Botox Aftercare: The Do’s, Don’ts and Don’t-Worry-About-Its

You’ve done it: You’ve gotten Botox® injections (or maybe some other type of injections, like Dysport®) in your face. Whether you got them to smooth some wrinkles or to address a medical issue, you may feel like you need to be extra careful with your face.

You’ve got a dozen questions running through your head: Is it OK to put on makeup? To wash your face? To … crack a smile?! Cosmetic surgeon James Zins, MD, walks you through everything you need to know for proper injection aftercare.

What to expect after Botox

Before we get into what you should and shouldn’t do after Botox, it’s important to know how you’ll feel post-Botox. In the immediate aftermath of your injections, you might experience some mild side effects:

• Bruising: The most common side effects of Botox injections are small, light bruises — especially in the laugh line area, where there are a lot of blood vessels. “Bruising occurs when the injection inadvertently hits a minor vein, which bleeds a little bit underneath the skin,” Dr. Zins explains.
• Swelling: You can reduce swelling by holding a cool compress or an ice pack wrapped in a towel to your injection site. This should only be done for 10 minutes at a time.
• Headaches: Some people say they get a headache right after having Botox injections. But because there are so many possible causes of headaches, Dr. Zins it’s hard to say for certain whether the two are related.

“The side effects that can happen after Botox are really quite mild, but it’s still important to be aware of them,” he says.

Botox recovery time

You’ll probably leave your provider’s office with an ice pack or a cool compress to tackle these immediate side effects like redness, swelling and soreness, and to prevent bruising.

But for the most part, Dr. Zins says that you’ll get your injections and be on your way — no negative side effects to be found.

“Usually, you come in, you have it done and you go about your business,” he says. “There’s no downtime afterward because of pain or any other issues.”

You also won’t see the desired effect of your Botox injections right away. They can take anywhere from a few days to a week to appear.

What shouldn’t you do after Botox?

For the most part, you can go back to your regular life almost immediately after your injections. Though there’s a lot of internet chatter about what you should and shouldn’t do after being injected, Dr. Zins says that if your injections are done properly, almost no special aftercare is required.

But there are a few best practices to abide by:

• Don’t lie down just yet. Try to stay upright for three to four hours after Botox.
• Don’t massage the area. Botox is liquid, and liquid can spread, although only by about half an inch. Still, that can make a difference in the way it settles, so don’t massage or rub your face for 12 hours after Botox.
• Avoid certain substances. It’s best to skip happy hour on your Botox day, and avoid NSAIDs like aspirin, ibuprofen and naproxen sodium. They can raise your blood pressure, which may promote bruising.

In general, Dr. Zins says that most lists of post-Botox do’s and don’ts are based more on your comfort than on the likelihood of something going wrong.

“There are a lot of myths out there, as far as aftercare is concerned,” he continues, “but most of the untoward effects we might see with Botox are because of poor technical injection, not because the patient has done anything wrong.”

Can you touch your face after Botox?

Touch, yes; rub, no. For the first 24 hours or so, avoid rubbing the spots where you’ve been injected, which could cause the Botox to move slightly from its intended location.

“We ask people not to massage the area because we don’t want to diffuse the Botox,” Dr. Zins says.

How soon can you get a facial or massage?

Facials and massages involve rubbing and, well, massaging, so wait at least 24 hours after your injections to schedule that type of self-care. If you have bruising or swelling, you may want to wait longer, for your own comfort.

Can you wash your face after Botox?

Your Botox is not the Wicked Witch of the West, and it will not melt away in water. It’s OK to wash your face after you’ve received injections — just do so lightly at first, so you don’t rub the affected area (see above) or contribute to any bruising or swelling.

Is it OK to exercise after Botox?

Some healthcare providers say you should avoid physical activity for at least 24 hours after you’ve gotten injections, but Dr. Zins says there’s little evidence to show that physical activity affects how your Botox settles.

“People are told not to exercise or even bend down after they’ve had injections,” he says, “it really has nothing to do with the possibility of complications.”

Exercise can raise your blood pressure, which can increase bruising, so you may want to avoid it for a few hours if you tend to bruise.

Is it OK to smile after Botox?

After you’ve had a few needles stuck in your face, you might feel a little nervous about ... well, moving your face. But feel free to be as expressive as you usually are.

“Moving your face is not going to affect Botox,” Dr. Zins confirms.

Some people claim that moving your face after getting injections can actually help your Botox work better, though studies show mixed results. In one study, 68% of participants felt that performing facial exercises sped up the results of their injections.

“We don’t have any data to prove that moving your face will make Botox absorb faster or better,” he continues, “but it’s certainly OK to move your face as you normally would.”

How soon after Botox can you wear makeup?

There’s no set timeframe to how long you should wait after injections to apply makeup, lip balm or anything else you’d normally put on your face.

“They can really be used anytime,” Dr. Zins says, though it’s best to wait until the injection site has fully closed (which only takes about 15 minutes). You may also want to wait until any swelling or irritation has gone away.

And just be careful with your application, making sure you don’t harshly rub the area where you’ve been injected.

Complications and side effects to look out for

Botox is generally considered very safe, and serious side effects are rare. But seek medical attention immediately if you experience:

• Blurred vision or other vision problems.
• Numbness or paralysis.
• Severe upset stomach.
• Shortness of breath.
• Signs of a urinary tract infection, like blood in your urine.
• Slurred speech.
• Trouble swallowing.

It’s more common — though still considered rare — to experience issues like a drooping of your eyelid or eyebrow.

“There is both science and art involved in giving Botox injections,” Dr. Zins says. “If your provider inadvertently injects into a muscle they don’t mean to inject, you may see these untoward effects.”

But there’s an upside: Because the effects of Botox injections are only temporary effects, so are most complications.

“Once the Botox is stopped, the muscles will relax and go back to their normal size and function,” he explains.

He also reiterates that drooping problems are almost always the fault of the provider and not related to anything a patient does after being injected — which drives home how important it is to choose the right person to perform your Botox injections.

• Do your research. No need to book an appointment with the first injector you find. Hit up Google for a full rundown of options and reviews, and go through them carefully.
• Ask for recommendations. Turn to people you know and trust, and ask: Where did they get their injections done? What was their experience like? What did they like or dislike about it?
• Always listen to your instincts. If you have a weird feeling about a possible injector — even if there’s no obvious, logical reason for it — trust your gut and start the search anew.