Follow-Up: What causes Botox to migrate? Effects on ALS?

Question

I'm a late forty something female considering Botox in the forehead. What causes it to migrate? I'm seeing more and more blogs about a connection to ALS or Motor neuron disease.... is there a risk for someone who has a relative (parent) with what is believed to be non-familiar limb onset ALS?

Jason Emer, MD · Answer

There is no evidence that Botox is connected to ALS or motor neuron diseases. It is recommended to avoid strenuous activity for 24 hours after Botox, but once botox is injected its integrated, there is minimal risk of migration. I recommend getting a formal evaluation with a cosmetic dermatologist to go over your concerns. Best, Dr. Emer

Monika Soni, MD · Answer

Thank you for your question. There is no evidence that Botox causes or triggers ALS or any other motor neuron disease. Once Botox is injected it’s integrated and there is minimal risk of migration. I recommend having a consultation with an expert to discuss your concerns and to determine the best treatment plan for you. Best of Luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for your question Georgia Anne 15. Botox is a purified protein used to address wrinkles associated with
facial expression. When injected into the skin the product spreads approximately 1 cm from the point of injection. There is no scientific evidence demonstrating an association between Botox and Lou Gehrig's disease or ALS. Please consult with a doctor for specific recommendations. Good luck!

Melvin Elson, MD · Answer

There is NO association between having Botox and getting ALS.  As far as migrating, the main thing is not to massage the area for 24 hours after the injection and it does work well for the forehead. Be sure you see a board certified dermatologist

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question, and for sharing your concerns.  There is absolutely no evidence that Botox causes or triggers ALS or any other motor neuron disease.  Botox temporarily blocks the action of neurotransmitters from affecting target muscles, resulting in temporary paralysis of treated muscles.  In fact, many, specially-trained neurologists actually use Botox to treat some of the symptoms of motor neuron diseases.Any time Botox is injected, there is a possibility that it will drift and affect other, unintended muscle groups.  The doses used in cosmetic treatments on the face are very small - generally speaking, when drift occurs during cosmetic treatments, it almost always results in very localized adverse effects such as a lowered brow or eyelid, or an asymmetric smile.  As least with cosmetic treatments, in many (if not most cases), this occurs due to poor injection technique rather than the properties of Botox itself.That said, cosmetic treatments with Botox are generally not recommended in patients with ALS or other known neuromuscular diseases.  This is due to the risk, however small, that the Botox may worsen the symptoms of the patient's preexisting disease, and not because Botox is thought to trigger the diseases themselves.  I hope this helps!

Follow-Up: What causes Botox to migrate? Effects on ALS?

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