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

Something that you can take before to alleviate the pain from Botox would be extra strength Tylenol. It is important not to take any blood thinning medications before the injections including fish oil, Advil, alive, etc. Tylenol is not a blood thinning medication.

Hi V,

You may find an office that uses inhalational nitrous oxide. Applying ice firmly in an area away from the injection a millisecond before the injection really helps. Good luck and be well.

Michael Persky, MD

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.

There are a few options to help with pain during Botox injections. The staff can use tapping interventions to help distract you from the pain. Pronox is another option. This is inhaled just prior to injections and helps to calm the patient during the procedure. Taking a Tylenol 30 minutes prior to your appointment may also help. I've included a video that I hope you find helpful.

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.