Allergic Reaction to Botox...When Will the Symptoms Go Away???

Contrary to what panel members are suggesting, we have had personal experience with a staff member that developed an allergy to both Dysport and Botox that was not an immediate response but progressed to this because she was unaware of the link to the Botox injections.  

We have also met two other practitioners that have reported an allergy (not resistance only) to these products that do not involve flu-like symptoms such as nausea/vomiting.  In our staff member's case, she develops large, nodules at each injection site with surrounding hives and swelling.  

Although we believe that a true allergy to Botox is uncommon, it certainly should not be considered "rare".  We don't believe that there is enough interest form the manufacturers or scientific community to pursue studies to speak to this in depth.  Besides being under-reported, many may not recognize symptoms of a potential resistance or allergy to these products.

In summary, report your condition to Allergan (the manufacturer) as well as your practitioner.

It is very rare but there have been reports of allergic reactions to Botox. Please refrain from getting anymore treatments and follow the advice of your doctor.

Allergies to Botox are very rare and if they occur, a true allergy would be manifested immediately not three days later.  There are other type of drug reactions that can be delayed.  It might be a component in the Botox or a component in the liquid used to dilute the Botox. You should see an allergist to whom the doctor who did your Botox refers you so they can provide the allergist with a sample of the diluent (liquid used to dissolve the Botox) and the Botox after diluted. The allergist can then test you to both. However, they need to treat you now to make the  hives go away. it may be coincidental and related to a totally different issue believe it or not.

This type of allergic reaction is very rare.  However, that really does not matter.  What matters is what your body does.  Please do not have BOTOX, Dysport, or Xeomin or any botulinum toxin treatment.  Place this information in your wallet or on the back of your drivers license.  I would recommend seeing an allergist to have formal testing to determine precisely what you had an allergic reaction to.  Also it is possible that the allergist will recommend that you carry an epipen.

Thanks for your interesting question. Botox injections are a regular part of my practice, and I have not seen a systemic allergy as you describe. You may want to get a second opinion from a certified dermatologist to help determine the cause of your rash and hives. You may also want to call Allergan, the manufacturer of Botox, to discuss your concerns:

BOTOX® Cosmetic
Allergan, Inc.
P.O. Box 19534
Irvine, CA 92623
USA
1-800-433-8871

Hope this helps.

Dr. Joseph

Thank you for your question! Allergies to Botox are very rare and if they occur, a true allergy would be manifested immediately not three days later.  There are other type of drug reactions that can be delayed.  It might be a component in the Botox or a component in the liquid used to dilute the Botox. You should see an allergist to whom the doctor who did your Botox refers you so they can provide the allergist with a sample of the diluent (liquid used to dissolve the Botox) and the Botox after diluted. The allergist can then test you to both. However, they need to treat you now to make the  hives go away. it may be coincidental and related to a totally different issue believe it or not. Best of luck! 

It is very rare to get a reaction from Botox. In fact, I have been treating patients with Botox for 15 years and have not heard of any problems like this from Botox. It is more likely the hives are from something else. You might add an anti-histamine and see a Dermatologist for  a more thorough evaluation.

In my opinion, and after having injected Botox for nearly 20 years (long before FDA approval even), these two things are unrelated. If you are allergic to Botox, the allergy would be immediate - starting within minutes - of being injected and would result in more than just a rash (like nausea, vomiting, throat closing, etc.) Additionally, since you had Botox previously and had no such reaction, you cannot be allergic to this extent now. I would suggest you sit down with your physician and go over anything else that might have changed with you - a new medication, a different medication (i.e., a pharmacy gave you a different version of a generic medication you were already taking), different lotions or creams you may have introduced, different foods you may have eaten, etc. A reaction like you are describing just cannot be related to a Botox injection done 3 days prior, not to this extent.

You really should consider seeing an allergist for evaluation and possible treatment if you  think this represents an allergic reaction to the Botox injections.  Ask the MD, that did the Botox injections, for a referral.  

There are many causes for hives (foods, medications, and infections for example) so it is highly unlikely your hives are caused by your previous Botox injections. There are also much better (and safer) treatments for hives then using Prednisone. Antihistamines are typically the mainstay of treatment. I recommend you see a board certified dermatologist for evaluation and treatment of your hives. No need to contact Allergan at this time as they will likely tell you the same thing.