# Botulinum Toxin Treatment > When does botulinum toxin take effect, how long does it last, what to watch for afterwards? Areas of use, who should not have it and possible side effects. Botulinum toxin is a substance that temporarily reduces the contraction of the muscle it is aimed at. Its common everyday name comes from a brand name; its medical name is **botulinum toxin type A**. **In short:** Botulinum toxin treatment is the injection of a substance that temporarily reduces the contraction of the muscle it is aimed at. Lines between the eyebrows and excessive sweating of the armpits are among its licensed (approved) uses; areas such as the forehead and crow's feet are also considered, but some of these are outside the licensed uses. It is not given during pregnancy, breastfeeding or in certain nerve–muscle diseases; the effect usually begins within 3 days, settles in 10–14 days and lasts an average of 3–4 months. ## What is it, and where does the name come from? The name comes from the Latin word *botulus* (sausage). Botulinum toxin type A was obtained **in 1946**. In the 1960s and 1970s it was used in the treatment of squint (strabismus), and it was **first applied for treatment in 1980**. Approval for lines between the eyebrows and for excessive sweating of the armpits was given **in 2002**. No brand name is used on this page. The choice of the product used in treatment depends on the doctor's medical assessment. ## Licensed uses It is useful to know that botulinum toxin is not only a cosmetic treatment. Its licensed (approved) uses are: - **Excessive sweating of the armpits** (axillary hyperhidrosis) in adults - **Lines between the eyebrows** (glabellar lines) - **Spasticity of the arm** in adult patients after a stroke - **Dynamic equinus foot deformity** due to spasticity in patients with cerebral palsy aged two and over - **Blepharospasm** (spasm of the eyelid) in adults - **Hemifacial spasm** (spasm of one half of the face) in adults ## Cosmetic areas of use The main areas considered for cosmetic purposes are: horizontal forehead lines, lines between the eyebrows (glabellar), crow's feet, lower eyelid lines, lines at the side of the nose ("bunny" lines), lines around the mouth, a downturned corner of the mouth, lateral brow lift, the jaw muscle (masseter), asymmetry of the face, neck lines and platysmal bands. Migraine and excessive sweating are also among the areas of use. The décolletage and cheek lines are rare areas of use. Some of these areas are **outside the list of licensed indications**. Which area is suitable for you, whether your expectation is realistic and the possible results should be discussed in detail with your doctor before treatment. ## Who should not have it? The following situations are obstacles to botulinum toxin treatment: - **Pregnancy and breastfeeding** - The use of certain medicines: aminoglycoside antibiotics, penicillamine, quinine, calcium channel blockers, magnesium, ciclosporin - **A tendency to allergy** - **Nerve–muscle diseases**: ALS, myasthenia gravis, Eaton-Lambert syndrome - Conditions in the treatment area such as **infection or eczema** - **Inflammatory skin disease** and **a bleeding disorder** - People who are not mentally stable and who have **excessive expectations** — treatment is not considered appropriate in conditions such as body image disorder (dysmorphic disorder), borderline personality, obsessive-compulsive disorder or narcissism For this reason the assessment before treatment covers not only the skin but also **how realistic the expectation is**. This assessment is part of the procedure. ## How does the process work? 1. **Information** is given about the treatment, the possible side effects and its effectiveness. 2. A **written informed consent form** is taken, and the information required under data protection law is given. 3. Photographs before and after treatment are taken **sitting upright**. 4. The muscles are assessed both **relaxed and contracted**. 5. The injection points and the dose are determined. 6. Ice is applied if necessary; the skin is cleaned with an **alcohol-free** product. 7. It is given with the appropriate technique; the procedure and the **batch number of the product** are recorded in the file. The treatment is a short injection procedure carried out in the clinic and usually does not need anaesthesia; for sensitive people a numbing cream or ice may be applied beforehand. Tell your doctor beforehand about any blood-thinning medicines and supplements you take (for example aspirin, painkillers, vitamin E), as they can increase the risk of bruising; do not stop any medicine without asking your doctor. ## When does the effect begin, and how long does it last? - **Onset:** the effect usually begins to become noticeable within the first **3 days**. - **Full effect:** the result settles in **10–14 days**. For this reason the check-up is usually done after 2 weeks; small adjustments, if needed, are planned at this check-up. - **Duration:** muscle strength returns over time; the effect lasts an average of **3–4 months** and in some people may last up to 6 months. - **Interval between treatments:** it is recommended that treatments are **not repeated at intervals shorter than 3 months**. Frequent and irregular treatments may increase the risk of the body developing antibodies against the medicine and the response weakening (reported frequency 3–10%). ## What to watch for after treatment - For the first **2–4 hours** stay upright; do not lie down or bend forward. The aim is to prevent the medicine from spreading to muscles it is not meant for. - For the first **24 hours** do not rub, massage or press the treated areas. - Do not wear make-up for the first 24 hours; avoid saunas, steam baths, hot baths and strenuous exercise. - If you have pain, use the painkiller your doctor recommends. ## Possible side effects **Common and temporary:** pinpoint bruising at the injection sites, mild swelling, redness, tenderness and a temporary headache. **Less common, and related to the injection technique:** - **Drooping of the eyelid (ptosis):** the reported frequency is about 0.5–4% (see below). - Drooping of the eyebrow, or its outer part lifting too much - Asymmetry of the smile or the eyebrows - Double vision, dry eyes or swelling under the eyes - After treatments around the mouth, temporary difficulty in puckering the lips, speaking or swallowing These effects fade as the effect of the medicine wears off; even so, see your doctor if you notice them. ## Armpit sweating (hyperhidrosis) Botulinum toxin temporarily stops the action of the nerve endings that stimulate the sweat glands. Excessive sweating of the armpits is among its licensed uses and is an option for severe sweating that does not improve with medicines. The sweating area is marked out and small injections are given into the skin at closely spaced points; the effect begins in 2–3 days and lasts an average of **4–12 months**. For more detail see [botulinum toxin for armpit sweating](https://www.muratalpay.com.tr/en/blog/koltuk-alti-terleme-botoksu-hiperhidroz-nedir-ve-nasil-uygulanir/). ## If the eyelid droops (ptosis) One of the possible side effects of treatment is temporary drooping of the eyelid. Eye drops with an alpha adrenergic action can be used in managing this; one drop is applied 3–4 times a day at intervals of 3–4 hours. Radiofrequency, ozone and PRP treatments are also listed among the management options. This is **a decision for the doctor**; do not use drops on your own. **With any surgical procedure, results vary from person to person.