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Botox, Dysport, Xeomin

Botox®, Dysport®, and Xeomin® are neurotoxins used in the treatment of frown lines and wrinkles. They works by preventing contraction of the underlying muscles, thereby decreasing the wrinkles that are formed by muscle movement.  Treatment consists of a series of injections through a tiny needle to muscles of the face.  The injections take about a week to take effect, and the effects usually last about 3-4 months. Repeat injections are required to maintain the effect. 


Neurotoxins work by causing changes in nerve transmission in the injected muscles. This causes a decrease in the ability to contract the muscles, which in turn results in decrease in the wrinkle lines, and also in the ability to frown and make some facial expressions.  As time passes, the nerve transmission can resume, and the wrinkles and lines of facial expression can return.  Although Botox® is FDA approved for use in a specific region, many providers also use it in other areas of the face

Click the link to see additional before and after photos from the makers of Botox®

Pre-Treatment Instructions

3 DAYS BEFORE treatment: AVOID topical products such as Tretinoin (Retin-A), Retinols, Retinoids, Glycolic Acid, Alpha Hydroxy Acid, or other “anti-aging” products. Also AVOID waxing, bleaching, tweezing, or the use of hair removal cream on the area to be treated. 

7 DAYS BEFORE treatment (to prevent bruising): AVOID blood thinning over-the-counter medications such as Aspirin, Motrin, Ibuprofen, and Aleve. Also avoid herbal supplements, such as Garlic, Vitamin E, Ginkgo Biloba, St. John’s Wort, and Omega-3 capsules.  

Do not drink alcoholic beverages 24 hours before (or after) your treatment to avoid extra bruising.   Inform your provider if you have a history of Perioral Herpes to receive advice on antiviral therapy prior to treatment.   

Do not use BOTOX® if you are pregnant or breastfeeding, are allergic to any of its ingredients, or suffer from any neurological disorders. Please inform your provider if you have any questions about this prior to the treatment.

Day of Treatment 

Arrive to the office with a “clean face” if possible.   You may experience a mild amount of tenderness or a stinging sensation following injection.    Redness and swelling are normal. Some bruising may also be visible.   You may experience some tenderness at the treatment site(s) that can last for a few hours or a few days. You may have bruises in the areas treated.

Immediately After Treatment

Stay in a vertical position for four hours following injection.  DO NOT “rest your head” or lie down; sit upright.  

Don’t touch or rub your skin where the BOTOX® was injected.  Avoid rubbing and massaging the treated area for 24 hours because you don’t want to make the BOTOX® spread. 

You may apply an ice or cold gel pack to the area(s) treated (avoiding pressure) as this helps reduce swelling and the potential for bruising.  Once you have adequately cooled/iced the area(s) as instructed and any pinpoint bleeding from the injection site(s) has subsided, you may begin wearing makeup.  

If you get a BOTOX® bruise, topical vitamin K and arnica can help.  Green or Yellow concealers can also help cover. 

AVOID placing excessive pressure on the treated area(s) for the first few days; when cleansing your face or applying makeup, be very gentle.  

AVOID exercise or strenuous activities for the remainder of the treatment day; you may resume other normal activities/routines immediately. You may take Acetaminophen/Tylenol if you experience any mild tenderness or discomfort.  AVOID extended UV exposure until any redness/swelling has subsided. Be sure to apply an SPF 30 or higher sunscreen.  Wait a minimum of 24 hours (or as directed by your provider) before receiving any skin care or laser treatments.

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