If you’ve ever experienced the searing, pulsating, debilitating pain of a migraine attack, chances are that you’re willing to try anything to avoid — or at least lessen — that pain.
But what about Botox? (Yep — the same stuff that reduces wrinkles.) Here’s what you need to know about this promising option and how to find a safe treatment plan that fits your needs (and your budget).
Does Botox work for migraine?
Botox is a neurotoxin protein that, when injected, gets absorbed by the nerves in your muscles. Researchers think this protein can help block the transmission of pain-producing chemicals in your nerves. There’s enough strong evidence that this interruption can help ease migraine pain frequency and severity that Botox is FDA-approved to treat migraine.
Botox is a protein made from the Botulinum toxin, which is produced by a rod-shaped spore forming bacteria called Clostridium botulinum.
Can the same neurotoxin that causes botulism actually be good for you? In some situations, yes. In small, injectable doses, Botox is considered a safe drug. In fact, it’s approved by the Food and Drug Administration (FDA) to treat chronic migraine in people that experience migraine episodes 15 or more days a month.
How does it work?
As a neurotoxin, Botox travels into your nerves where it alters the release of certain neurotransmitters that carry signals between your brain cells. That disruption is why this toxin can be so dangerous if you take it orally. It can even lead to paralysis.
But in small, injectable amounts, research suggests that this same process can lessen migraine pain by blocking the release of pain-producing chemicals (like substance P and calcitonin gene-related peptide). That interruption’s how researchers think this process could help ease the pain caused by chronic migraine.
It also can help reduce other migraine symptoms, like:
- nausea
- vomiting
- sensitivity to lights, sounds, and smells
FYI: Researchers don’t think Botox can “cure” migraine. It won’t be able to address the underlying cause of a chronic migraine condition.
Botox wasn’t created to treat migraine. It’s most famous for its ability to fight wrinkles, but Botox was actually developed to treat crossed eyes. People who received Botox treatment for other reasons began to notice they had less migraine symptoms as well.
To test this connection, scientists ran two double-blind, controlled clinical trials in 2010 that included over 1000 adults across North America and Europe. Both studies found that Botox decreased the frequency of headache days.
And more recent studies over the last decade have confirmed these findings.
- A 2017 review concluded that there’s good clinical evidence that Botox improves quality of life for people who deal with chronic migraine.
- A 2018 study found Botox as a treatment for chronic migraine to be effective, safe, and well-tolerated over a 3-year period. They also found that it helped reduce the average number of headache days.
- Another 2018 study found that Botox helps decrease the number of migraine days by an average of 2 days per month.
- A 2019 review of research found that 3 months of Botox injection therapy helped prevent chronic migraine.
If your doctor decides you’re a good candidate for Botox treatment for your chronic migraine, you’ll receive 31 injections into the muscles under your skin.
These injections are almost painless. If you feel them at all, you might feel a small sting or slight burning sensation.
The injections will be spread out across various areas, including your:
- forehead
- face
- temples
- back of the head
- upper bridge of your nose
- neck
- upper back
The exact locations will vary depending on where you feel your pain. Why can it change? That’s because your injection specialist will essentially be targeting “trigger points” where your individual migraine pain originates.
It only takes about 10 to 15 minutes to administer all of the injections.
What happens next?
After your session is over, you’ll probably be able to go about your day as usual without any downtime.
But be aware that it can take a few weeks to feel relief. You should also be prepared to repeat the treatment several times. Receiving treatment once every 3 months is pretty common.
Some people will only need a few treatments to see long-lasting relief while others need the treatments more regularly to keep migraine pain under control. Your doctor will develop a personalized treatment plan with you.
Botox treatments for chronic migraine are generally considered safe.
When side effects occur, they’re generally minor and include:
- neck pain
- stiffness, bruising, or swelling at the injection site
- headache
- flulike symptoms
- temporary neck and upper shoulder muscle weakness
In rare cases, the Botox might spread beyond where it was injected. This could lead to more serious side effects that develop over the course of a few hours or days. These could include:
- vision changes
- muscle weakness
- drooping eyelids
- sharply raised eyebrows
- trouble speaking or swallowing
- bladder issues
- difficulty breathing
Call your doctor right away if you experience any of these symptoms.
Botox can be a powerful tool for fighting migraine, but it can be dangerous if it’s not administered correctly. To lessen your chances of having any severe side effects or complications, make sure you’re working with a trained healthcare professional, like a board certified physician or neurologist.
When you’re selecting a doctor, make sure they have experience using Botox as a treatment.
Be prepared that some doctors — and insurance companies — may want you to try other treatment options first before trying Botox for migraine. Other options include lifestyle changes (i.e. less caffeine, more exercise, dietary changes) and other approved medications.
Paying for treatment
The FDA-recommended dosage of Botox for migraine is 155 units which costs an average of $300 to $600 each time treatment is administered. This means that if you’re paying out-of-pocket and need several treatments for your chronic migraine, you could pay thousands of dollars.
If you have health insurance, though, there’s a good chance you’ll pay a lot less. This treatment is FDA-approved so it’s covered by most plans, including Medicare and Medicaid.
The pharmaceutical company Allergan also offers a “Botox Savings Program” to reduce your remaining costs.
Again, most insurance companies will require you to try other preventative treatments first.
Botox isn’t just a recurring character on the early 2000s show “Nip/Tuck.” It’s also a powerful treatment option for folks who experience chronic migraine. Researchers aren’t totally sure how it works, but it seems to block pain neurotransmitters, leading to fewer migraine pain days.