What not to do after botox
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Protecting Your Treatment: A Practitioner's Advice on Post-Botox Aftercare
Congratulations on investing in yourself with a Botulinum Toxin (Botox) treatment. The procedure itself is remarkably quick, but the journey to your beautifully refreshed and natural-looking results continues in the hours and days that follow. The care you take during this initial period is crucial for ensuring the product works precisely as intended, minimising potential side effects, and protecting your investment.
Think of this guide not as a list of restrictive rules, but as a simple, proactive partnership between you and your practitioner. By following these essential steps, you are taking control of your outcome, allowing the treatment to settle perfectly and reveal the smoother, more rested appearance you desire. Let’s walk through what to do—and more importantly, what to avoid—to ensure a flawless result.
If you remember only one piece of advice, let it be this: do not touch, rub, massage, or apply any significant pressure to the injection sites for the rest of the day. It is perfectly normal to see small, raised bumps or a little redness at the injection points immediately after your treatment—these typically fade within the hour. The temptation to massage them away can be strong, but it is vital that you resist.
Why is this so important?
The botulinum toxin is skilfully injected in tiny, precise amounts into specific muscles. In the first few hours, it needs time to bind to the nerve receptors in those targeted muscles. Rubbing or pressing on the area can physically push the product into adjacent, unintended muscles. This is known as Botox migration, and it is the primary cause of unwanted side effects such as a drooping eyelid (ptosis) or asymmetrical results, like one eyebrow lifting higher than the other. To ensure the Botox stays exactly where it was placed, simply leave the area alone.
For at least four to six hours following your treatment, you must remain upright. This means no lying down for a nap, bending over to tie your shoes, or performing any activity that involves positioning your head below your heart for an extended period.
Why?
In the initial hours, gravity can influence how the product settles into the muscle tissue. By keeping your head elevated, you are working with gravity to ensure the Botox remains in the intended muscle compartment. Lying down or inverting your body too soon after the injections increases the risk of Botox migration to the orbital muscles around the eyes, which can contribute to eyelid drooping or blurred vision. When it is time for bed on the first night, try to sleep on your back, perhaps with an extra pillow to keep your head slightly elevated.
We strongly advise that you avoid all strenuous exercise and vigorous physical activity for at least 24 hours after your Botox injections. While a gentle walk is perfectly acceptable, anything that significantly raises your heart rate should be postponed.
Why are there two main reasons for this?
Firstly, strenuous exercise, such as high-intensity interval training (HIIT), running, or heavy weightlifting, dramatically increases blood flow throughout your body. This surge in circulation can potentially disperse the botulinum toxin away from the specific injection site before it has had a chance to fully bind to the nerve endings. This could dilute its effect, leading to a less effective or shorter-lasting result.
Secondly, activities that involve inverted positions (like in certain yoga or Pilates poses), significant facial pressure, or excessive sweating can also increase the risk of product migration and may exacerbate swelling or bruising. For this reason, activities like hot yoga should be avoided for at least 48 hours.
For the first 24 to 48 hours, it is essential to avoid exposing the treated areas to high temperatures. This includes avoiding saunas, steam rooms, hot tubs, and very hot showers or baths (opt for lukewarm water instead).
Why?
Heat causes vasodilation, a process where your blood vessels widen. This increased blood flow to the skin can heighten the risk of swelling and bruising at the injection sites. In theory, it could also contribute to the dispersion of the Botox, potentially impacting the precision of your results.
Direct sun exposure and tanning beds are also off-limits during this period. The ultraviolet (UV) radiation can inflame the skin, worsening any redness or swelling. After the first 24 hours, it is crucial to apply a high-factor, broad-spectrum sunscreen (SPF 30 or higher) diligently to protect your skin and the longevity of your results.
We advise all our patients to avoid consuming alcohol for 24 hours before their appointment and for at least 24 hours afterwards. The same advice applies to certain over-the-counter medications and supplements.
Why?
Alcohol acts as a vasodilator and has anticoagulant (blood-thinning) properties. This combination significantly increases your susceptibility to bruising. The tiny needle pricks made during the treatment can more easily lead to noticeable bruises if your blood is thinner and your blood vessels are wider.
Similarly, common substances like aspirin, ibuprofen (and other NSAIDs), Vitamin E, and fish oil supplements also thin the blood. It is best to avoid these for a few days before and after your treatment to minimise your risk of bruising. If you are taking any prescribed blood-thinning medication (such as Warfarin or Plavix), it is imperative that you discuss this with your practitioner and your GP well in advance of your appointment.
Your Post-Treatment Skincare Routine: What to Use and What to Pause
Your skin may feel a little tender after treatment, so a gentle approach to skincare is key. For the first 24 hours, cleanse your face using a mild, non-abrasive cleanser and lukewarm water. Instead of rubbing your skin, gently pat it dry with a soft towel. You can apply a simple, hydrating moisturiser, but avoid any aggressive application techniques. It is crucial to pause your use of active or harsh topical products for at least two to three days. This includes:
- Retinoids (Retinol, Tretinoin)
- Exfoliating Acids (Alpha Hydroxy Acids like Glycolic Acid, and Beta Hydroxy Acids like Salicylic Acid)
- Physical Scrubs or exfoliating devices.
We also recommend postponing any other professional facial treatments. For at least one to two weeks, you should avoid facials, chemical peels, microdermabrasion, microneedling, and laser treatments. Even services like eyebrow waxing or threading should be delayed if they are close to a treated area. This is to prevent excessive pressure, skin irritation, and potential interference with how the Botox settles. If you are planning combination treatments, such as dermal fillers, your practitioner will advise on the optimal schedule to ensure both treatments deliver their best results safely.
What to Expect: Managing Side Effects and When to Seek Help
Rest assured that Botox is a very safe and well-researched treatment when administered by a qualified, medically-trained professional. The vast majority of side effects are mild and temporary.
Common and Expected Side Effects:
- Minor swelling, redness, or small bumps at the injection sites (usually resolve within an hour).
- Slight tenderness or a dull headache, which can be managed with paracetamol (avoid ibuprofen).
- Mild bruising, which can be concealed with makeup after the first 24 hours and will fade over a few days.
When to Contact Your Practitioner
While serious complications are rare, please contact your practitioner promptly if you experience any of the following: significant eyelid or eyebrow drooping (ptosis), noticeable asymmetrical results that persist after the two-week settling period, blurred or double vision, or difficulty speaking, swallowing, or breathing.Remember, the full effect of your Botox treatment will take around 10-14 days to develop. We typically schedule a follow-up appointment for two weeks after your procedure to assess your results and make any minor adjustments if necessary.
Conclusion: Patience for Perfect Results
Your diligence in these first few days is the final, crucial step in achieving the beautiful, natural-looking outcome you deserve. By simply remembering to keep your hands off, stay upright, and avoid heat and strenuous exercise, you are ensuring the Botox works its magic precisely where intended.
These small, temporary adjustments to your routine are your personal contribution to a successful treatment, setting the stage for weeks of smoother, revitalised skin.