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

Question

I received Botox for the second time for my face and 3 days later was covered in hives, a sunburn like itchy burning rash over my torso, neck, chest and hands. The first botox treatment caused no such reaction. My Dr. put me on prednisone for a 10 day treatment. It has now been over 9 days since the botox, 6 days since being on the prednisone, and I am still itchy with hives that come and go. There are no hives on my face where I received the botox. When will this go away!!!

Harold J. Kaplan, MD · Answer

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.

Jerome Edelstein, MD · Answer

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.

Ron Shelton, MD · Answer

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.

Kenneth D. Steinsapir, MD · Answer

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.

Eric M. Joseph, MD · Answer

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&reg; Cosmetic
	Allergan, Inc.
	P.O. Box 19534
	Irvine, CA 92623
	USA
	1-800-433-8871

	Hope this helps.

	Dr. Joseph

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

Answers (10)