** You are advised to discuss the procedure with your doctor in detail beforehand. ## Frequently Asked Questions ### When does botulinum toxin take effect? The effect usually begins to become noticeable within the first **3 days** and fully settles in **10–14 days**. The check-up to assess the result is usually done after 2 weeks. ### Is it permanent? How long does it last? It is not permanent; muscle strength returns over time. The effect lasts an average of **3–4 months** and in some people up to 6 months. For armpit sweating the effect lasts an average of 4–12 months. It is recommended that treatments are not repeated at intervals shorter than 3 months. ### What should I watch for afterwards — can I lie down? It is recommended that for the first **2–4 hours** you stay upright, do not lie down and do not bend forward. For the first 24 hours do not rub or massage the treated areas; avoid make-up, saunas, steam baths, hot baths and strenuous exercise. ### What are the side effects of botulinum toxin? The most common are bruising at the injection sites, mild swelling, redness and a temporary headache. Less commonly, drooping of the eyelid or eyebrow, asymmetry and, after treatments around the mouth, temporary difficulty speaking or swallowing may occur. These effects fade as the effect of the medicine wears off. ### Is botulinum toxin only a cosmetic procedure? No. Its licensed uses include excessive sweating of the armpits, spasticity of the arm after a stroke, dynamic equinus foot deformity in cerebral palsy, blepharospasm (spasm of the eyelid) and hemifacial spasm. Long before its cosmetic use it began to be used **in the 1960s and 1970s in the treatment of squint**. ### Can it be applied to every area of the face? There are many areas considered for cosmetic purposes — the forehead, between the eyebrows, crow's feet, the lower eyelid, the side of the nose, around the mouth, a downturned corner of the mouth, the jaw muscle, neck lines and so on. But **some of these areas are outside the list of licensed uses.** Which area is suitable for you should be decided together with your doctor. ### Can it be given in pregnancy or while breastfeeding? No. **Pregnancy and breastfeeding are a contraindication (a situation in which a treatment is inadvisable)**; that is, they are among the situations that are an obstacle to treatment. ### Will the medicines I take prevent treatment? Some may. Aminoglycoside antibiotics, penicillamine, quinine, calcium channel blockers, magnesium and ciclosporin are among the situations listed as obstacles. For this reason **you need to declare all the medicines you take** before treatment. Nerve–muscle diseases such as ALS, myasthenia gravis and Eaton-Lambert syndrome are also an obstacle. ### Why are photographs taken before treatment? Photographs before and after treatment are taken **sitting upright**, and the muscles are assessed both relaxed and contracted. This is so that the injection points and the dose can be determined correctly and the result can be compared. The photographs and the record of the procedure are filed together with the batch number of the product. ### What happens if my eyelid droops? Temporary drooping of the eyelid (ptosis) is one of the possible side effects and is a manageable situation. Eye drops with an alpha adrenergic action can be used 3–4 times a day at intervals of 3–4 hours; radiofrequency, ozone and PRP treatments are also among the options. **This is a decision for the doctor** — do not use drops on your own; see your doctor. ### Can my expectation itself be an obstacle to treatment? Yes. In people who are not mentally stable and who have excessive expectations — in conditions such as body image disorder, borderline personality, obsessive-compulsive disorder or narcissism — treatment is not considered appropriate. For this reason the assessment before treatment covers not only the skin but **how realistic the expectation is**. ## Sources 1. Botulinum Toxin Treatments — course material from a training programme in aesthetic and cosmetic applications. The history, licensed indications, cosmetic areas of use, contraindications, treatment planning and the management of ptosis are taken from this source. 2. Complication Management — course material from a training programme in aesthetic and cosmetic applications (10.1): the common and less common side effects of botulinum toxin. 3. Baumann L. Cosmetic Dermatology: Principles and Practice. 2nd edition, McGraw-Hill, 2009 — duration of effect, frequency of ptosis, treatment of armpit sweating. 4. Kontis TC, Lacombe VG. Cosmetic Injection Techniques. Thieme — position after treatment and duration of effect in armpit sweating. 5. Ferneini EM et al. Applied Head and Neck Anatomy for the Facial Cosmetic Surgeon — onset and settling time of the effect, what to watch for after treatment. The information on this page is based on the national and international guidelines listed above. The page is reviewed whenever those guidelines are updated. ## Practice and Contact Details The information on this page is general. Please speak to your doctor about your own situation. - **Doctor**Op. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology - **Address**Op. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya - **Telephone**0505 351 77 88 - **Hours**Monday – Saturday 09:00 – 18:00 · Closed on Sunday [← All treatments](https://www.muratalpay.com.tr/en/tedaviler/) --- Original page: https://www.muratalpay.com.tr/en/tedaviler/botoks/ Last updated: 2026-09-29 Op. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology Op. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya 0505 351 77 88 · Monday – Saturday 09:00 – 18:00 · Closed on Sunday *This information is for general guidance only and does not replace examination, diagnosis or treatment.*