Do I keep the botox frozen? The doctor said the injections would hurt less.

Question

The injections are for headaches. So is it true to keep the botox frozen up until treatment. Because the innjections will hurt less.

Parham Ganchi, PhD, MD · Answer

Botox needs to be reconstituted with saline before use.  Before adding saline, it can be kept frozen.  However, this will not affect pain once it is ready to be injected.  Once Botox is reconstituted, it should not be frozen.  It is usually kept refrigerated.  At the time of injection, there is minimal discomfort if a tiny needle and good technique are used.  Some feel that icing the area to be injected just before the injection can help with pain.Parham Ganchi, PhD, MD - NJ Plastic Surgeon

Stephen Weber MD, FACS · Answer

The short answer is no. Botox is typically kept in the refrigerator at a specific temperature range before and after reconstitution. Freezing it will not change the level of discomfort at the time of injection. Most people feel very little discomfort during Botox injection if the procedure is properly performed and care is taken to minimize pain.

Daniel Shapiro, MD · Answer

Freezing the botox before the saline is added to it will most likely not decrease the effectiveness of the injections. Once the saline is added by your doctor it should not be kept frozen. There is no reason to believe this will reduce pain after the injections.

Jo Herzog, MD · Answer

Botox should not be frozen once saline is added. However, if you are bringing your own Botox I assume that it has not been reconstituted. You can keep it frozen until your doctor receives  it but he/she will add saline and it will no longer be frozen. I think that the only thing that effects comfort is using bacteriostatic saline to reconstitute and not plain saline.

Steven F. Weiner, MD · Answer

Freezing Botox after adding saline may affect the effectiveness of it. I don't think this is a good idea. Adding saline with preservative to reconstitute it does decrease the discomfort when compared to saline without. Also applying ice to the area treated is helpful. I have seen an article that states topical lidocaine can decrease the effectiveness of the Botox so I don't use that.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  Freezing the Botox is done to preserve the activity of the Botox.  Freezing the Botox solution does not affect pain during injection because the Botox has to be thought.On the other hand cooling the skin before injection with ice or a cooling roller will reduce injection pain.

Do I keep the botox frozen? The doctor said the injections would hurt less.

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