Is it ok to have Botox if you have Graves’ disease?

Question

I was diagnosed with Graves 2.5 years ago. My thyroid levels remain normal without medication and I have mild eye symptoms. I guess I am technically not in remission (because my TSH has never returned to normal. Is it ok to resume Botox injections in my forehead without causing an increase in eye buldge?

Martin Jugenburg, MD · Answer

There is no contraindication for doing botox on an individual who has graves disease. I would however go to an board certified plastic surgeon for your treatment plan.

Roberto E. Garcia, MD, FACS · Answer

Botox has a few contraindications.  Myesthenia Gravis and Eaton Lambert Syndrome are the two major ones due to the fact that these are diseases that are manifested at the Neuromuscular junction (where botox works).  Graves Disease is an autoimmune disorder of the thyroid whereby antibodies attack the thyroid gland, ultimately rendering it weakened and ineffective at its job.There is no reported contraindication, however you should see a Plastic Surgeon of the Face who is familiar with the anatomy of the face to the most meticulous level.  Best of Luck

Anteneh Roba, MD · Answer

There is no problem getting Botox injections if you have Grave’s disease. I would be careful injection around the eyes. See a cosmetic doctor for a full evaluation.

Jason Emer, MD · Answer

Yes, you can have Botox with Graves disease. You'll want to see someone meticulous. Botox results last 3-4 months. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Richard A. Bartlett, MD · Answer

Dear lisab337,Thank you for your question. Having botox injected into your forehead is safe to do when you have Graves disease. Having injections done around your eyes however, may make your eyes more prominent. I hope this helps!

Asaf Yalif, MD, FACS · Answer

Yes, it is safe to get botox. It should not affect your thyroid. It may be useful to find an injector that has experience with Grave's patients.

Benjamin Barankin, MD, FRCPC · Answer

If you have thyroid disease of any sort, including Graves', there is no issue with injecting Botox as far as safety or efficacy.

Chad Pfefer, MD · Answer

Thank you for your question lisab337.  There is no reason why you could not get Botox given your underlying Grave's disease.  I also have/had Grave's and researched this very question for myself.....my conclusion?  I kept getting Botox.  Cheers and best of luck to you.  Remember, always see a qualified and competent provider.

Megan Deacon-Casey, MD · Answer

Thank you for your question. Having Graves disease shouldn't stop you from getting botox in your forehead. However, I would make sure that the provider evaluates your concern with your eyes to prevent any unwanted results. Also, keep in mind that your metabolism may be faster with Graves disease leading to faster breakdown of the product. 
Best of luck.

Laura Phan, MD · Answer

There should be no contraindication to Botox injection of the forehead with Graves' disease. If you are considering other areas, such as the crows feet or the eyebrow, then I would caution you. While it is not an absolute contraindication, Botox in the the crows feet or eyebrow can affect your ability to blink or close the eye and, therefore, may exacerbate lagophthalmos and dry eye that are associated with Graves' disease. This is even more common with Botox to the lower eyelid.

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Is it ok to have Botox if you have Graves’ disease?

Answers (14)

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