Pain from Botox Injected into Scar Tissue on Face for Migraines?

I had Botox injections for Chronic Migraines (caused by Head Trauma a few months ago) and it was pure torture. I was offered no numbing cream, or pain relief of any kind. The doctor said it was painful due to the Inflamation and scar tissue. Is this common? If so, it is a horrible experience and I have a high pain tolerance.

Doctor Answers 2

Botox for scars or migraines

injection of scars is often painful, whether it is a corticosteroid, local anesthetic or Botox. Scar tissue is dense and replete with nerve endings when acute. mature scars may become more numb as time goes on.  Topical ice, cold blowing air (Zimmer cooler) and field blocks with local anesthetic, if practical, may help.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Pain with scar tissue and Botox on injection

If there is scar tissue in the area of a Botox injection this can be very hard to make for a comfortable injection.  Botox does have a positive effect on scars.  You could try icing the area or using topical numbing cream but that would only get the skin numb, not the muscle area underneath the skin that needs the Botox. If it is really an issue nerve blocks could be tried but this may be overkill for a quick injection.  After a trauma the nerves may be hypersensitive.   This is  not an issue in a normal Botox injection for migraines without previous trauma.

Janet M. Neigel, MD
Florham Park Oculoplastic Surgeon
4.6 out of 5 stars 21 reviews

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