fairly clear answer that suggests four hours without massage to the area.

One, light treatment to the skin surface should be fine. Skin care, moisturizing, and make up are all supported in my practice right away. Logically I just can't see how a gentle surface treatment would disrupt botox behavior properly placed in the muscular layer below.

Two, the four hours is also a completely random, unstudied duration. It began because the maker of Botox, Allergan, initially made that suggestion. So even though most docs will quote that four hour window for aggressive massage or significant physical exertion, they are really towing the Allergan company line. Again, no data.

I have found that very active patients, ie those that work out 4 or more times a week, as well as those high energy type A patients, all seem to break down botox faster. So my observation is that it is either the amount of exercise or the general speed that you live your life that influences duration more than what you do the first four hours post injection.

Madison Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Gentle contact is OK after Botox

After Botox treatments, I advise my patients not to massage or press on the treated areas for at least 4 hours. Gentle contact such as washing or make-up application are OK, but should be minimized. Botox is injected into a specific set of muscles to exert a specific effect. To minimize the risk of having the Botox unintentionally affect the wrong facial muscles, give your body 4 hours to absorb the medication. There are no studies that can specify an exact time frame. My recommendations are based on experience. As always use your best judgement.

Richie L. Lin, MD
Summit Dermatologic Surgeon

Touching Botox-treated area after injections

I have extensive experience injecting BOTOX in too many people for many years. I make virtually no restrictions or limitations on my patients following BOTOX injections and I have yet to see any problems related to activity. My patients can touch their face, wash their face, and put make-up on their face immediately following the BOTOX administration. They can lie down, stand-up, and exercise. I suppose I would not recommend a deep massage of the areas injected shortly following the injections but I do not think that any of my patients have done this. Basically, I recommend that, following your BOTOX injections, you follow your normal routine.

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

Don't want to spread Botox to untreated area

The idea behind not massaging or manipulating the Botox treated area is that you do not want to spread the Botox to a different muscle. 4 hours is a good rule of thumb because by that time the saline solvent is pretty much absorbed.

Having said that, light touch is OK (as in applying make-up, washing). I would not worry too much unless the frown area or eyelids (actual lids, not the crows feet) are treated because those areas are most sensitive to unwanted Botox spread affecting the levator muscle in the orbit causing temporary eyelid drooping.

This is also the reason why patients are cautioned not to lay down for 4 hours. Bending, upside down positions, exercise should not be a problem.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
5.0 out of 5 stars 19 reviews

You can do most activities after Botox

There is no scientific proof for either spreading or altering the effects of Botox based on activity after getting an injection. There used to be some doctors who told patients to go home and lie still for 4 hours. Others told patients to squeeze their facial muscles to get the Botox to "work in." I go more with common medical sense. For the first few hours, I tell my patients not to rub the are or engage in vigorous exercise. Most activities are OK. Patients often apply makeup back on even before leaving my office.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 62 reviews

Botox injection limitations.

I would agree that four hours is consdiered a reaonable time limit during which the treated areas should not be manipulated and avoidance of vigorous physical activity or excercise.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 60 reviews

Exercise and touching the face after Botox

There has not been any clear scientific studies investigating this issue, but a safe guideline has been not to bend over at the waist or recline back flat for four hours after surgery. Whether this is a real concern is not known. Some may say less is OK, but until proven otherwise, four hours is what had been recommended many years ago. Gentle cleansing of the area and application of makeup should be OK four hours later, sooner if you're able not to bend over while washing the area and are extremely gentle.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 34 reviews

Botox 4 Hour Recommendation

Theoretically it is possible to manipulate or move the neurotoxin into an undesirable muscle resulting in drooping of the brow, eyelid or lower face. For this reason, we recommend that within the first 4 hours after receiving Botox or Dysport that our patients avoid rubbing or touching the area of injections (except to gently apply makeup), engage in highly aerobic activity or lay face down in bed or a massage table.

Lee Robinson, MD - RETIRED
Portland Facial Plastic Surgeon
3.5 out of 5 stars 2 reviews

No massage!

Always get your advice from your doctor, but most experts recommend you do the following:

1. Never massage the area, but it is OK to apply cosmetics, especially if you use a brush

2. Do not do yoga or any unside-down position for at least 3 hours

3. Move the injected muscles: frown, smile, look surprised, etc for 3 hours while the neuromodulator is being incorporated into the the neuromuscular junction

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 12 reviews

4 Hour Recommendation for Botox

Looking at various websites, some are saying don't rub/massage/touch your brow for 4 hours, 24 hours, 48 hours, 72 hours, 4 days, 2 weeks. I am confused, as you have to rub your brow to cleanse, moisturise, foundation, etc.

Bruce E. Katz, MD
New York Dermatologic Surgeon
4.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.