Your Brain on Botox

Botox can get into your head. Literally. Researchers from Pisa, Italy have been injecting rats with botox and watching what happens. The results were a little surprising.

gaetan-lee-brain.jpgBotox® blocks the release of neurotransmitters from specific nerves. When it is injected into the skin, it is taken up by the nerves, and over time blocks the release of neurotransmitters, shutting off those nerves.

In dermatology, we use botox to shut off the nerves that control muscles in your face, like your forehead and brow. With those nerves off, you cannot contract the muscles, so they stay flat. It is analogous to having wrinkles in your pants. While you are standing, the pants hang loosely and are smooth. When you sit, your thighs and hips crinkle the material, forming creases or wrinkles. In the same way, when your facial muscles contract, they bunch up, creasing the skin and forming wrinkles.

So what about the botox brain?

Results from this Italian study refute the belief that botox stays locally in the skin. They found that the botox injected into the rats followed the nerves back to the rat’s brain, shutting off nerves there.

What does this mean?

This is a critical question. The study was done in rats, not people. We do not know if it would do the same thing in humans. Even if some botox did get into the brain, there is no evidence at all that it has any meaningful effect, good or bad. For example, we know that smoking kills brain cells and stops other cells from developing. Does that mean that smokers or ex-smokers have any meaningful brain effects from their habit?

Botox is a wonderful and powerful drug. In treating wrinkles, there are few if any treatments short of invasive surgery that can compare to the results botox offers. It is, however, a drug and has side effects and has the potential to be misused and even abused. Botox has been used safely in millions of people, but there are risks. It is also expensive and its effects are temporary, so botox is not for everyone.

If you’re not comfortable with assuming risks of botox, or your budget doesn’t allow for it, then consider this effective alternative: Use a night cream that contains tretinoin (prescription Renova, Retin-A, Tazorac) or retinol (over the counter, ROC). No facial cream is more effective at reducing fine lines than tretinoin.

If you recently had botox and look in the mirror one morning and think that you’re ten years younger, don’t worry, it’s not brain damage, it’s just your face on botox.

Post written by Jeffrey Benabio, MD

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Photo credit: Gaetan Lee,

18 thoughts on “Your Brain on Botox”

  1. well, wasn’t Botox taking actions, on the contrary, on muscles blocking the release of neurotransmitters from specific nerves? there are no muscles in the brain!

  2. Interesting post. It brings to mind the allegations that were being made a few years back linking Botox to migraine headaches. Might be some correlation after all.

  3. Just found your blog via Grand Rounds. A lot of good information here.

    I’m curious about the link to Botox and Migraines mentioned by Neumed above. I’ve heard the same thing. Perhaps you could do a post on that?

    By the way, I believe my readers will find your blog interesting so I’ve added you to my blogroll. I will be back.


  4. Monica-
    The neurotransmitter blocked by Botox that controls muscles is also present in other places (e.g., nerves in the brain, sweat glands, etc).

  5. Neumed and Dean-
    Thank you both so much for reading.
    I had not thought of the migraine connection; it is an interesting question. If I can find anything on how Botox in the brain might cause migranes, I’ll post it.

    I am glad you liked it. Thanks for stopping by.

  6. Tricia Butler says:

    I’m curious, do you think the botox could help with rosacea (the flushing and burning part) and/or blushing?


  7. Thank you for your answer, I apologiwe I felt irritated:) but it seemed strange to me, knowing botox causese muscle palsy…now i am more curious, in fact, how important is the damage. I’ve not done botox but i consider doing it, to sole a facial assymetry caused to a palsy

  8. Its an interesting article. I as someone who uses Botox, I do have to say I do get a migraine following Botox injections however I am already predisposed to migraines. I do have to note that my migraines usually do go away after the Botox has been fully taken up into the muscle and has become active where I can no longer create a wrinkle with motion. Is there a link? Who is to truly say. I have heard of Botox being used for facial ticks as well as patients with chronic muscle spasms in the limbs due to other underlying medical conditions. I have also heard of patients being injected in the base of their skulls with Botox to prevent migraines. Does it work? Its interesting to find out the relationship between the brain and botox.

  9. Tricia-
    I do not think that botox would help with rosacea, sorry.

    Botox is safe. The issue of botox in the brain is as written here, it is probably true, but not likely important. Botox is an excellent treatment to make facial asymmetry as from facial palsy, more symmetric.


  10. Wow…that’s actually kind of scary. I’ve never really liked the idea of Botox. This isn’t helping its case any with me!

  11. I just read this article, and I am suffering serious confusion, memory and visual awarness as well cognitive challenges, I did botox on July this yr and my whole world has been affected, I am not aware where I am or what is going on around me, I have been to Dr.’s and neurologists and they can not make what is wrong, maybe it affected my brain the botox injections, when I got my shots went on plane same day and pressure of plane or who knows what could have been part of the problem, would like to know if there is anyone out there having the same issues after botox.

  12. This can be a flawless illustration whereby dreams are created of just where you commence by tinkering with the intellect, then together with your arms.

  13. Hi I am having a bad reaction to botox as well…confusion depersonalization ocd type thoughts.

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