Are there different quality Botox needles?

I recently had my fourth Botox tx by the same doc. I am a guy and get about 100 units. The pain level the first three times was surprisingly small. This last time, however, some sticks really hurt. Aware there are different gauge needles, I am wondering if there are also different quality needles? A female friend who sees the same doc said her pain was so bad that she is going to find a different doc. Thanks!

Doctor Answers 11

Pain with Botox injection

Pain is mostly related to technique. Smaller needles are probably less painful than larger (thicker) needles. If the Botox is mixed with plain saline it will hurt more than if preserved saline is used. I use vibration and cooling to improve comfort during injections as well. "Quality" of the needle probably is not a factor.

Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Pain with injection of Botox

I am sorry you experienced discomfort during your Botox injections! Unfortunately, pain is relative to the person who experiences it. The needles for Botox injection vary as you mentioned, by gauge size, not by quality. The injection technique may vary slightly, but should not result in significant variations of pain. I would suggest for future injections taking Tylenol prior (not ibuprofen, as that would be a blood thinner) and seeing if that improves your overall experience. Best, -Justin Harper, MD. 

Justin Harper, MD
Columbus Physician
5.0 out of 5 stars 19 reviews

Botox injections tolerable

Most patients should have no trouble tolerating botox injections with the pain level rated as minimal to mild. Typically the skill of the injector is far more important the the gauge of the needle. If you continue to experience significant discomfort with your subsequent botox treatments, it would be wise to consider another injector. 

Andrei Metelitsa, MD, FRCPC
Calgary Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Are there different quality Botox needles?

Hello, and thanks for your question. I use 32 gauge needles (smaller than the 30 gauge needles some use), and topical numbing, when desired by my patients. If your injections are painful I suggest trying a different injector. Best of luck, Dr. Frucht.  

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Different Botox Needles

I use a 32 gauge needle which is tiny and is smaller than 30 gauge.  I also use cold air cooling during the injections which helps quite a bit to reduce any discomfort (we call this gentle technique "Kool-Tox").  My patients generally feel minimal discomfort during Botox injections.  If you find that your injections are very uncomfortable, I would suggest trying a different injector.  


Dr. Ort

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 27 reviews

Are there different quality Botox needles?

Hello Rick77,

When it comes to experiencing discomfort with Botox injections, or any injections, the needles won't be what is causing the difference.  As long as they are using a 30 gauge then the needle isn't the reason why you felt pain at this past injection.  A lot of the comfort level is going to be technique driven (such as not going down and actually hitting the bone, using distraction techniques, not injecting too much in a given area, etc.).  Some of it will be inherent to the individual, but since you had three injections before without discomfort then that is now what happened here.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Botox Injection Technique is very Important

Botox injections should not be painful.  There can be different gauges to Botox needles but most of them should be small enough where it should not make a difference.  A gentle technique can make the procedure quick and easy with minimal discomfort. If you had been to the same provider in the past and were happy with his technique and results, I would bring this issue up with him/her.

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews

Botox needles and discomfort.

Hello Rick77,

Thank you for your question. Being that the needle used to inject Botox is very small and delicate (30 gauge) it will not remain sharp and durable over the course of repeated injections as would a much larger one say 18-22 gauge which you would definitely not want for Botox! Other subtle things such as hitting bone during an injection will not only increase the pain but quickly dull the needle. Professional injectors have many methods to minimize the discomfort of an injection (ice, vibration devices, numbing creams etc.), number of injections per needle etc. The standards for quality (materials, sterility, strength, manufacturing process) are regulated for all surgical instrumentation however there can be subtle differences between various manufacturing companies which affect the ultimate functionality of a specific needle, scalpel or instrument. Bring your concerns to the physician you have been seeing I am sure a simple remedy can be found for your ongoing comfort. 

Paul Pietro, MD
Greenville Physician
5.0 out of 5 stars 3 reviews

Pain with Botox injection

Yes, needles vary . I doubt that size is the issue because I don't know anyone that uses a needle thicker than a 30G and a bigger needle might also be more likely to drip bigger drips and nobody wants to waste even a drop. However, needle quality varies a lot and there are sharper and duller needles. A needle that came out of same box as another might not even be identical and I sometimes throw one out after one stick when I don't think that it is quite right. Doing many injections with same needle dulls it. If you reconstitute your Botox with saline that is not bacteriostatic, it hurts like the devil.  your Botox

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 19 reviews

Pain with botox injections

Pain with botox injections varies greatly with technique, needle size, and diluent of the product.   Larger needles, high volume injections, multiple injections with the same needle and use of a diluent that doesn't have bacteriostatic solution can all hurt worse.   The other major factor is with needles used to draw up solution that accidentally hit the glass of the vial and cause a burr.  

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 11 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.