Botox for Migraines - Does It Work?

I have been having bad migraines for almost my entire life and they kill me or at least feels like they will. I have heard about Botox Injections to help the amount and intensity of migraines?

Doctor Answers 39

Botox for Migraines

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Botox does work for migraines that have a muscle tension component.  The original studies on this originated from UCLA about 9 years ago.  If the migraine is due to other causes such as hormonal, it will not respond to Botox.  Over the years, many of my patients that had migraines due to tension in the forehead have benefitted from Botox in those areas to reduce forehead wrinkles.  If you have tension related migraines that originate from other muscle areas on the scalp or neck, it is best for you to go to a neurologist for treatment since they use larger amounts of units and can sometimes get it covered by your insurance.

Botox for migraines

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Botox has become a staple for migraine patients. Although a number of studies have come out showing benefits, and all of us performing the injections know the benefits, still, the use of Botox for migraines is off-label. When Reloxin comes out, the greater volume of distribution may be even more beneficial for patients with migraines than Botox.

Neurologic evaluation is always necessary before treating patients for migraines. You wouldn't want to treat a brain tumor with Botox!

The injections for migraines are in entirely different locations than conventional Botox for frown/crow's feet/forehead areas.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Botox for the treatment of migraines

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The answer is yes. Botox works on many migraine sufferers and is currently FDA approved for the treatment of migraines. My daughter suffers from migraines and she has Botox quarterly and it has made a significant difference in her life. When she does suffer the occasional migraine she states the pain is less severe and shorter lasting. Migraines can be debilitating for so many who suffer with them and I am a strong supporter of Botox in managing migraine pain. It may not cure all migraine patients however it is certainly worth the try. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 214 reviews

Yes, Botox often works for chronic migraines

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Numerous studies have shown Botox to be helpful for many patients with migraine.

Also, it is common for patients who get Botox for cosmetic reasons to remark that they suffer fewer headaches in the 3 or 4 months following Botox injections. 

The reasons why Botox is often helpful for headaches are not clear.

It is important that a person's chronic headaches are first evaluated and optimized by conventional methods by a physician who frequently sees headache patients.  After that,  many migraine patients find that giving Botox a try by an experienced specialist is well worth it.

Mark Lucarelli, MD, FACS

Madison, WI

Botox and migraines

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Botox is wonderful in the treatment of migraine headaches that are triggered by stress and muscle contracture. My wife is the poster child for this--she had horrible migraines, was on daily beta-blockers, rescue medications and would require a day spent in a dark room for a headache. So, we tried botox and within about 2 weeks her headaches seemed much less frequent, she came off her daily headache med, she no longer needs rescue meds. She hasn't taken a day off work in years due to a headache. And her forehead looks fabulous. We basically took away one of the triggers for her migraines. Now, does she still get headaches, yes...sinus most frequently, and those go away with Advil. She usually can tell when her botox is wearing off because just before her muscles are moving visably she'll get a nasty headache--still treatable, but present none the less.

It is not a cure all, but for her and for many of my patients, any decrease in severity or number is a blessing and well worth it. And it is also not a permanent fix. You do have to be treated every 3 months or so. For the most part, insurance will not pay for botox administered by a plastic surgeon but neurologists do treat  headaches with botox.

Good luck!

Thomas B. Lintner, MD, FACS
Atlanta Plastic Surgeon

Botox - A cost effective treatment for Migraines

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Migraines are debilitating and costly to treat.  Often patients spend hundreds of dollars a month on Fiorenal, Imitrex etc.  each of which can also have side effects.  While botox doesn't work in all patients, the side effects are minimal.  At a cost of approximately $500, many people get relief for 3 to 4 month.  Sometimes insurance even covers the cost.  I recommend giving it a try.  Good luck.

Craig Vander Kolk, MD
Baltimore Plastic Surgeon

Botox for Treatment of Migraine Headaches

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Hello and thank you for the question.

Allergan recently received FDA approval to market Botox for chronic migraine headaches in adults. If the migraine is due to non-muscle tension component causes, it will not respond to Botox. During the duration of my practice, I have noted that several of my patients with a history of migraine headaches have benefitted from Botox Cosmetic. Having said that, the injections for migraines are in administered in entirely different anatomic locations than conventional Botox Cosmetic for the management of cosmetic rhytids (frown/crow’s feet/forehead areas); thus a qualified professional should assess you for an accurate evaluation and management plan. Additionally, a proper neurologic evaluation is requisite prior to treating patients for migraine, as there are a multitude of causes for headaches, some of them sinister.

Kindest Regards,

Glenn Vallecillos, MD, FACS

Botox for migraines

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Yes,  Botox has been proven to work for "chronic" migraine headaches.  It was recently FDA-approved for this.  Chronic migraines are those that regularly occur more than 14 days per month.  Of course, just like the cosmetic treatment, botox for migraines is not a permanent answer.  Follow-up treatments are necessary.

Botox for migraines can be very effective in the right patient

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Botox for migraines can be tremendously effective in the right patient. The right patient is one who has a specific focus or trigger point for their migraine which is associated with a compression area of a sensory branch of a cranial nerve. These areas would be the brow, temporal and occipital areas. If patients feel that their headaches specifically starts at a point area in these regions, they may likely have muscular compression or squeezing of the nerve exit or pathway. Botox works by stopping the muscle squeezing the nerve. If Botox provides a significant relief, one may also be a candidate for surgical decompression which can provide a longer lasting, and maybe even a permanent, cure to their migraines. 

It works in selected cases

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Indeed if the headache has a tension component, injecting the muscle responsible for the tension has a good chance to treat or at least diminish the headache episodes. Very often headaches have many components, so if a patient comes for cosmetic botox treatment and asks for a trial treatment of his/her headache, it is definitely worth a shot.

I have treated the Temporals muscle (large chewing muscle at the temple) and the Occipitalis muscle (high in the neck) a number of times with success.

Alexis Verpaele, MD
Belgium Plastic Surgeon

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.