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Botox — wrinkles, sweating, teeth grinding

Botox is a preparation that temporarily relaxes the muscle it is injected into. The same mechanism is used for three different things: wrinkles caused by movement, excessive sweating and increased clenching of the jaw.

What concerns does it address?

• Face tightening

How does botox work?

Botox interrupts the transmission of the signal from the nerve to the muscle, so the muscle it is injected into temporarily stops contracting.

The effect is temporary: movement returns as the connection between nerve and muscle is restored.

What is it used for?

Wrinkles caused by movement

Botox works on wrinkles that are formed by muscle contraction — between the eyebrows, on the forehead and around the eyes.

Excessive sweating

Botox is used for increased sweating of the armpits, palms and feet.

→ Botox for excessive sweating

Teeth clenching and grinding (bruxism)

Botox is injected into the chewing muscle for increased clenching of the jaw.

Migraine

For chronic migraine, botox is injected at several points on the forehead, temples, back of the head and neck, following an established protocol, about every twelve weeks. It is done for people whose neurologist has diagnosed chronic migraine and proposed this form of treatment; it does not treat the cause and does not help everyone, and the effect is assessed after two to three cycles. The decision to start and to continue is made together with the neurologist.

How is it done?

Botox is injected with a fine needle at precisely chosen points, depending on which muscle is being relaxed.

Botox is not a cosmetic product but a registered medicine — botulinum toxin type A, which has been used in medicine for decades for spasm of the eye muscles, squint and neurological conditions, and in aesthetics since the 1990s. It is given only by a doctor, in a room equipped to deal with an allergic reaction — which is why it is not done in salons or at promotions.

It is done sitting or half-reclining, so that facial asymmetries and the muscles that form the wrinkle can be seen well. It is better to give less and top up at the follow-up visit than too much at once: at the follow-up visit after two weeks, more is added where the effect is weaker. On the face, most movements have an opposing muscle, so the dose and the site are chosen so that no muscle group gains the upper hand.

It gives the best results for wrinkles caused by movement, while the skin still has some elasticity — in most people between thirty and fifty. A wrinkle that is visible at rest needs filler or your own fat tissue as well as botox; botox is then given first, so that the muscle does not push the filler out.

→ Facial fat transfer

When is the procedure not suitable?

The treatment is not done during pregnancy and breastfeeding, when there is active inflammation or infection of the skin at the treatment site, or with a known allergy to the ingredients of the product.

Botox is not given in disorders of nerve-to-muscle transmission (myasthenia gravis and similar), or if you have received aminoglycoside antibiotics in the last three days. With a clotting disorder and with blood-thinning medicines, bruising is more common, so this is discussed beforehand.

General reasons for postponing a procedure (pregnancy, breastfeeding, inflammation, a clotting disorder, smoking): When is a procedure postponed?

What can the procedure not do?

Botox relaxes a muscle. It does not tighten loose skin, does not restore lost volume and does not change skin texture.

Risks

Expected — redness and slight swelling at the injection sites in the first hours, sometimes bruising. Occasional — a weaker or uneven effect, which is topped up at the follow-up visit; a passing headache; for wrinkles between the eyebrows a drooping upper eyelid, for the forehead a drooping eyebrow or asymmetry, for wrinkles around the eyes an asymmetric smile, for the upper lip asymmetry when speaking and smiling — all of this passes as the effect passes. Rare — an allergic reaction, double vision, and, for the neck, muscle weakness and difficulty swallowing.

Expected, and rare but serious → Risks and complications: what is the course of healing, and what is a complication?

What if the result is not as agreed?

The result of a procedure is assessed at a follow-up visit, once the swelling has gone down and the scar has matured, not in the first weeks. If it differs from what was agreed at the examination, the same surgeon carries out the correction.

→ Poliklinika Barbel's correction policy

In the same visit

• Facial fillers — a wrinkle that is visible at rest needs botox as well as filler; botox is given first so that the muscle does not push the filler out, and both need no recovery.
• Profhilo, PRP and microneedling — procedures with no recovery are almost always done together, at one visit.
• Botox for excessive sweating — the same medicine, a different dose and depth — often done together with botox in other regions, in the same visit.

Frequently asked questions

How long does the effect of botox last? In most people three to five months on the face, in some longer; for underarm sweating six to eight months.

Is botox dangerous? The doses used in aesthetics are many times smaller than those used in neurology, and the effects — both wanted and unwanted — are temporary.

Will my face look “frozen”? The aim is to weaken an overly strong movement, not to abolish expression. That is why the dose is divided over several points and it is better to give less and top up. If the effect is too strong, it passes as the effect wears off.

Does the body get used to botox? In most people it does not — the effect is the same each time. In some people the muscle weakens over time, so less is needed; rarely, antibodies form and the effect weakens.

Can I go straight back to work? Yes. For the first four hours you do not lie down or massage the treated area, and on the same day you avoid sauna, exercise and alcohol, so that the preparation does not spread beyond the muscle it is meant for.

Is it allowed in pregnancy and breastfeeding? No.

Medical review: doctors of Poliklinika Barbel · October 2026.