I have a bump/massive swelling and indent in forehead 3 months after Botox. What was the cause?

I had botox on my forehead 3 months ago. One injection became a small pimple w/swelling, Then became a HUGE red inflamed hard bump with swelling 2cm each direction. The swelling lasted three weeks, the bump JUST went away two weeks ago, I now have a red mark and the skin is indented where the bump was.My doctor who injected me said there was no possible way it could be from botox. She offered more shots, and 1 of the injection sites is like a mosquito bite and has been for about eight days.

Doctor Answers 4

Swelling and redness after Botox

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Thank you for your question KaylaStacy. Botox is a purified protein used to address wrinkles associated with facial expression.SHOW MORESwelling can happen after a Botox treatment. I recommend that my patients apply cold compresses to minimize the swelling. Usually swelling lasts less than 24 hours. Any redness after a lesion can be addressed with IPL, KTP, or pulsed dye lasers. Please consult with a doctor for specific recommendations. Good luck!

Swelling after Botox

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Dear rain1980,

Thank you for your clinical post. I’m sorry to hear this unusual but certainly physiological possible reaction following Botox injection. The Botox itself is a neuromodulator that affects muscle contraction. The fluid itself, however, can obstruct the excess egress of certain glands that secrete oil onto your skin and this can affect the pilosebaceous units near the brow as well as the apocrine and eccrine glands that secrete sweat. If these glands become blocked then an inflammatory papule or red “zit” or “pimple” like process can ensue. This may take many weeks to resolve and when it does there may be some post-inflammatory depression or indent as you pointed out. At this point in time, strategic use of soft tissue fillers and fractional laser devices to achieve smooth contour should be your focus and a follow-up with your certified physician injector should ensue. If your injector is not experienced in managing these types of skin techniques then seeking out a certified plastic surgeon or dermatologist that is an expert in these matters will help you restore normal contour and shape. Because this occurred with one Botox injection does not mean other Botox injections should go uneventfully and provide the kind of improvement you’re looking for.

I hope this information is of some assistance and best of luck.

To find out more, please visit the link below. There will be other sections on the website that can be helpful such as laser resurfacing and soft tissue fillers.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 100 reviews

Huge bump after Botox

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Do you have any photos you can provide? This is hard to comment on without seeing something?

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Scar on Forehead -- Needs fractional laser/RF, microneelding, filler ; maybe surgical scar revision

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I suggest you see a scarring expert to determine what can be done.  This may mean combination of lasers, fillers, needling or surgery/subcision.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 204 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.