Sharp Shooting Pain During Botox Procedure. Is This Normal?

Question

I usually get Botox every 4 months in my forehead. I recently switched doctors and have noticed the Botox will last 6-8 months which is great for me. However, during the injections on my right side of my forehead I will get 1-2 very sharp shooting pains that go all the way from the injection site to nearly the top of my skull. This has happened both times I have went to this plastic surgeon.It quickly goes away but if I scratch my right forehead I still feel a slight shooting sensation. Normal?

Michael I. Echavez, MD · Answer

There are several small sensory nerves that travel up the forehead. If the needle from the Botox treatment comes near these nerves, it is possible to get a sharp, shooting pain that goes up to the top of the head. It is nothing worrisome, as there is no damage to the nerve. You mention that you can still have a slight shooting sensation afterwards when you scratch the area, and this should resolve completely. If it does not, I would consult with your treating physician.

Larry S. Nichter, MD, MS, FACS · Answer

It sounds like the fine injection needle irritated the sensory nerves that go to the top of your forehead. This is not uncommon and should go away in several days.

Stewart Wang, MD, FACS · Answer

What you are experiencing is the sensory nerve irritation from either the needle or the Botox. These small nerves travel and branch out from the eyebrow area all the way to the top of the scalp. Most of the time this sensation is temporary and goes away by itself. Because the nerves are not located at identical location for each person, it's quite possible to hit it or be very near it during the injection process. Discuss this with your plastic surgeon will help and maybe adjust or slightly alter the injection sites in the future.

	Best Wishes,

	Stewart Wang, MD FACS, Wang Plastic Surgery

Sam Naficy, MD, FACS · Answer

It sounds like your provider is near one of the numerous sensory nerves while injecting, that branch across the forehead. Discuss this with them next treatment and let them know you're feeling pain - it's not common, nor uncommon to be very sensitive if the injection disturbs nearby nerves.

Cameron Rokhsar, MD, FAAD · Answer

The face and head are filled with nerve fibers and if one of these happened to be irritated by the injection, it is possible that you're continuing to feel residual pain when you stimulate the nerve. However, this should be temporary, as nerves will heal themslves, albeit sometimes slowly. Not to worry!

Sharp Shooting Pain During Botox Procedure. Is This Normal?

Answers (9)