Botox injection site swelling to look like bug bite? Is this normal?

Question

Is it normal for smelling after botox on crow's feet to appear as a small bug bite? That's what I have at one of the injection sites 24 hours after surgery. Is that within the range of normal? Thank you.

Martin Jugenburg, MD · Answer

It is typical to have small 'bumps' after botox treatments that look like small bug bites.  They would typically resolve in 15 mins to an hour.  Unusual for it to last longer than that.  Follow up with your injector

Nelson Castillo, MD · Answer

Thank you for sharing your question.  A photograph would be more definite in terms of a diagnosis and treatment recommendation but I would watch the area of swelling for improvement.  Most injections of botox resolve within a few hours of injection unless a patient participates in an activity that increases their heart rate and blood pressure in which case they may see prolonged swelling.  If you see little improvement contact your injector.

Sean Doherty, MD, FACS · Answer

Yes. It is quite normal to have a small red "bump" where the Botox was injected. These typically resolve very quickly (within the hour). Unusual to have them 24 hours later. I would suggest that you call your injector and make an appointment to be seen in person. Best of luck.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question.  Patients often can see small bumps or wheals at Botox injection sites immediately after treatment.  These typically resolve within a hour (or less) after treatment.  It's uncommon for swelling to persist for 24 hours - I would recommend scheduling a follow-up with your injector to discuss your concerns.  Best of luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question jryan91. Botox is a
purified protein used to address wrinkles associated with facial expression. After any injection swelling is possible. I recommend that my patients apply cold compresses to the sites of injection to decrease swelling. Please consult
with a doctor for specific recommendations. Good luck!

Tianna Tsitsis, MD · Answer

Usually Botox causes some swelling for a few minutes, but not for hours, unless there is a hematoma underneath (a blood vessel that got tapped by the needle could cause this).  A picture would be helpful here, but it should resolve.  And remember, Botox is non-invasive; it is not surgery.  It does look fabulous though!

Matthew Elias, DO, FAAD · Answer

Thank you for your question.  Bumps immediately after Botox particularly in the forehead is quite normal - this is due to the saline the the powder is mixed with, it tends to resolve within an hour.  A bump 24 hours later in the crows feet does not sound normal, please follow up with the board certified Dermatologist/PS who injected you for evaluation.  Regards, Dr. Matt Elias

Vicki J. Levine, MD · Answer

Is the bump also black and blue ? Did you put on ice after the botox was initially injected ?  Do you sleep on that side? If it's not better in another day I would call your doctor .

Olanrewaju Ladipo, MD · Answer

Hello jryan91,
Small bumps after botox may be the result of trauma to the area also known as a hematoma, a small amount of blood within the tissue. How long a hematoma takes to resolve generally depends on size, but on average small ones resolve in less than 1 week. 
Dr. Ladipo

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