Can Botox Make Autoimmune Disease Worsen?

Question

I have been receiving botox injections in my eye area due to an eye problem as a result of bells palsy which occured over 26 years ago. It is more that 3 years now that I have been receiving the injections every 4 to 5 months. It has been now a little over 2 years I have felt extreme fatigue and muscle pain to the point where it interferes with my daily activities and which at times is so severe that I do not know how to deal with it . I have been also seeing doctors for the past 2 years who have told me that the symptons were due to depression and menopause. However just this week I have some results from the immunologist that I have Lupus. I am now wondering could it be that I have had an autoimmune desease for awhile now and the botox injections have made things worse for me , and led me to get Lupus.

Ron Shelton, MD · Answer

There is no evidence that I am aware of that links continued Botox use and the stimulation of autoimmune diseases, including Lupus. I don&rsquo;t see any similarity between the antigen of Lupus (the molecular structure to which the body attacks via antibodies) and Botox.

David Shafer, MD, FACS · Answer

Mariano,
Botox does not cause autoimmune disease.  It is more likely in your case to be a coincidence rather than a cause.  It sounds like you are seeing the right doctors.  Good luck with your progress.

Kenneth D. Steinsapir, MD · Answer

First, I hope that now you have been diagnosed with Lupus and can get appropriate treatment, you will feel better.  There is currently no evidence that treatment with botulinum toxin A causes any autoimmune diseases. Know that there is now a 20-year history of treatment with Botulinum toxin A.
Last year something like 4 million treatments were done.  WIth these kind of numbers, if Botulinum toxin A did cause an autoimmune disease, there would likely be evidence to support this idea.  There is not.  In fact, botulinum toxin A is used to help focal spasms associated with multiple sclerosis, an autoimmune disease affecting the nervous system.
I would recommend following the advice of your rheumatologist regarding treatment for your lupus.  Also, while it is easy to tell someone to get treatment for depression, recognize that one can become depressed when every day you don't feel right and no one seems to have an answer for what is causing the problem.
I would encourage you to monitor you feelings and consider that you may also have a mild chronic depression. This type of problem is best assessed by a psychiatrist who should spend enough time talking with you to decide if you are depressed or not.  Again don't get a treatment if you don't have a problem but do get the help you need.    Good luck and feel better soon.

Steven H. Williams, MD · Answer

Botox works by chemically binding and blocking acetylcholine release, causing a chemical denervation. Acetylcholine release requires docking and binding of the neurotransmitter vesicles to the presynaptic membrane.
I am aware of no scientific evidence linking Botox and autoimmune disease.
I hope this helps.

Steven Wallach, MD · Answer

As far as I know, there is no association between getting botox injections and developing an autoimmune disorder.

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