Botox Injections- Botulinum Toxin

female face with wrinkles on her forehead

At Cedars we have significant expertise in Botulinum Toxin injections for wrinkles and also for excess sweating (hyperhidrosis). Some of our consultants are recognised national experts in this field.  They take tertiary referrals for difficult cases and manage complications of other practitioners.

We use the full range of toxins available including Botox®, Vistabel®, Dysport® Azzalure®, Bocouture®, Xeomin® and Neurobloc®

In addition to routine treatments we take on more difficult cases such as hyperhidrosis of the face, palms and soles and cosmetic treatments where toxins are becoming less effective. We see and treat complications of treatments done elsewhere and also provide expert witnesses reports for medicolegal cases involving cosmetic dermatology treatments.

What is botulinum toxin treatment and how does it work?

Botulinum toxin is a powerful chemical agent derived from a bacterium that blocks the release of acetylcholine (Ach), the substance which is responsible for transmitting electrical impulses which elicit muscle contraction. The substance has been used safely and effectively for treatment of Strabismus (cross-eye) and blepharospasm (lid spasm) for decades. Botulinum Toxin is also very useful in controlling muscle spasm, pain, hyperhidrosis (excessive sweating) and urinary incontinence. Activity of the facial expression muscles over a long period of time results in the development of deep frown lines, forehead lines and/or crow’s feet. An injection of a tiny quantity of Botulinum Toxin into the affected area initiates temporary weakening of the underlying muscles of the face, the effect is a more relaxed and pleasing appearance to the face. When used cosmetically, the treatment aims to reduce the visible signs of aged skin. Trade names for Botulinum Toxin include Botox®, Vistabel®, Dysport® Azzalure®, Bocouture®, Xeomin® and Neurobloc®.

How long does botulinum toxin last for?

Whilst the initial effects of treatment can be visible within 48 to 72 hours, it can take up to 1 to 2 weeks for the treatment to reach its maximum effect. Your facial expression will become more relaxed but by no means mask-like, the intended overall result is very natural and subtle. The overall effect of treatment generally lasts for 4 to 6 months. With each successive treatment many patients find that the muscles become progressively more susceptible to treatments, i.e. the injections last longer and longer. The best results are demonstrated when regular botulinum toxin injections are administered.

Are there any risks associated with botulinum toxin?

Botulinum toxin injection is generally a safe and very effective procedure. Nevertheless, certain side effects can occur but they are mostly reversible. Your doctor will inform you of potential side effects, you should feel free to voice any initial concerns you might have with your doctor during consultation. Any procedure incurs a certain degree of risk, it is important that you evaluate the potential risk compared to the overall benefit and the consequences of Botulinum toxin injections. Some potential side effects are:

  • Bruising or swelling at the injection site
  • Headache (usually wears off after a couple of hours)
  • Slight feeling of nausea
  • Tiredness, pain in the arms and legs
  • Temporary drooping of the eyebrow or eyelid (when injected into face)
  • Brief visual disturbances
  • Dryness of the eyes
  • Skin rash
  • Itching or Allergic reactions
  • Dry mouth
  • Muscle atrophy
  • Excess compensatory sweating elsewhere (when used to treat sweating)

If you notice any side effects which persist or feel you are suffering from an allergic reaction, you must contact your doctor as soon as possible- generally complications are easier to treat earlier than later. Most people suffer no side effects at all, and many people are able to continue normally after receiving the injections without anyone realizing they have had the procedure.

What should I do after the procedure?

  • Do not have a facial, rub, massage or chemical peel around the treated areas for up to 24 hours.
  • Do not lie down for 90 minutes after the treatment. Avoid excessive exercise, using a sauna or hot tub for 24 hours after your treatment.
  • Some patients experience a mild headache shortly after Botulinum toxin treatment; you may wish to take Paracetamol as needed. Avoid taking any anti-inflammatory drug such as Aspirin, Ibuprofen or Neurofen as this might increase bruising.
  • Any tiny bumps or marks will go away within a few hours of treatment. There is a small risk of bruising and of this does occur, it will be temporary and can be easily covered with make-up.

Is a botulinum toxin right for me?

You should alert your doctor before receiving Botulinum Toxin:

  • if you are Pregnant or Breast-feeding
  • if you suffer from Myasthenia gravis
  • if you suffer from Lambert-Eaton syndrome
  • if you have any Blood coagulation disorder

Drug interactions can occur if botulinum toxin is used concomitantly with other medications. Please ensure your doctor is aware of any medications you are taking. It is also recommended that you disscuss your optimum outcomes and expectations of treatment with your doctor at consultation. Although, botulinum toxin injections are not permanent, it is important that your doctor is aware of the extent of treatment that you wish for.

If you are interested in anti-wrinkle injections or have any questions, please contact us at our dermatology clinics in Elstree, Northwood, Harley Street or one of our other London clinics by calling our friendly team on: 0207 307 7467, alternatively, email us on: or fill out our contact form.

To make an appointment call us on 0207 307 7467

Other treatments and services

  • Children’s Dermatology

    Paediatric dermatology encompasses skin, hair and nail problems affecting children, including newborns and infants

  • Cosmetic Dermatology

    Cosmetic dermatology represents that aspect of diagnosing, treating, and preventing the changes to the skin that are aesthetically not pleasing to the patient.

  • Intense Pulsed Light (IPL)

    IPL is a good treatment for many skin conditions particularly rosacea, hair removal and some pigmentation problems. We have access to 3 IPL machines including the Soprano IPL

  • Fillers

    Cedars dermatologists are highly experienced in a range of dermal filler treatments. Some of our consultants are recognised national experts in this field. They take tertiary referrals for difficult cases and manage complications of other practitioners.

  • Confocal Microscopy

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  • International Patients

    Patients visit us from around the world for help with their skin issues