What Does Botox Feel Like When It Starts to Work?

If you know anything about Botox (Botulinum toxin injections) you probably know that it is a widely popular non-surgical treatment that removes dynamic wrinkles (e.g. forehead lines and crow’s feet) in a gradual way by relieving and paralyzing the muscle in the treated area. The keyword here is “gradual.” Since this anti-wrinkle solution does not offer instant results, first-time patients often ask about the signs and symptoms showing that Botox has started to do its job. Many of them are particularly interested in how they will feel when the power of the neurotoxin finally kicks in. And indeed, there are a few sensations that one can anticipate during and after such a procedure and even when the effects start to wear off. You will experience them regardless of whether you were injected with a brand like Neuronox known for its versatility or the FDA-approved Xeomin.

What does a Botox injection feel like?

The term “Botulinum toxin injection” is a bit misleading since a Botox treatment requires not one injection but a series of punctures on each injection site. While that may sound like a painful experience, it is not since the needles used for this procedure are very thin and the treatment is over after a few minutes. You may feel pinching that may vary in its intensity but this mild discomfort can be easily eliminated with a small dose of local anesthetic applied prior to the injection session. So, even people with hypersensitive skin and fear of needles can breeze through this experience. Immediately after the injection, there may be some bleeding and/or tiny bumps on the injection points but these symptoms usually disappear within the first minutes after the procedure. If you have more delicate skin, you may also notice redness and bruising. Those mild potential side effects may take a little longer to subside (anywhere between several hours to several days) but they can be easily, safely and effectively soothed with some arnica cream and covered with a standard concealer.

  • Pinching
  • Stinging
  • Mild or no pain
  • Slight discomfort

What does Botox feel like when it starts to work?

It can be tricky to predict how a patient will feel when Botox’s properties are activated but in most cases, the sensations are similar and they change every few days. There may be headaches during the first couple of days which may be slightly more annoying and persistent that you are used to. Between days 1-3, it is not uncommon to feel heaviness and tightness in the treatment area. This means that your muscles are trying to adapt and adjust to the neurotoxin. With some patients, these symptoms may take over the entire face which can be an unsettling thing for newbie Botox users or even for veterans who may be too quick to assume that the Botulinum toxin has started to spread into other muscles. Worry not because this sensation should disappear within the first 5 days. A week after the treatment, the tight and numbing feeling will become more localized and it will focus mainly on the injection site. At the same time, the muscles that were treated with the neurotoxin will feel incredibly rested and relaxed. That will result in a mild change of the intensity of your facial expressions which will considerably improve the appearance of your lines and wrinkles.

  • Heaviness
  • Stiffness
  • Numbness
  • Tightness
  • Headache
  • Facial muscles may feel rested and relaxed
  • Slight change in the intensity of one’s facial expressions

How does Botulinum toxin feel like when it has reached its peak?

By Day 15, when the effects of Botox usually peak, the target muscles will become paralyzed, leaving no trace of frown lines or crow’s feet. Your range of facial movements will be more reduced than normal. And while that may make you feel in an odd way and leave you to worry that your expressions may look unnatural and frozen, that is hardly ever the case. A vetted clinician can administer just enough Botulinum toxin to smooth dynamic wrinkles without giving their patient a still and frozen look. Any heaviness and numbness which you may have felt during the first two weeks after the treatment will also disappear which is a sure sign that Botox has peaked. There will finally be some synchronicity between your appearance and your sensations. Your face will both look and feel smooth, rejuvenated, rested and revitalized.

Table: Which post-Botox feelings and sensations are normal and which are not

Common side effects and sensations that subside within minutes or hoursCommon side effects and sensations that disappear within hours or daysRare adverse effects and symptoms that require timely medical attention










Loss of bladder control;

Vision problems;

Trouble swallowing;

Severe muscle weakness (especially such affecting the jaw, shoulders and other areas of the body);

Breathing problems;



How does Botox feel when it starts to wear off?

Just like you can tell when Botulinum toxin’s effect starts to kick in, you can also feel when it begins to wear off. That is an even more gradual process. It starts after the treatment’s peak (10-15 days in) and it continues by the 3-6 month after the procedure, depending on the formula of the chosen medication. Bocouture injections, for example, tend to be a bit more durable compared to other Botox-like products due to their reduced protein content. During that period, your facial muscles will slowly but surely start to regain their scope of movements. With each month, your muscles will become less relaxed until they reach a point in which they will again start to form lines and wrinkles. This is when you should call your plastic surgeon and schedule a maintenance session – that is if you want to preserve your wrinkle-free appearance.

If you are about to use Botox for the first time, rely on the assistance of an experienced doctor who will take the time to prepare you for the procedure.