Botox Cosmetic Use with Long-term Illness or Medical Condition

Are there any illnesses or medical conditions that would make Botox Cosmetic unsafe to use?

Is it safe to use Botox if you have a long-term illness like cancer or HIV? What about if you have a medical condition (I have Ehlers Danlos Syndrome Type 3, a genetic disorder)?

Doctor Answers 9

Ehlers-Danlos is not a contraindication to Botox

Patients with Myasthenia Gravis, Eaton-Lambert synrome, or ALS should not have Botox, as well as pregnant or breast feeding women.

Ehlers-Danlos patients (a connective tissue disorder) can have Botox but it's a good idea to discuss this with your internist or rheumatologist.. For those reading this that don't know, E-D patients have very stretchy skin and loose joints. There can also be internal manifestations in the organs .Keep in mind:---Botox will not tighten the skin and does not replace the need for a facelift, browlift, eyelid lift, etc to remove excess skin.

HIV and cancer are not contraindications, but one should not have Botox injections if you have an active infection which may be more likely if your immune system is compromised from HIV or chemotherapy

Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 40 reviews

Botox Contraindications

Hi Anna,

There are some contraindications to Botox use. Patients with neurological disorders such as myasthenia gravis should not receive Botox. Patients with HIV, cancer, and Ehlers Danlos may safely receive Botox treatments. Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Medical Conditions and Botox

Botox is a very safe and locally acting medication when injected by experienced board-certified plastic surgeons and dermatologists.  Having cancer or HIV does not preclude you from enjoying the benefits of Botox.  There is some concern about Botox use with neurological disorders.  However, I feel many of these fears are unfounded.  The medical companies are just being very cautious to ensure the highest level of saftey.  

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Botox and contraindications

I would avoid Botox use in patients  with neurologic disorders.  Certainly patients that have multiple medical problems should probably avoid Botox.  In addition pregnant women or women who are actively breast feeding should not have Botox.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Botox & Chronic Medical Conditions


Botox is an extremely safe and very effective medicine. It works by entering muscles and relaxing them. Botox is injected directly under the skin or into the muscle directly. Botox remains in this area and does not typically move. Botox is been used successfully in many patients with chronic conditions such as cancer, HIV, diabetes or high blood pressure. Patients who have autoimmune disorders should consult with their rheumatologist before beginning a course of Botox.

For more information on Botox or to schedule an iConsult, please visit us online at: 

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 108 reviews

Contraindication to BOTOX

Ehler Danlos type 3 is mostly hyperextesibility of joints and may be skin. However, Ehler Danlos patients can have muscle weakness as one of their symptoms. If you do have muscle weakness in any form I would advise you not to have BOTOX. Cancer and HIV is NOT a contraindication to the use of BOTOX

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Contraindications to using Botox

None of the medical conditions you mentioned would be made worse by using Botox. Botox acts by locally weakening muscles which produce wrinkles.

The only conditions under which we should re-think using Botox are nerve and muscle diseases in which the body may be extremely sensitive to the use of Botox such as Eaton-Lambert Syndrome, Myasthenia Gravis,amyotrophic lateral sclerosis [ALS or Lou Gehrig’s disease],OR could be allergic to the Botox itself (based on past reaction)

To fully understand Botox, follow the comprehensive link below -

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Botox safe for most people.


There are really very, very few conditons that make Botox injections unsafe.  People with your particular condition can have multiple Botox injections without any evidence of harm.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Botox not recommended for certain neuromuscular conditions

Botox is very safe, having been used medically for over 20 years for certain medical conditions affecting the muscles around the eyes, as well as being used for certain spastic conditions in children. More recently, medical uses include treatments for pain and migraines. It is not recommended for persons with neuromuscular disease such as myasthenia gravis. Always seek the advice and treatment from a reputable aesthetic physician who is board certified in dermatology, plastic surgery, otolaryngology, opthalmology as they are qualified to understand the best use of botox and who is not a candidate. Ehlers Danlos is not a contraindication as that is a disease of the elastin and collagen of the skin and joints.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 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.