Botox is perhaps the most recognizable brand of a medication called botulinum toxin. As a cosmetic treatment, Botox injections can reduce wrinkles on the skin. In addition, Botox is used to treat migraine headaches. Botox and similar drugs — like Dysport, Myobloc, and Xeomin — may help block pain signals in the head that cause migraine headaches.

While migraine attacks aren’t considered a primary symptom of lupus, migraine is common among people with systemic lupus erythematosus (SLE), and it can be painful and debilitating. The term “migraine” is often used in reference to a migraine headache, but migraine is actually a neurological condition with various other symptoms, including nausea, vomiting, and sensitivity to light, smells, and/or noise.

Along with other medications, lifestyle changes, and knowledge of migraine triggers, formulations of botulinum toxin may help lessen pain and improve the quality of life for people who live with migraine headaches.

Many members of MyLupusTeam have discussed Botox. “Has anyone ever tried Botox to help with migraines?” one member wrote. Another said, “I’ve tried it and it worked really well.”

Read on to find out what you need to know about the safety of botulinum toxin for people with migraine attacks who are living with lupus.

What Is Botox?

Botulinum toxin is a molecule extracted from a bacteria called Clostridium botulinum. It usually acts as a toxic chemical, preventing muscles from moving normally. However, this effect may be helpful for people with migraine.

Since 2010, Botox — a formulation of onabotulinumtoxinA — has been approved by the U.S. Food and Drug Administration (FDA) to treat migraine headaches with chronic migraine — specifically, for people who experience migraine-related headaches lasting at least four hours more than 15 days per month. It can be used by adults over the age of 18.

People with frequent migraine headaches may find relief by using Botox or other formulations of botulinum toxin. It may be worth trying for those who haven’t seen much effect from other treatments, don’t like the side effects of their current treatments, or are likely to overuse pain medications.

How Does Botox Help?

Nerve cells connect different parts of your body with your brain and spinal cord. Your muscles, including the ones in your head and face, contain nerves that help them communicate with the brain. Once a migraine headache begins, these nerves produce chemicals called neurotransmitters that send pain signals to the brain.

Botulinum toxin is injected near the migraine-producing nerves in the head, face, and neck region, blocking nerve endings in the muscle. This temporarily paralyzes the muscle and stops the tissues from creating pain signals, which helps prevent migraine symptoms such as headache and auras (visual disturbances such as flashing lights).

Migraine, Lupus, and Botox

Headaches and migraine attacks are common among people living with lupus. One study found that about 54 percent of people with SLE experience headaches, with migraine being the most common type reported.

Although it’s unclear what causes migraine attacks to happen, they can be connected to certain triggers, such as stress, some medications, or tiredness. Some MyLupusTeam members have shared their experiences with migraine triggers.

“Between the weather and eating cake, I have a migraine,” one member wrote.

Another said, “I was getting horrendous migraines more than once a week, but since I cut dairy products completely out of my diet, the frequency has reduced greatly.”

Talk to your health care team if you experience frequent migraine attacks. They can discuss potential treatment options, advise you on which ones will work well with your current lupus treatment regimen, and share whether you should eliminate any stimuli that might trigger headaches.

In some cases, your doctor may suggest botulinum toxin injections. This treatment is not considered a risk factor for triggering a lupus flare, but you should always discuss the potential risks of any migraine treatments with your rheumatologist first.

What To Expect During a Botox Appointment

For treating chronic migraine, botulinum toxin is administered by general neurologists or headache specialists. Cosmetic botulinum toxin treatments from a dermatologist’s office or spa may not be as effective for headaches, as they have different targets.

During treatment, your health care provider injects the medication into your muscles with a very thin needle. General recommendations for Botox say to treat migraines with a set of 31 injections containing 155 units of the drugs. Injections are spread out over seven areas of the head, face, and neck. However, a doctor may modify the injections based on a person’s anatomy and trigger points.

Overall, each appointment generally lasts about 20 minutes. The effects of these injections usually last about three months, after which they can be repeated.

Botox and Migraine: How Well Does It Work?

Research has found that Botox for chronic migraine may help some people. In early clinical trials, this treatment didn’t lead to fewer numbers of headaches overall. However, people using Botox did experience fewer headache days per month and had a better quality of life.

Later research has supported these results, showing that botulinum toxin treatments are safe and likely to work for many, but not all, people with chronic migraine. Some people need to go through multiple rounds of treatment before they notice any effects.

Some MyLupusTeam members have experienced life-changing effects from Botox. “Botox is safe — it relieves my migraines,” one member wrote.

Another said, “I have been getting Botox for about three or four years and it works for me. Not only are the migraines far less frequent, but if they do occur, they are so much less intense and painful than they were previously.”

Is Botox Safe?

Common side effects of botulinum toxin injections include:

• Pain or soreness
• Swelling or bruising at the injection sites
• Dry eyes or eyes that tear up more often than usual
• Drooping eyelids
• An uneven smile
• Drooping or sagging on one side of the face
• Flu-like symptoms

Many MyLupusTeam members have discussed the side effects of Botox for migraine:

• “I had Botox for migraine headaches. … It really made my head and shoulders feel locked in place.”
• “The shots hurt but are worth it.”
• “It made my forehead and eyes really droopy.”

In some cases, botulinum toxin can cause more serious problems, including:

• Vision changes
• Speaking or swallowing difficulties
• Shortness of breath
• Muscle weakness

These side effects are rare, but make sure to tell your health care provider right away if you experience them.

Talk With Others Who Understand

On MyLupusTeam — the social network for people with lupus and their loved ones — more than 223,000 people with lupus come together to ask questions, give advice, and share their stories.

Have you tried Botox injections for migraine headaches while living with lupus? What was your experience like? Post your thoughts in the comments below, or start a conversation by sharing on your Activities feed.