Botox for migraines is a preventive treatment that aims to help reduce headache attacks in people with chronic migraine. Low doses of botulinum toxin are injected into specific muscle areas of the head and neck.

Migraine is a neurological condition with recurring, often throbbing headaches, sometimes with nausea and sensitivity to light and sound. Frequent attacks can disrupt work, social life and sleep. The active ingredient is the same as in cosmetic Botox; what differs is where it is injected and the purpose of the treatment.

Botox relaxes the muscles in these areas. It is also thought to lower sensitivity to pain by reducing the release of certain substances involved in carrying pain signals. As a result, migraine attacks may become less frequent and less severe.

Migraine Botox is not used like a painkiller to stop an attack that has already started. Its aim is to help attacks occur less often when it is repeated at regular intervals. The response varies from person to person.

Migraine Botox is not a treatment for every headache. For attacks a few times a month or for tension-type headaches, other treatments are usually recommended. It is generally considered for people diagnosed with chronic migraine, defined as headaches on 15 or more days a month for more than three months, with migraine features on a significant share of those days.

For this reason, migraine Botox is planned together with a neurological assessment. Before treatment, the following are reviewed:

• Diagnosis: confirming through a neurological assessment that the headaches are chronic migraine.
• Previous treatments: preventive medicines tried before and how you responded.
• Headache diary: how many days a month you have headaches and how severe the attacks are.
• General health: medicines you take, allergies and other conditions.

Sudden, unusual or new headaches always need a neurological examination first. Because overusing painkillers can itself increase headaches, your medicine habits are also reviewed.

Treatment is planned after the neurological assessment and examination. Injection points are chosen according to the head and neck muscles involved in migraine. Injections are usually given symmetrically on both sides of the head, with small extra points where the pain is concentrated if needed.

1. The treatment areas are cleansed.
2. Specific points on the forehead, temples, back of the head, neck and upper shoulders are marked.
3. Botulinum toxin is injected at these points in the planned doses using very fine needles.
4. The areas are checked, and you are observed for a short time.

The procedure takes about 15–30 minutes, and you can return to your day afterward. Clothing that leaves your neck and shoulders easy to reach is helpful.

Stopping aspirin and aspirin-containing medicines beforehand, after checking with your doctor, is recommended. Avoiding alcohol for a week before treatment also lowers the risk of bruising. Migraine Botox should be performed by an experienced doctor so that the doses and points are set correctly.

Mild redness, small bumps and tenderness may appear at the injection points and usually fade quickly. Some people feel mild neck pain or tightness in the first days, which usually settles on its own.

• First 6 hours: do not lie down or sleep; stay sitting upright.
• First 1–2 hours: while upright, gently move the muscles in the treated areas.
• First 24 hours: avoid strenuous exercise and do not massage the area.
• First day: avoid hot showers, saunas, Turkish baths and swimming.

These rules help keep the medicine from spreading beyond the target muscles. Unless told otherwise, keep taking the medicines your neurologist has recommended. Keeping a headache diary during treatment, noting headache days, attack severity and the medicines you take, makes it easier to assess the results.

The effect usually begins within a few days, but the full response varies: some people notice a clear difference after the first treatment, while others may need several. That is why results are usually judged after a few treatments rather than one.

The preventive effect usually lasts about 12 weeks, so treatment is generally repeated every 3 months. Whether to continue is decided based on your headache diary and follow-up visits. If headache days and attack severity decrease, treatment can continue at the same intervals; if the response is not sufficient, the plan is reviewed with your neurologist.

Migraine Botox does not fully replace other migraine treatments; it is one part of the plan your neurologist recommends. For another medical use of Botox beyond aesthetics, see Botox for sweating.