Can you have Botox if you have recently had a tetanus injection?

Question

I had a Botox consultation and because I had a tetanus injection 2 weeks ago I have been told that I can’t have the Botox due to the tetanus making the Botox work too well. Is this true? Can someone please advise?

Aldo Guerra, MD · Answer

I appreciate your concern and I believe there's no contraindication. Always consider using an experienced injector and discuss your medical history before treatment.Best, Dr. ALDO

Alex Eshaghian, MD, PhD · Answer

Thank you for your question jen26368. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment without a formal exam where the entire medical history is reviewed. However, I hope the information provided here is useful.The safety record of Botox is well established. The product has been used for over 20 years for a variety of treatments with minimal side effects. Botox is amongst the safest treatments for treating facial wrinkles.
  
While Botox is one of the safest treatments offered, there are some situations where it is not appropriate. These include anyone who has an allergy to any of the inactive ingredients or who has had an allergic reaction to any botulinum product including Botox, Dysport, Xeomin, or Myobloc. The safety and efficacy of Botox has not been established in women who are pregnant, trying to become pregnant, or breast feeding. Therefore, women in these categories are advised to wait until breast feeding is completed prior to having a Botox treatment. Botox should not be placed in the skin on the site of an infection. Those who are taking an aminoglycoside antibiotic, an anesthetic, D-penicillamine, antimalarials, or immunosuppressants should not be treated, nor should those who have undergone chemotherapy within the previous six months. It is important to avoid blood thinners before and after a treatment. These include both prescription and non-prescription medications such as warfarin (coumadin), aspirin, ibuprofen, alcohol, fish oil, vitamin E, and ginko biloba. Those with conditions that affect muscles and nerves such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome should not undergo Botox treatments.Having a tetanus shot two weeks prior is not a contraindication to receiving a Botox treatment. If I had a patient with the concern described here I would say that it is safe to have a Botox treatment two weeks after a tetanus shot assuming there are no contraindications.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
  
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
    
Please consult with a doctor for specific recommendations. Good luck!

Selena Lantry, MD · Answer

There should be no issue with your Tetanus injection affecting your Botox treatment or vice versa.  I have not heard of any research or cases indicating that a Tetanus injection caused any difference to the functioning of Botox.  Just let your doctor and provider know beforehand and you should be fine.

Benjamin Gonzalez, MD · Answer

I have not heard of this as an issue or contraindication. I spoke with Allergan, the company who supplies Botox and they said there are no contraindications. I have safely done both treatments in the same week with no issues. I would be interested in learning from where you heard this information. Would love a reply if you don't mind. This may be something to research directly. Thanks!

Steven Swengel, MD · Answer

Hello, thank you for your question. There is no contraindication of having a tetanus injection and Botox treatment close together. Hope this helps, Dr. S.

Anteneh Roba, MD · Answer

I I'm not aware of a correlation between tetanus injection and botox injections. I don't see why you can't get a botox injection two weeks out.

Wayne Wertheim, MD · Answer

although i haven't researched it i can see no reason why you cant! at this point there is no reason to think that there would be any interference. Speak with your injector. Good luck

Thomas Platt, MD · Answer

An interesting question!  Forgive me for a somewhat complex answer.  Tetanus toxin and botulinum toxin are both neurotoxins that are produced by Clostridia bacteria, so one might wonder if getting a tetanus shot would affect their response to Botox.  Although I could not find any studies in the medical literature on this specific question, it seems unlikely that a recent tetanus shot would enhance Botox - if anything, I would expect the Botox to be less effective if the tetanus antibodies react against Botox.  This is strictly hypothetical.  You may want to ask the consultant for more information.  I have not been advising against getting Botox after a tetanus shot.

Can you have Botox if you have recently had a tetanus injection?

Answers (8)

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