Botox is a treatment that uses a type of botulinum toxin to momentarily paralyze muscle function. Best remembered for its ability to minimize the occurrence of facial lines, Botox has also been shown to help avoid chronic migraine headaches in certain individuals. This is primarily used by people who have headaches more than 15 days a month. The Botox administered is likely to be absorbed by the pain receptors in the nerves of the muscles. The drug then deactivates the pain receptors and blocks the signals that the nerves transmit to the brain.

For certain patients, Botox therapy alone is adequate to manage their chronic headaches. However, in addition to Botox, some also need other drugs to avoid migraine attacks. These can include cardiovascular medications, such as beta-blockers and calcium channel blockers, some antidepressants, and certain anti-seizure medications, among others. Treatments taken at the time of migraine headaches can also be very useful.

The use of Botox therapy for headaches every three months is a national practice, as suggested by the American Headache Society. Treatments are not given more often due to a small risk that your body can build up antibodies to botulinum toxin if you receive Botox more frequently. Such antibodies may, in principle, prevent Botox from functioning in potential injections. The aim is not to become entirely free from headache or migraine, but to improve the quality of life and transform migraine from chronic to episodic.

Approximately one in four patients do not respond; one in four responds well to the first or second set of injections, and half need more than two sets of injections to get a successful response. Studies show that 47 percent of patients had a 50 percent or more decrease in the number of days with headache. While very rare, the effect of botulinum toxin can spread to other parts of the body and cause symptoms such as muscle weakness, vision problems, speech or swallowing problems, or trouble breathing.

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