Can botox wearing off cause migraines?

Question

Hi, I've recently suffered from my first cycle of migraines. These are awful and don't wish them on anyone. I haven't done anything differently and can't think of any specific triggers. I then had a thought.. I have used botox on my frown lines for cosmetic reasons for the past 3-4 years and this is the first time I have let it go this long without a top up.. Could the wearing of the botox be causing these migraines even though I've never suffered from them before?

Mark Beaty, MD · Answer

I have found that about half of my botox patients who have migraines improve when they have their botox injections.  I don't think botox could have caused the migraines you are suffering from but it is possible that using botox may decrease the frequency and severity of the migraines.

Camille Cash, MD · Answer

Botox is actually used as a treatment for migraines.  The Botox wearing off wouldn't cause them but theoretically if you used it regularly in the past it may have been keeping them at bay for you.  I encourage you to speak your injector about this treatment.

Elliot M. Heller, MD · Answer

I don't feel that the Botox wearing off is causing your migraines. botox helps with the migraines. you may want to consult your doctor.

Martin Jugenburg, MD · Answer

Thank you for your question. Botox can actually be used to treat tension headaches. Consider a Botox treatment and evaluate if it helps to resolve your migraines. Best,

Peter Karlsberg, MD · Answer

Many of my Botox Cosmetic patients report that they experience relief from their migraine headaches when their Botox is in effect and that their migraines return when their Botox wears off.  Botox Therapeutic, the same active neuromodulator found in Botox Cosmetic, is FDA approved for the treatment of Migraine headaches and is successful in some, but not all, migraine headache sufferers.  I agree that your Botox did not cause your migraines, but that your headaches developed as a result of allowing the Botox to wear off.There is a great deal of debate among physicians and even among neurologists regarding the differences, and potential common link or overlap, between true migraine headaches and the much more common "tension" headaches:  Tension headaches are typically a consequence of prolonged contraction or spasm of the muscles of the head, neck and face, and they are often relieved by everthing from massage, stress reduction, physical therapy, improved ergonomics at work (for example, improving the position of the shoulders, head and arms while using a keyboard for many hours a day), muscle relaxants, and even meditation, but also Botox.  One unifying theory of the relationship between migraine and tension headaches is that, although the originating causes of true migraine headaches are typically different, often the final common pathway toward the experience of pain with migraine headaches is the spasm of the muscles of the head, neck and face.  This is the likely reason why Botox alleviates the symptoms of many who suffer from true migraine headaches.  You may have migraine headaches relieved by Botox, or you may have tension headaches relieved by Botox.  Either is possible, and if Botox works well for you, then it may be the treatment of choice.  But I would also recommend that you have your eyesight evaluated by an ophthalmologist:  You may be squinting, or fretting your brows, in order to see things up close more clearly, in which case having corrective lenses may help solve your problem as well!I wish you good luck, and be an imformed patient above all.Peter Karlsberg, MD

Can botox wearing off cause migraines?

Answers (5)