Botox is an effective treatment for migraine headaches.
It is thought that botulinum toxin gets into the small nerves that carry pain signals from the head to the brain, known as C-fibres. This reduces the amount of chemicals released from the nerve endings and therefore interrupts the feedback pathway that perpetuates migraine and headache. Essentially the botulinum toxin works on the neurovascular junction (between the nerves and blood vessels) primarily in the area above the eyebrows to treat migraine headaches.
Botox is given as a series of tiny injections under the skin or into the muscles in and around the forehead, above the ears, and into the neck and shoulders. The injections usually need to be repeated every 12-16 weeks, after which time the effects of the botulinum toxin wear off. Normally a response is seen after the first or second set of injections. Only about one in ten people respond to a third set of injections if the first two sets fail.
The appointment takes approximately 15-20 minutes.
The goal is improvement in the patient's quality of life.
About one in four patients do not respond to the treatment. One in four respond well to the first or second set of injections, and half need more than two sets of injections to get a good response. Studies show that 47% of patients had a 50% or greater reduction in the number of days with headache.
We have audited our results and have more than a 70% success rate of relieving patient's migraine headaches. In the majority of cases this is complete remission allowing people to get on with their lives, whilst in others it means more days of the month headache-free or in some a far better response to migraine medication than prior to the treatment.
The biological effect of botulinum toxin on nerves takes 3-5 days or a week or two to work. Some patients do not start to improve until after their second set of injections which can be given 12 weeks after the first set of injections.
People who are pregnant or breastfeeding.
If you have a neurological disease, for example Bell’s palsy, a neuropathy, or Myasthenia Gravis. Also patients with multiple sclerosis affecting the head and neck areas.
If you have recently (within the last 3 months) had cosmetic botulinum toxin then the side effects could be increased.
Tell our doctor if you:
▪ Have had problems with injections (eg. fainting) in the past
▪ Have had problems with previous botulinum toxin injections
▪ Have inflammation, weakness or wasting of the muscles where your doctor plans to inject ( botulinum toxin is a contraindication in patients with or suspected to have myasthenia gravis)
▪ Have had problems with swallowing or food or liquid accidentally going into your lungs
▪ If you have been treated for persistent muscle spasms in the neck and shoulders
▪ Suffer from any other muscle problems or chronic diseases affecting your muscles
▪ Suffer from certain diseases affecting your nervous system
▪ Have an eye disease called closed-angle glaucoma or were told you were at risk of developing this type of glaucoma
▪ Have had any surgery that may have changed the muscle that is being injected
▪ Are taking any blood thinning medicine
The procedure can sometimes be performed on the same day, but for those new to the procedure or that have medical issues, a “cooling-off period” is generally recommended, followed by another scheduled appointment.
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The injections cause slight discomfort but nothing worse. There is a crunching/popping sensation.
It is possible to have an allergic response resulting in a mild body rash. This is extremely rare and just means that a different agent could be used to make up the botox solution at a future date or that it would be best to avoid it completely. It is not a life-threatening reaction.
Less than 1 in 10 patients experience each of the following side effects:-
1 As with all injections there is a risk of pain, bruising, bleeding or infection at the injection site
2 Drooping of eyebrows or eyelids. This could happen 1-2 weeks after the injections. It always reverts to normal as the botulinum toxin wears off. Therefore this fully reversed after a period of time, which can vary from a week to up 12-16 weeks when the effects of the toxin completely wear off. This is the beauty of botox that there are ever any lasting side-effects. Even in the worst case scenario of an unwanted side-effect like an eyelid droop/ptosis (doctor and patient), this completely wears off and reverts to normal.
Less than 1 in 100 may experience:
▪ Difficulty in swallowing
▪ Skin pain
▪ Jaw pain
▪ Swollen eyelid
If you were to have any difficulty in breathing, swallowing or speaking after receiving the treatment you would contact our Doctor immediately.
If you experience hives, swelling including the face or throat, wheezing, feeling faint or shortness of breath you would also contact our Doctor immediately.
Side effects relating to the spread of botulinum toxin far away from the injection site have been reported very rarely. If you experience any untoward side effects that you feel could be as a result of Botox ideally you would see our doctor or visit A&E.
This information is provided as a general guide only and is not a comprehensive overview of prescribing information. If you have any queries or concerns about your headaches or medications please contact us.
The Migraine Treatment price is £250
This price includes:
- A professional treatment carried out by a qualified Doctor, not a nurse or beautician.
- Free consultation.
- A 2 week review appointment.
- A fixed price for men or women.
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Botox is used as a treatment for chronic migraine in the UK.
Botox (botulinum toxin type A) is a type of nerve toxin that paralyses muscles. It comes from a bacterium known as Clostridium botulinum. It was discovered as effective for people with chronic migraine while being used for cosmetics treatment. It was found that people who had Botox experienced fewer headaches.
It’s not clear why Botox is effective in migraine. However, doctors think it works by blocking chemicals called neurotransmitters that carry pain signals from within your brain.
Botox aims to reduce how often you have migraine attacks and how severe they are.
Most people have at least two treatment cycles before deciding if Botox is effective. A good response to Botox is usually a 30-50% reduction in how many headaches you have. Doctors will also consider any improvements in your quality of life. Some people notice an improvement in their quality of life with Botox even if they don’t have a big reduction in headache days.
The guidelines recommend Botox is given as a series of between 31 and 39 small injections. These are given under the skin or into the muscles in and around the head of the forehead, above the ears, and into the neck.
Injections are usually given every 12 weeks.
Botox is available on the NHS for people with chronic migraine who have tried at least three other preventive treatments. It is currently only available via a specialist such as a headache specialist or consultant neurologist.
If you think you are eligible for Botox and would like to considered for treatment you can ask your GP for a referral to a specialist.
Generally, Botox is well-tolerated. The most common side effects include neck pain, muscular weakness and drooping of the eyelid. These side effects are temporary because the treatment wears off over time.
Dr CAROLE McALISTER
MBChB DRCOG MRCGP
Private GP and Aesthetics Doctor
GMC Reg number: 3275151
Dr Carole McAlister is a General Practitioner and Aesthetic doctor based in Glasgow.
She graduated as a doctor of medicine and surgery at the University of Edinburgh in 1988.
Read more about Dr McAlister.
A professional treatment carried out by a qualified Doctor, not a nurse or beautician.
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GMC Registered - Registration number 3275151
ICO Registered - ZA487876
Healthcare Improvement Scotland Registered - 0046418
2 week review appointment if clinically indicated.
Fixed price for men or women.