Using Cefaly and Botox Together to Treat Migraine

Patient Expert & Health Professional
Medically Reviewed

There has been a lot of interest from Migraine patients in using Cefaly and Botox together. At one point, there were questions about the safety and efficacy of using the combined treatment strategies. Fortunately, we now have a definitive answer.

At the 2017 American Headache Society’s 59th Annual Scientific Meeting, I caught up with representatives from Cefaly to clarify the issue. They assured me that Cefaly was not contraindicated for use with Botox, and they directed me to contact the company’s Medical Department for more information. A few days later, I received an email response. Cephaly’s Medical Director, Dr. Paul Rigaux, explained:

  • In clinical trials, patients receiving Botox were excluded in order to assess the true therapeutic action of Cefaly.
  • In clinical practice, Cefaly is safe to use when patients are receiving Botox.
  • Cefaly recommends patients stop using the device for two weeks after receiving Botox injections to allow the skin at the injection sites to heal and to avoid skin irritation.

What you need to know about Cefaly

  • External trigeminal nerve-stimulation device
  • FDA-approved to prevent frequent episodic Migraine when used daily for 20 minutes
  • 60-day money-back guarantee
  • Available by prescription
  • Noninvasive
  • No risk of medication overuse headache
  • Not covered by insurance
  • Reduces frequency of attacks by 54 percent
  • Reduces medication use by 75 percent

Side effects

About 4 percent of patients experience mild and completely reversible side effects. The most common are:

  • Fatigue
  • Headache
  • Skin irritation
  • Some patients are unable to tolerate the sensation felt on the skin when the device is active.


  • Implanted metal or electronic device
  • Pain of unknown origin
  • Pacemaker or defibrillator
  • Not approved for children or women who are pregnant or may become pregnant.

If you are interested in using Cefaly as part of your current Migraine treatment, talk to your doctor. Although not covered by insurance, the cost of Cefaly may be reimbursable through your flexible-spending or health-savings benefits.

See more helpful articles:

Cefaly for Migraine – Answering Your Questions, Sharing My Experience

Cefaly Device Approved by the FDA for Migraine Treatment

Migraine Study Results – Cefaly Supraorbital Transcutaneous Stimulator