What Makes the Ouchless Needle Pain-free?

I heard about an "ouchless needle" for Botox injections. How is it pain free if I'm still being poked with a needle?

Doctor Answers 7

What makes needles less ouch-less

My colleagues below answered your question quite thoroughly. I would add a point related to your question...


It is important to manage the needles well when drawing up dyspoprt or botox. If the needle scrapes the side of the glass container or is traumatized, it can acquire a teeny barb which makes entry less smooth, and possibly more painful. I also think technique makes a big different..a steady, experienced hand can really do a good job. Still, in my experience, there's often 1 out of about 6 injection spots that seems to hurt a bit more. Luckily, the pain doesn't last.


Best of luck,


Bay Area Plastic Surgeon
4.8 out of 5 stars 18 reviews

Ouchless pain-free needles with botox

Is there really such a thing as pain free needle sticks?  Sometimes, one or several injection sites are not felt by my patients.I routinely use a tiny diameter 32 gauge needle for botox and we use a numbing cream for most patients prior to the injections. We also use some distraction techniques but even with all of this and the slow delivery through a gentle pressure, some injections are more painful than others. The deeper glabellar injections can be a little more unpleasant than the rest, but most patients find that Botox and Dysport injections are minimally uncomfortable.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

The Ouchless Needle is NOT The Needle at all

The ouchless needle is a proprietary vapocoolant.  It is attached directly to the syringe the physician utilizes for Botox, Dysport, Xeomin, Radiesse, Restylane, Juvederm and other facial fillers.

Unlike numbing creams that need to be placed 30 minutes or more prior, this gentle cooling spray is placed immediately prior to injection.  This saves time for the client and increases comfort during the injections.

Our patients at Accents Cosmetic Surgery and Medical Spa have been very happy with this addition.

Mark Berkowitz, MD
Sterling Heights Oculoplastic Surgeon
4.7 out of 5 stars 61 reviews


The finer the gauge of the needle, the less painful the injection. Botox injections should feel like a prick and are not painful. For paitents who need to have the edge taken off, I will offer Valium or Atavan because I do not like the effect that anesthesic creams have on the vascularity of the skin. There is always a tradeoff of a little discomfort for the benefit of the treatment.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Ouchless Needle

Exactly.  There are different methods to numb the skin with anesthetic creams or gels.  There are also ways to distract the nerves with vibration techniques.  However, when using a 32 gauge needed to inject botox, there should just be a very small prick if anything.  So, most people do not even use the numbing creams.  Botox is not a painful procedure.


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Ouchless Needle

According to their website, it is a precise stream of numbing liquid that is sprayed before the injection. We do not use these syringes in our office but their website seems to offer a lot of great information.
We try to make injections as pain free as possible – either with ice or numbing creams. Botox needles are very small and should not give any type of discomfort if you ice the area beforehand. Most fillers now come with lidocain mixed in the solution to help with any kind of discomfort. If patients are very apprehensive about pain, we make sure to do all that we can to alleviate their fear.


Philip Young, MD
Bellevue Facial Plastic Surgeon
4.2 out of 5 stars 86 reviews

Ouchless Needles

A needle is a needle and is sharp by definition.  A small needle such as those used to inject Botox should feel like a tiny pin prick.  The material itself does not sting when it is injected.  

Sheri G. Feldman, MD
Beverly Hills Dermatologist
5.0 out of 5 stars 1 review

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