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​Look, injectables aren’t easy. 

Getting Botox injections (or Dysport, or Daxxify, or Xeomin, or whatever) can mean pain at the injection site, and swelling or soreness afterwards as your skin recovers. 

If you can manage the pain away with medication, why wouldn’t you? 

But of course, we would never want to do anything before or after our Botox treatment that might prevent us from getting the best possible results. After all, you’ve spent the money and come out for the appointment, so you may as well make sure you get the optimal results. 

So, this post will review a few simple tips for pain management and what you should and shouldn’t do after your Botox treatment to get the maximum out of your Botox treatment. 

Before we get started: I’ve written a lot on this topic before including 

• Can I Eat After Botox? Toxin Aftercare to Maximize Results and 
• Smoother, Longer: Does Dysport Last Longer than Botox? and 
• Can I Get Botox Right After Microneedling? 

if you want to read some more before your Botox appointment! 

So, let’s talk pain: 

How much does Botox hurt?

So, you already know that Botox is a brand name for botulinum toxin, and that it is used to reduce the ability of a muscle to move. It’s best known as a cosmetic treatment that people use for anti-aging, but it’s also used to treat excessive sweating and teeth grinding and all sorts of other conditions. For anti-aging, it creates a more youthful appearance by smoothing out the appearance of wrinkles and the crow’s feet along the eyes. You already know all that. 

But! if you want to know how much it hurts…well, it depends on your pain tolerance. But I would rate the pain of Botox a 3/10. The needle is significantly smaller than anything you’ve ever had for a vaccine, and the injections are placed only millimeters below the skin. 

It also depends on the treated area. I find that the injections for my horizontal forehead wrinkles hurt the most because the skin is so thin there. For some other facial muscles, the pain is not nearly as bad. Like, the “elevens” between my eyebrows and the fine lines outside my eyes barely hurt at all because they’re a fleshier part of the face. 

As far as Botox vs. fillers pain — Botox hurts a lot less. It goes into the muscle, not the skin. Also, they use a much smaller amount of Botox than they do filler, so there’s less volume being squished in. 

In my experience, it also hurts significantly less than laser treatments. I’ve had both Fraxel and IPL, and both were a bit more painful than Botox (and also went on a lot longer.)

However…even though it’s relatively little pain, it makes sense to manage the pain with meds if you can. Why feel the pain if you don’t have to, as long as you can still get great results? But which painkiller is best for Botox? 

What can I take for Botox pain? Can you take ibuprofen after Botox?

To ensure you get the best possible effects of Botox, you want to be sure to avoid blood-thinning medications. Blood thinners will increase your risk of bruising in the injected area. Some injectors warn that blood thinners can also increase the possibility of the Botox spreading beyond the injected site, which would prevent you from getting the full effect of your treatment.  

Okay…but can you take ibuprofen after Botox?

Unfortunately, ibuprofen is a blood-thinning medication. So ibuprofen, Advil, Motrin, Midol, all forms are out. 

Aspirin is a blood-thinner, too, so skip aspirin before and after your Botox treatment. 

So is naproxen, which you may know as Aleve!

BUT! Not all anti-inflammatory medications for pain are out. Acetaminophen, or Tylenol, is not a blood thinner and will not cause bruising. So if you’re planning to use a painkiller either immediately before or right after your Botox treatment, take Tylenol. You’ll be glad when you get the full benefits of Botox!

Honestly, when I learned this I was a little annoyed, because I typically take ibuprofen when I need pain medication. I never felt like Tylenol was as effective and I didn’t think I was going to get any pain benefits at all out of taking Tylenol. But I did, actually — I found that taking Tylenol an hour before really improved my appointment. (Now I just wish they could get rid of those little popping sounds when the needle goes in! 

On the subject — if you take prescription blood thinners, you might want to talk to your doctor about discontinuing them for a week prior to your appointment. But your health should come first and you must consult your doctor!) 

Medication for days after Botox

​So can you take ibuprofen after Botox, like a day or two later?

It can take up to a week to see the full Botox results, and for the first couple of days all you can see is the negatives! You might have bruises, tiny bumps, or swelling around the injection sites. So if you’ve still got excessive swelling going on that you want to bring down with medication, you can take an anti-inflammatory. 

It’s probably safest to take Tylenol that second day, but you are good to go ahead and use ibuprofen after that if you want to. The pain and swelling shouldn’t last more than a day or two.

Manage Botox pain without medication

Honestly, if you prefer not to take medication unless it’s necessary, you can push through without it. Cold compresses or ice pack will manage your swelling and pain in the first few hours or even the first day, if you need. Just remember not to lie down in those first four hours when you are supposed to be standing upright! 

What to avoid after Botox for best results

After your Botox appointment, Botox aftercare is so important. 

Your goal is to ensure that you don’t encourage your body to metabolize the toxin, and you don’t shift how the toxin is sitting in the muscles in your treatment area. 

​What does that actually look like? 

To avoid making your body process the toxin faster:

• Skip strenuous exercise. Physical activity like heavy lifting or vigorous cardio will get the blood pumping through your blood vessels, which will help your body process out the toxin before it is fully in the muscle. Plan to back off your workouts for the first three days after your appointment, and stick to walking or Pilates. Try not to break a sweat in your normal activiites. 
• Do not rub the treated skin or do facial exercises. ​For the same reason–movement in these muscles will bring blood flow to the area and result in a less effective toxin treatment. No facial massage, no scrubs, no scratching. Try not to touch the parts of the face that were treated. 
• Avoid heat. No hot showers, sauna, or hot tub in your first couple of days. This creates the same problem that physical activity does! 

To avoid shifting or moving the toxin:

• Don’t lean forward for the first four hours. Try to imagine holding your head high so the toxin does not move or shift within or out of the treated muscle. This is a pain, but try to think of it as working on your posture or counterbalancing your tech neck.
• Don’t lie down for four hours. ​Similarly: don’t lie down or go to sleep for the first four hours after your appointment, because your toxin can shift, pool, or spread as you lie down. This isn’t the treatment to book a late-night appointment!
• Try to sleep on your back the first night. If it’s possible for you to do so, sleep on your back so your toxin stays even. Sleeping on your side could theoretically lead to more toxin on one side than the other. (I absolutely can not sleep on my back, so I just book morning appointments instead.) 

All of these changes are a little bit of an inconvenience, but for what you’ve paid for your toxin, you do not want to get anything but the best results. Putting in the little bit of extra effort in the days after your appointment can be the difference between an okay outcome and a WOW outcome. 

Got a Botox appointment coming up? Pin this post to come back to it!