BOTOX® is a neurotoxin prepared from the bacterial compound onabotulinumtoxinA. It’s used for medical purposes to treat specific muscular disorders, and in the cosmetics industry to remove wrinkles by briefly paralyzing the facial muscles. While BOTOX® has been around since the 1970s, it was approved by the Food and Drug Administration (FDA) for use as a preventive migraine option only in 2010. Since then, however, it has become frequently used as a treatment to provide relief for sufferers.

How BOTOX^® Works for Migraine

The botulinum organism lives naturally in lakes, streams and coastal waters. It’s highly toxic when concentrated, but in small quantities, it prevents brain signals from reaching some muscles. This prevents contraction of the muscles, which results in the patient not feeling any pain. Researchers are not completely clear on how the use of BOTOX® helps migraine, but it’s believed that the relaxation of affected muscles can reduce the physical effects of stress and tension. Since these are common triggers for migraine, avoiding them helps to reduce the likelihood of a migraine episode. BOTOX® also blocks nerve and muscle activity, preventing the transmission of pain signals to the brain.

Eligibility for BOTOX^® Therapy

A patient’s eligibility for BOTOX® therapy depends on several factors, because research shows it isn’t effective for all types of migraine. It delivers the best results when used for patients suffering from chronic migraine, according to the American Migraine Foundation. This means more than 15 headache days each month with at least 8 migraine episodes, or if your headaches last for four hours or more. In these cases, BOTOX® is not necessarily any more effective than medications like amitriptyline or prednisone, and usually results in a reduction in the frequency and severity of the headaches. Episodic migraine and tension headaches don’t typically benefit from BOTOX® therapy.

Getting BOTOX^® Treatment

Most migraine therapies require patients to take medication after the headache begins. With BOTOX®, however, the drug is administered as a preventive or prophylactic measure. The patient receives a set of 31 injections delivered every 12 weeks, which takes around 15 minutes each time. The doctor uses an injection with a small needle, inserted in the 7 primary sections of the head and neck, including the bridge of the nose, forehead, temples, neck area and the back of the head. These are generally not painful, and patients usually only feel small pricks in each site.

It’s important to get Botox treatment from a clinic or doctor experienced in administering it for migraines. A practitioner who has delivered Botox for cosmetic purposes does not necessarily know the correct injection sites to use for migraine treatment.

Results of the Treatment

Patients usually need to have the first two treatments before they can expect to benefit from the effects. Some people react faster than others, however, and occasionally patients benefit almost immediately. You may also need several courses of treatment before you can determine whether the BOTOX® has helped you or not. In some instances, it can take up to 9 months and two or three courses before the patient notices an improvement. Anyone who doesn’t respond to the treatment by end of the third course of injections can assume it isn’t working for them. For those who do respond to BOTOX®, the results usually last for 4 to 6 months.

How Effective is BOTOX^®

Many people experience an improvement as a result of BOTOX® treatment, but very few find it to be a complete and lasting cure. The majority of patients who respond well report fewer migraine episodes each month, reduced pain intensity during the episode, and quicker recovery after an episode. For chronic sufferers, the treatment can reduce the number of headache days a month by up to 50%, which improves their quality of life significantly.

Benefits of BOTOX^® Treatment

Apart from the obvious benefits of reduced migraine frequency and severity, BOTOX® offers a number of other advantages for patients, including:

• The injection process is quick, simple and relatively painless.
• Patients don’t need to be sedated in any way and can drive themselves home afterward.
• Results can begin within 72 hours after injection, although this typically only happens after the second treatment.
• Side effects are minimal compared with many other migraine medications.

BOTOX® can help chronic migraine sufferers tremendously by reducing the number of attacks they experience, but it is still considered a preventive treatment rather than a cure.

Potential BOTOX^® Side Effects

Most prescription medications have some side effects, and while BOTOX® is no exception, the side effects are fewer than many drug therapies. The most common development is stiff and sore neck muscles, which can be accompanied by bruising, swelling and pain around the sites of the injections. This is caused by the weakening of the tissue that occurs when the muscle is penetrated by the toxin, and it results in the surrounding muscles tightening to compensate. The pain usually only lasts for a couple of days and then disappears.

Other side effects of BOTOX® therapy include:

• Small humps that develop on the forehead immediately after the treatment
• Nausea and headaches, although these aren’t in the range of the typical migraine versions
• Dry eyes, skin rash or symptoms that resemble influenza
• Occasionally, the treatment can trigger a migraine.

Doctors usually advise using an ice pack on painful, stiff or swollen areas, and continuing with your regular migraine medication during attacks. If you experience any difficulty breathing or swallowing, an irregular heart rate, pain in the chest or arms, drooping eyelids or other vision problems, you may be having an allergic reaction and should get to an emergency room immediately.

Financial Matters

BOTOX® has improved the lives of many migraine sufferers, but insurance companies may still view it as a “cosmetic” treatment. This often means the companies won’t cover the cost, or they will demand evidence that other treatments have failed before they make a decision whether to cover it or not.

The price of BOTOX® treatment ranges between $200 and $500 for each session. This can add up to several thousand dollars for the two or three courses some patients need to get results, so it can be an expensive process. Regular patients can apply for a BOTOX® savings card that will save them up to $1200 a year for FDA-approved treatments. For many patients, the expense compares well with the costs of lost work days, over-the-counter medication and alternative therapies such as acupuncture and massage.  

BOTOX® is a promising treatment for many people suffering from chronic migraine. It can reduce the frequency of the headache attacks as well as the pain and other symptoms, and improve their overall quality of life substantially if it works for them. Every case is different, however, so the first step is to consult with a migraine doctor and find out whether you’re a candidate for BOTOX® therapy.