Botox site pain, “inside of my left brow” is constantly aching. What's going on? (Photo)

Thank you for your question! It does sound like nerve irritation- if from the botox it should settle but you may need a check up to make sure nothing else is happening - if there is any rash you may have shingles which would need immediate attention. Best of luck! 

I'm sorry to hear of the issues you've been having since your treatment.  The symptoms you described are not typical reactions from Botox injections.  I recommend returning to your injector for an evaluation.

Thank you for your question beautyfreak1. 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 in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. 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.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.Sometimes a bruise can put pressure on a nerve leading to pain. This goes away once the bruise resolves after one to two weeks. If I had a patient with the concern described here, I would recommend that she be patient until the pain goes away. For my patients I recommend Tylenol for pain after Botox treatments.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!

It does sound like nerve irritation- if from the botox it should settle but you may need a check up to make sure nothing else is happening - if there is any rash you may have shingles which would need immediate attention.

So Sorry for your pain. It seems that a branch of the 5th nerve has been affected by your botox injection. This is a rare complication and may be secondary to swelling putting pressure on the nerve or a injection directly into a small branch of the 5th nerve. This injury is tracking back to the 5th nerve ganglion and causing referral of pain up the 5th nerve. I would apply warm compresses alternating with cold compresses. The cold will reduce the swelling while the warm compress will help dissolve the hematoma. Either way, I think the complication is temporary. i would suggest you see the physician who injected you. If the pain persists you may require Neurontin for the pain.

Judith Rubin , MD 
Gig Harbor WA 

I am sorry that you are having pain after your Botox injections. Unfortunately, sometimes an injection can cause a bruise which can irritate a nerve, or the needle can hit a nerve directly. For this type of pain, I recommend massage to the area twice a day in front of the mirror with occasional massage throughout the day.  As always, follow up with your provider is very important!