Why does the area between my eyes hurt 10 days after Botox?

Thank you for your question and I am sorry you are having side effects like these after your Botox injections. It is rather unusual to be experiencing these types of effects this long after treatment. I encourage you to schedule an in-person assessment with your injector to assess your healing process and make recommendations for further treatment if appropriate.

Its  hard to determine what's going on without seeing photos to determine if there are any issues. People do get headaches sometimes after a botox injection.

I'm sorry to hear of the issues you are having after your Botox injections. These symptoms are not typical. Some patients report headaches or a heavy feeling, but these often subside soon after treatment. I encourage you to contact your injector for a follow up examination.

Thank you for your question cml555. 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 in the absence of consistent photographs before and after in the same lighting and angles for comparison and without knowing the dose used and the exact placement of the product. However, I hope the information provided here is useful.The pivotal studies used 20 units of Botox in the forehead area above the brows to address the horizontal lines seen when one raises the brows. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary. 
The pivotal studies for the horizontal lines on the upper forehead were published many years after doctors had been using Botox. In these studies, 20 units of Botox were used to treat this area. However, in my experience I find that anywhere from 10 to 20 units works well in this area. For patients with narrow foreheads a lower dose may be used and those with a broad forehead generally require higher doses. I have also found that the full results in this area are seen by two weeks. Therefore, we have our patients return two weeks after their treatment to assess the results via photographs. At that point additional units may be used if further enhancement is desired.
When patients present with concerns about specific wrinkles in the upper face such as the frown lines, I always assess and usually treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles in the glabella which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows (frontalis) serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, I recommend that my patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.
When Botox is used in the upper forehead, if the dose is too high or the placement is too low it can result in the feeling of heaviness in the eyebrow or even lower the position of the brow. In order to reduce the risk of this possibility, I use a conservative dose in the area and place the product high on the forehead, sometimes near the hair line. Additionally, I recommend that my patients simultaneously receive a small amount Botox between the brows and at the corners of the brows. This will relax the muscles that pull down on the brows to counteract this effect and provide a harmonious balance to the position of the brow. The results are assessed two weeks after the treatment. If there is any asymmetry a small amount of Botox can be placed in the upper face for correction.If I had a patient with the concern described here I would want to know the dose and placement of the product. It may be that only the upper forehead was treated and perhaps the product was placed too low. This can be corrected as described above. I recommend my patients take Tylenol for headaches after a Botox treatment. Headaches are temporary and resolve on their own. For headaches that do no go away, I recommend that my patients consult their general doctor or a neurologist.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!

Some patients have headaches after having Botox but should subside shortly after. Follow up with your injector at 2 weeks if you have any questions or concerns. Hope this helps. 

Hello cml555:If Botox is mixed in a dilute concentration or placed too high above the brows, you can get the issues you describe.I would look for a provider that mixes with just 1 cc of saline per a 100 unit vial, and knows how to inject close to the brow. Headaches may occur but usually only after the first session, and even that is not common. It may happen because the patient is not accustomed to having those muscles relaxed, and tries to frown strongly, recruiting the surrounding muscles, to overcome the relaxation of the muscles of the glabellar complex.

Botox is the most popular procedure in the office.  Some patients have headaches after having Botox but it should go away shortly.  If there is a cosmetic result that doesn't look correct then you should return to your treating physician for examination.  Best, Dr. Green