What can I take to alleviate the pain during & after Botox injections for migraines?

I have used Botox for cosmetic as well as migraines, TMJ pain, etc for many years now, and less than 2% of my patients have any real issue with the pain. There are many ways to reduce pain from tinier sharper needles (higher gauge), to slow injection, to knowing the right depth and anatomy to inject. That said, taking acetaminophen(or 2) 1hr prior to your appointment, & adding a topical anesthetic 1hr prior, as well as considering ice or vibration at time of injection (along with "talkesthesia"/distraction), and a squeeze ball can all be helpful. Your dermatologist should be able to do it for you one way or the other with negligible pain.

I have been using Botox since 1995 and I have never had a patient who has complained of painful administration. As long as the neurologist, store, plastic surgeon who is using Botox on you apply a 30 gauge or a 33 gauge needle you should not feel anything at all. My recommendation is try another doctor. I hope this helps and good luck from New York City Plastic Surgery.