Why do vitamin E and fish oil interefere with the effects of Botulinum Toxin?

Thank you for your question.  Botox typically lasts anywhere from 3-4 months, and I think that is wonderful that your treatments are lasting 5 months!  Botox is a purified protein which works by relaxing the muscles of the face.  Once these are relaxed the overlying fine lines and wrinkles are softened and diminished.  Vitamin D and Fish oil tend to thin the blood and possibly could give you a higher risk of the bruising after your Botox injections.  However, I have not read anywhere that these agents interfere with the action of Botox.Be sure to consult with a board certified injector for your Botox treatments.  Here you will have a full evaluation and be able to discuss your goals.I hope that this helps!–David Gilpin

Vitamin E and fish oil do not directly interact with Botox.  Since both of these substances cause a thinning of the blood, it is recommended to refrain from using them prior to Botox injections to decrease the chance of bruising. 

the average on label duration of botulinum toxin is 3-6 months. Doctors commonly will ask if a patient is taking fish oils, vitamin E, blood thinners of any sort due to their effect on blood; they are natural blood thinners therefore may cause bleeding which may cause bruising. Although not a contradiction it is nice to know if you are susceptible to bleeding or bruising so proper steps can be put in place to reduce chances of a bruise.