When I was at the hospital for the latest round of Botox for Migraines, there were at least three people getting treatment for the first time. All had the same questions and I hope to answer those here for others who are new to this treatment or considering it as an option.  Please feel free in the comments to ask more.

[This information does not constitute medical advice; the information below has been gleaned from personal experience and conversations with migraine consultants. Always follow your consultant’s advice before embarking on any new treatments.]


1. What does it feel like? Does it hurt?
Botox for migraines feels like a number of rapid sharp pin pricks, almost like quick wasp stings. You feel them and then the sharp pain fades.
The pain is not long-lasting, and is nowhere near as painful as an Occipital Nerve Block (the Frankenstein injections I used to get). I used to believe that if I was in a lot of pain with my migraine then they didn’t hurt much, and if I wasn’t in a lot of pain, they hurt a lot but last week changed that, as my hair was hurting – a common migraine feeling – and the sharp pain felt more intense than usual. But it is still all over in 2-3 minutes. Afterwards bits of my scalp felt sore, but this passes very quickly.

This is after my first treatment.

2. How many injections are there?
You will usually get between 31 and 39 injections. The consultant injects all the known migraine points (31) in your forehead, scalp, neck and shoulders, and will ask you before the injections start if you have any localised pain when you get migraines. Depending on where these pain sites are, they may give you bonus injections (between 1 and 8) to ensure you have all points covered.

3. How soon can I wash my hair afterwards?
It is recommended not to wash your hair for the first 24 hours. This is more to do with the injection sites rather than diminishing the effects of the Botox.

4. Will my forehead and eyebrows freeze?
This depends on where your consultant injects. For example, those going to the clinic in the room opposite where I got treatment, were having the forehead injections lower down, around their frown lines and eyebrows. I asked the consultant I see about this, and he said that he prefers to injection higher up to reduce any risk of wonky eyebrows.

Since originally posting this, the consultant now gives me three injections above my eyebrows, this is to help balance out the muscles. I still have not had a frozen forehead or any ill effects.

5. Will I get a wonky eyebrow?
This is always a risk regardless of where your consultant injects, but any such side effects usually wear off in a few hours. I’ve yet to experience this at all in over 8 treatments. I used to always aim to keep a straight face (and not screw up my face) when the injections are taking place. I’m now told by the consultant that by screwing up my face, I reduce the risk of a wonky eyebrow.  Either way, it is something I have yet to experience.

Before                                                                   After

6. Do I need to take time out after the injections?
No, you do not need to take time out after the injections and many people drive home after having them. This is one of the beauties of Botox compared with other injections; you can resume your life instantly. Although, I usually still give myself some time out of 1-3 days. But everyone is different. If you feel you need time out and this gives you the reason, then take time out.

7. How long before you feel results?
The first time I had the treatment, I started to feel some respite from neuralgia pain within 8 hours, but it took 2-3 weeks before the migraines started to reduce. It can take between anything from 2-6 weeks before you feel any benefit, and two treatments, before that benefit becomes major. This is why the NICE guidelines recommend two treatments before deciding whether Botox is working for you.

8. How often do you get injections?
This depends on your migraine, your consultant and treatment plan. I get injections every 3 to 4 months.

9. Is there a build up?
I understand that there is a build-up and I’ve been having better results from Botox the more I have it.

10. How long will you receive the Botox treatment for?
You will receive the treatment as long as you still fall within the NICE guidelines. The consultant that I see tells me that the beauty of Botox is that it ‘appears to retrain the migraine’ and ‘tells the migraine how to behave’ so that when I come to the point of no longer qualifying for Botox, it is likely that my migraine will have changed to episodic migraine rather than the chronic state before this treatment.

I hope this answers any questions you might have.  If you want to ask me something else, please post in the comments or use the contact form.