Risks - introduction
It is one of the most common treatments in the USA with millions of people using it.
It has been used medically for over 16 years.
- Avoid if pregnant, breast feeding, on warfarin, if known muscle problem. Eg myasthenia gravis,
or if taking aminoglycoside antibiotics or spectinomycin
- Do not have a hot bath immediately after
- Do not fly for 48 hours
Immediate risks
- Local bruising
- Pain at injection
- Skin rash or local inflammation
Risks later on
- Misplaced injection or too high a dose causing paralysis of a neighbouring muscle, for instance causing double vision or a drooping eyelid (ptosis), or a mouth drop.
- Asymmetry
- Eyebrow change of shape "Mr Spock" look with outside lateral ends higher if an unbalanced glabella injection is given
- Loss of normal facial expression particularly at time of peak action
- Secondary lines caused byadjacent untreated facial muscle groups working "overtime"
Allergic reactions are very rare and only with repeated very high doses as used for neck torticollis.
