Botox is an effective treatment for migraine headaches.
It is thought that botulinum toxin gets into the small nerves that carry pain signals from the head to the brain, known as C-fibres. This reduces the amount of chemicals released from the nerve endings and therefore interrupts the feedback pathway that perpetuates migraine and headache. Essentially the botulinum toxin works on the neurovascular junction (between the nerves and blood vessels) primarily in the area above the eyebrows to treat migraine headaches.
Botox is given as a series of tiny injections under the skin or into the muscles in and around the forehead, above the ears, and into the neck and shoulders. The injections usually need to be repeated every 12-16 weeks, after which time the effects of the botulinum toxin wear off. Normally a response is seen after the first or second set of injections. Only about one in ten people respond to a third set of injections if the first two sets fail.
The appointment takes approximately 15 minutes.
The goal is improvement in the patient's quality of life.
About one in four patients do not respond to the treatment. One in four respond well to the first or second set of injections, and half need more than two sets of injections to get a good response. Studies show that 47% of patients had a 50% or greater reduction in the number of days with headache.
We have audited our results and have more than a 70% success rate of relieving patient's migraine headaches. In the majority of cases this is complete remission allowing people to get on with their lives, whilst in others it means more days of the month headache-free or in some a far better response to migraine medication than prior to the treatment.
The biological effect of botulinum toxin on nerves takes 3-5 days or a week or two to work. Some patients do not start to improve until after their second set of injections which can be given 12 weeks after the first set of injections.
People who are pregnant or breastfeeding.
If you have a neurological disease, for example Bell’s palsy, a neuropathy, or Myasthenia Gravis. Also patients with multiple sclerosis affecting the head and neck areas.
If you have recently (within the last 3 months) had cosmetic botulinum toxin then the side effects could be increased.
Tell our doctor if you:
▪ Have had problems with injections (eg. fainting) in the past
▪ Have had problems with previous botulinum toxin injections
▪ Have inflammation, weakness or wasting of the muscles where your doctor plans to inject ( botulinum toxin is a contraindication in patients with or suspected to have myasthenia gravis)
▪ Have had problems with swallowing or food or liquid accidentally going into your lungs
▪ If you have been treated for persistent muscle spasms in the neck and shoulders
▪ Suffer from any other muscle problems or chronic diseases affecting your muscles
▪ Suffer from certain diseases affecting your nervous system
▪ Have an eye disease called closed-angle glaucoma or were told you were at risk of developing this type of glaucoma
▪ Have had any surgery that may have changed the muscle that is being injected
▪ Are taking any blood thinning medicine
Cooling-off period
The procedure can sometimes be performed on the same day, but for those new to the procedure or that have medical issues, a “cooling-off period” is generally recommended, followed by another scheduled appointment.
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Generally, Botox is well-tolerated. The most common side effects include neck pain, muscular weakness and drooping of the eyelid. These side effects are temporary because the treatment wears off over time.
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The Migraine Treatment price is £250
This price includes:
- A professional treatment carried out by a qualified Doctor, not a nurse or beautician.
- Free consultation.
- A 2 week review appointment if indicated
- A fixed price for men or women.
Medical Director & Founder
MBChB DRCOG MRCGP
Private GP and Aesthetics Doctor
GMC Reg number: 3275151
In 2008 she undertook the “Facial Aesthetics in General Practice” course and subsequently she studied for the “Advanced Facial Aesthetics and Dermal Fillers” certificate for Doctors.
Dr Carole McAlister is fully qualified and experienced as an advanced practitioner and she has been treating patients for over 15 years with botulinum toxin for both cosmetic and clinical conditions such as hyperhidrosis (excessive sweating), migraine and teeth grinding.
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Botox is used as a treatment for chronic migraine in the UK.
Botox (botulinum toxin type A) is a type of nerve toxin that paralyses muscles. It comes from a bacterium known as Clostridium botulinum. It was discovered as effective for people with chronic migraine while being used for cosmetics treatment. It was found that people who had Botox experienced fewer headaches.
Botox is approved for use on the NHS for the treatment of chronic migraine in adults. Chronic migraine is defined as having at least 15 headache days a month, with at least eight of those featuring migraine symptoms.
It is not an effective treatment for other types of headache including episodic migraine (headache on fewer than 15 days a month), tension-type headache and cluster headache.
Botulinum toxin is used to treat other conditions such as hemifacial spasm, cervical dystonia, cerebral palsy, bladder pain, lower back pain, neuropathic pain and stroke.
In England and Wales, the National Institute of Health and Care Excellence (NICE) recommends the use of Botox for people with chronic migraine who:
have failed at least three preventive treatments
have been appropriately managed for medication overuse headache
In Scotland, the Scottish Medicines Consortium (SMC) approved Botox for chronic migraine where people have failed to respond to three oral preventive treatments and any medication overuse has been appropriately managed.
In Northern Ireland, the Department of Health endorsed the NICE appraisal approving Botox for chronic migraine in 2012.
It’s not clear why Botox is effective in migraine. However, doctors think it works by blocking chemicals called neurotransmitters that carry pain signals from within your brain.
Botox aims to reduce how often you have migraine attacks and how severe they are.
Most people have at least two treatment cycles before deciding if Botox is effective. A good response to Botox is usually a 30-50% reduction in how many headaches you have. Doctors will also consider any improvements in your quality of life. Some people notice an improvement in their quality of life with Botox even if they don’t have a big reduction in headache days
We have audited our results and have more than a 70% success rate of relieving patient's migraine headaches. In the majority of cases this is complete remission allowing people to get on with their lives, whilst in others it means more days of the month headache-free or in some a far better response to migraine medication than prior to the treatment.
The guidelines recommend Botox is given as a series of small injections. These are given under the skin or into the muscles in and around the head of the forehead, above the ears, and into the neck.
Botox is only available on the NHS for people with chronic migraine who have tried at least three other preventive treatments. It is currently only available via a specialist such as a headache specialist or consultant neurologist.
If you think you are eligible for Botox and would like to considered for treatment you can ask for a referral to a specialist. The specialist will assess your history and symptoms to make sure Botox is an appropriate treatment option for you. You should be asked to keep a headache diary to monitor the effectiveness of the treatment.
If Botox doesn’t work for you or stops working your specialist will discuss other treatment options with you.
The Botox effects can last up to six months but typically range from three to four months. Eventually most people require re treatment as the wrinkles reappear.
However in some treated areas (such as frown wrinkles), the wrinkles may return less severe after repeated treatments as the unconscious muscle contraction habit is broken.
Botox treatments are designed to smooth dynamic wrinkles in the forehead and around eyes, they do not affect your facial expression.
The final result can be tailored to each patient and can be discussed at the initial free consultation.
Try to contract the treated muscle areas for up to four hours after treatment, by frowning and lifting eyebrows to allow the toxin to reach all of the treated muscle.
Avoid rubbing or touching the injected areas and avoid having facials and massage for 48 hours this is to ensure that the treatment remains at the site of injection.
Avoid vigorous exercise and alcohol-based products on the area treated for 48 hours.
If bruising develops then you can apply Arnica cream
Paracetamol can be taken for mild pain post procedure
Reduce excessive alcohol consumption or medically necessary blood-thinning medication before the treatment to prevent bruising.
Botulinum Toxin injections consist of a safe, naturally purified protein. A course of treatment has little impact on usual day-to-day activity and will not affect your sleeping patterns. To allow the BOTOX® injectables to settle, you should avoid putting pressure on the treated area or laying on your front for around four hours.
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