Why can't you apply ice or heat to head after Botox injections?

Question

After I received Botox injections today for my migraines the doctor told me not to apply ice or heat for 1 or 2 days. I researched it and everything I read said that the ice should be okay. If I get a migraine I wrap ice packs around my head and I'm worried if that happens in the next 2 days that I won't be able to do that. Can someone please help me?

Brock Ridenour, MD · Answer

You can safely apply ice after Botox.  We routinely apply a cold compress after each Botox treatment for patient comfort and to minimize swelling. You could also apply heat, but that would only increase swelling and perhaps increase the risk of bruising. Botox is heat sensitive, but only at high temperatures (176 degrees Fahrenheit) that you skin couldn't tolerate. I hope this helps

Joseph J. Castellano, MD · Answer

You may want to ask for some clarification from your doctor as to why he or she didn’t want you to use ice packs on your head after BOTOX®. One possibility may be to reduce the likelihood that you will apply too much pressure to the area and risk moving the product around and thus affecting your results. However, it’s generally recommended that you avoid rubbing or putting pressure on the area for the first 24 hours after injections. After that, you should be fine to use ice packs if you have to.

Emmanuel De La Cruz, MD · Answer

Hello Pulama,

I think it’s safe to apply ice to head in case you get migraines after receiving BOTOX injections. In fact, ice would be beneficial the first 24-48 hours. However, you shouldn’t apply the ice packs directly over the skin to avoid burns. Furthermore, I wouldn’t recommend applying heat because it could worsen the swelling. Thank you for sharing your questions! Dr. De La Cruz.

Brian S. Glatt, MD, FACS · Answer

It is safe to apply ice to any area following an injectable treatment.  However, I advise patients to refrain from pushing or applying pressure with the ice pack to avoid moving the product around. When treating the 11's (area between the eyebrows) especially, we do not want to push anything down towards our eyes but up and away from the eyes.  Hope this helps!

Jason Emer, MD · Answer

You can apply either ice or heat after Botox. Keep in mind, it will take 1-2 weeks for final results with Botox. See an expert. Best, Dr. Emer

Anteneh Roba, MD · Answer

You can apply cold or warm compresses to your head post Botox if you wish, but if you want the swelling that sometimes accompanies Botox injections to go down I would use cold compresses

Thomas J. Walker, MD, FACS · Answer

I am not sure what this recommendation is based on. There should be nothing wrong with placing ice on the areas treated with Botox. I suppose that placing a warm compress on the area can cause vasodilation (widening of the blood vessels), which in theory could increase the risk of bruising, but that should be a negligible factor. Best wishes!

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Neither cold nor warm compresses are contraindicated after Botox injections in that your results will not be affected.  That said cold compresses will help with any swelling from the injections while warm compresses will only exacerbate it - as a result many injectors will place ice immediately after treatment.  Hope this helps.

Camille Cash, MD · Answer

You can safely apply intermittent ice or cold compresses after your Botox treatment.  We encourage patients to refrain from massaging the area or exercise for 24 hours after treatment.  For more Do's and Don'ts speak with an expert provider near you.

Garrett M. Crabtree, MD · Answer

You can apply ice after Botox. I always caution patients not to massage the area  but cool compresses would be fine.
Garrett Crabtree MD

Why can't you apply ice or heat to head after Botox injections?

Answers (13)