Hello, Dr. Watson and Teri. I have what I hope is a quick and simple question to answer. How many times is it advisable to try Botox for migraine prevention? I don’t want to sell it short, but even with insurance coverage, it’s an expensive treatment, and some of the injections go beyond uncomfortable to painful. I’m usually not a big baby about needles, but the injections in the eyebrow and forehead area really do hurt. I saw no results from the first treatment, but I’ve heard that Botox should be tried more than once to give it a fair shot (pun intended). Thank your time and expertise, Jenelle.
The migraine preventive effects of Botox tend to be cumulative with patients getting more benefit from each subsequent treatment until it reaches maximum effectiveness. It’s not all that uncommon to get little or no noticeable results from the first Botox treatment, but to have success with the second or even third round. If, after three rounds of Botox, there are still no results, it’s then reasonable to come to the conclusion that Botox isn’t going to work for that patient.
We don’t consider you a “big baby” for saying some of the injections hurt. They can hurt. That’s a simple fact. For a method that may reduce that pain for you, check out Botox for Migraine - A Suggestion for Easing Injection Site Pain.
Thank you for your question,
Dave Watson and Teri Robert
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Do you have questions about Migraine? Reader questions are answered by UCNS certified Migraine and headache specialist Dr. David Watson, and award-winning patient educator and advocate Teri Robert. Questions may be submitted via our submission form. Accepted questions will be answered by publishing the answers in our Ask the Clinician column. For an overview of how we can help and questions we can and can’t answer, please see Seeking Migraine and Headache Diagnoses and Medical Advice.