It generally takes several days for patients to start seeing the effects of Botox® after it is injected and most people have maximum benefits with minimal to no muscle contractions within 5-7 days. There is then very little change for about three to four months until the effects gradually wear off and the weakened or paralyzed muscles start to function normally again and the wrinkles reappear.
The effects of Botox® do not last for the same period of time in all patients and the effects tend to last longer for some non-cosmetic conditions. Some patients note that their treatment lasts 4-5 months while others find that it only lasts 2-3 months until the effects start to wear off. It is not uncommon for patients to find that, if they get their next treatment before the last one wears off completely, the next treatment seems to last longer. Since the effects wear off gradually, these patients come in for their next injection as soon and they see their muscles start to move again. Botox®, Dysport® and Xeomin® are not dissimilar to other medications in that they don’t have the same effect on everyone.
Those patients who get Botox® injections to treat migraine headaches call to come in for their next treatment when they first notice that their headaches are coming back. Relief of headaches seems to parallel the cosmetic improvement of wrinkles and seems to last for the same period of time. It has recently been determined that many migraine and some tension headaches are caused by sensory nerves being pinched by facial muscles as they pass through the muscle on their way to the skin. By paralyzing or weakening the muscle with Botox® Dysport® or Xeomin® injections, the nerve does not get squeezed and patients tend to have fewer, less frequent and less severe headaches.
Botox® is often used to shrink the lower jaw (masseter) muscles which gives a more angular, feminine and youthful appearance to the lower face. Shrinking and weakening the masseter muscles can and also reduce grinding of the teeth at night (bruxism) which can help with TMJ pain and headaches. Many patients get six months or more relief with these injections which are given to actually reduce the size of the muscle in addition to making it weaker. As the masseter muscles are considered, pound for pound, the strongest muscles in the body, it is almost impossible to completely paralyze them so there is not a risk of losing the ability to chew.
Another common use of Botox® is to reduce sweating of the underarms, hands and feet where it interrupts the communication between the nerve endings and the sweat glands. In these areas effects have been known to last up to a year. To map out the area that sweats the most, the area can be dried and coated with starch. As the starch gets moist from sweat, it changes to a dark blue or purple color, indicating which areas need to be treated.