Is Botox risky for people with chronic conditions?

New research suggests people with chronic conditions, including type 1 diabetes, may be at a greater risk of side effects from Botox injections.    

The U.K.-based study surveyed over 900 adults who received Botox for aesthetic reasons, and people with pre–existing medical conditions reported more severe side effects. 

Most side effects from Botox are mild and include bruising, redness or pain at the injection site, headaches or flu-like symptoms. Side effects, such as drooping eyelids or eyebrows, vision problems or difficulty swallowing, can occur but are usually rare.   

Yet survey respondents with medical conditions noticed these symptoms far more often than those without. The degree of risk varied by condition:  

• People with type 1 diabetes were 92 times more likely to experience nausea after Botox treatment. 
• People with thyroid disorders or chronic migraines were 10 times more likely to be nauseous after Botox treatment.  
• People with cataracts were 30 times more likely to report headaches.    
• People with prior injuries had a 21 times greater risk of losing facial expression.   
• Muscle weakness and persistent eyelid droop were also frequently reported complications. 

Is Botox safe? 

While the findings shed more light on how people might respond to Botox, experts caution that more research is needed to know how side effects truly impact people with these chronic conditions.    

“In my experience, underlying medical conditions do not appear to increase the risk of major side effects with Botox injections,” says Dr. Michael Ogilvie, a plastic surgeon at Advocate Health Care. “In fact, some patients feel that Botox injections actually help their migraines.” 

Botox has long been considered one of the most common cosmetic procedures to prevent wrinkles, crow’s feet and forehead creases. It also has become an increasingly common treatment for chronic migraines and conditions like excessive sweating and temporomandibular joint dysfunction (TMJ).   

Many patients find relief from these conditions worth the potential trade-offs, but people with autoimmune conditions, like Hashimoto’s disease and diabetes, could be more susceptible to negative reactions.    

“There is concern among some clinicians that patients with autoimmune disorders may have negative effects from Botox,” Dr. Ogilvie adds. “However, I have not found that to be the case and have safely and effectively injected several patients with autoimmune disorders without any problems.”  

Dr. Ogilvie says an experienced health care provider will guide patients through potential concerns and provide appropriate treatment.   

“People with a milk or egg allergy should be cautious as they may be allergic to some active ingredients used to prepare Botox for use,” Dr. Ogilvie says. “Other than that, the biggest concern is when too much Botox is used or improperly placed, which can cause impaired function in important face and neck muscles.”  

Considering Botox? Find a plastic surgeon in Illinois or Wisconsin.