People Are Getting Botox for This Surprising Reason—a Derm Explains Why It’s Worth Considering

All your beauty questions—answered. Our resident dermatologist, Dr. Geddes Bruce breaks down the biggest topics in beauty, from hair loss to Botox and everything in between. Send us a DM @camillestyles with your own burning q’s and we may address it in a future column. 

My algorithm thinks I need Botox. Scrolling through social media, I see ads, testimonials, and before/afters all to convince me to make an appointment at my nearest medspa. I’m at the age where many of my friends have injected a syringe or two of Botox into their fine lines, foreheads, and even their armpits (apparently it can stop sweating)! But even with all the hype, Botox is still misunderstood. Board-certified dermatologist, Dr. Elizabeth Geddes Bruce, agrees. Beyond its aesthetic benefits, Botox is gaining more popularity as a wellness tool. Surprised? I was too! But as a painkiller, Botox for muscle tension could be the thing you’re looking for to ease your discomfort. Let’s investigate.

Featured image from our interview with Cyndi Ramirez by Belathée Photography.

Everything You Need to Know About Botox For Muscle Tension

I’ve starting hearing about people using Botox for muscle tension. I’m Botox-curious, but how do I know if this treatment is for me? And is it something that derms recommend?

As a beauty editor, I know the buzz around Botox is real. But could it be too good to be true? Or worse, could Botox be dangerous? Botox for muscle tension might be the next big thing, but it’s imperative to understand what you’re getting into. So I invited Dr. Geddes-Bruce to share her insights.

First things first, she told me that what we think of as “Botox” isn’t always… Botox. “Botox is a trademarked name but is used colloquially to refer to all neuromodulators,” Dr. Geddes-Bruce explains. It’s a brand, albeit the most popular, not the name of the treatment. Whether you’re opting for Botox or another neuromodulator, the possibility of an injectable painkiller might be right for you. But as with all treatments, be sure to consult a derm.

Why are patients using Botox for muscle tension?

Neuromodulators like Botox prevent muscles from contracting too strongly, thus causing a relaxing effect. We’ve capitalized on this effect in medicine and use it to safely treat painful conditions ranging from migraines to teeth grinding or jaw clenching, and much more.

How do you know if you need Botox for muscle tension?

This is subjective and depends on how your pain and tension affect YOU and your quality of life. Different tools help us as clinicians assess this in the office. In general, you should consult the appropriate specialist for evaluation before using Botox for muscle tension. For example, see a neurologist for migraines.

Which muscles can benefit most from Botox?

Neuromodulators work by binding to receptors on the muscle and blocking the signal sent from the nerve to “move.” The muscles that benefit the most are those that are contracting so strongly that they create medical issues, or those that can create a softer expression when weakened.

One of our most popular treatments is treating the masseter muscles of the jaw. We can improve tension headaches and save your tooth enamel by relaxing those muscles. Not to mention, an added benefit is a more tapered jawline and facial slimming. Another, newer treatment is injecting the superior portion of the trapezius muscle to relax the shoulders, elongate the neck, and relax muscle tension of that region. This has been popular for our patients who spend a lot of their day sitting at a desk, working on a computer.

Image by Belathée Photography

How long does Botox take to relax a muscle?

Depending on the specific brand of neuromodulator, you can start to see results a couple of days after the injections. However, full results usually take about two weeks to visualize. And full weakening of the muscle can take up to a month to fully appreciate.

The relaxing effect is twofold. First, we see an initial relaxing of the muscle when the neuromodulator fully kicks in around two weeks. Then, we see further relaxation when that muscle is no longer being used like it had been previously, which usually happens around one month after treatment. 

How often do you need to get new Botox injections?

Several factors determine how frequently you need to get new injections. Everyone metabolizes them a little differently. The most important is: how long does the effect last for you? On average, we see it last anywhere from 2.5-4 months. There are a few outliers that may go through it quicker or have it last closer to 6 months. And we’ve learned that the dosage used affects the duration—the more units, the stronger the initial effect, and the longer it will last.

Is Botox FDA-approved for tight muscles? Do Derms recommend it?

Yes! Botox is FDA-approved for the treatment for several conditions, including

  • Cervical dystonia, in which the neck muscles are involuntarily contracted and cause the head to twist to one side)
  • Overactive bladder leading to urine leakage
  • Prevention of chronic migraines
  • Blepharospasm and strabismus, aka involuntary blinking or crossing of the eyes).

All of these conditions stem from tight or overactive muscles. As dermatologists, we use many medications “off label” in the treatment of disease, as long as they have been proven safe for our patients. This includes neuromodulators for teeth grinding or jaw clenching, shoulder tension, excess sweating, and many different cosmetic benefits such as softening a gummy smile or frown line. 

Are there any risks to using Botox for muscle tension?

Thankfully, neuromodulators like Botox are pretty low risk because they are temporary. If Botox is placed incorrectly or diffuses into an unwanted muscle, then you can get undesirable effects like the dreaded eyelid drop or an asymmetric smile!

However, these things are rare with an experienced injector. Patients with baseline medical conditions involving muscle weakness (such as myasthenia gravis, for example) avoid neuromodulator injections, as well as anyone who has had a hypersensitivity or allergic reaction to neuromodulators, or pregnant women.

Are there any similar treatments to consider instead?

There are muscle-relaxing medications that are most often used temporarily after an acute injury, like a back strain. For chronically tight muscles, one can also consider gentle massage, physical therapy, targeted exercise, mindfulness, meditation, and acupuncture.

What else should we know before we go?

It’s not necessary to fully weaken or paralyze a muscle to see the cosmetic and medical benefits of Botox. We can tailor the dosage to your desired effect, and the results can be as subtle or strong as you please! Also, know that there are five different FDA-approved neuromodulators for use in the United States: Botox, Dysport, Xeomin, Jeaveu, and Daxxify. Each one has subtle differences in effect (and price) and you can discuss which one is best to fit your needs with your doctor. 

If you can, it’s best to avoid any blood thinners before receiving injections to minimize any risks of bruising. Things like aspirin, ibuprofen, fish oil, and even alcohol can thin the blood. After the injections, you can expect some mild swelling that will mostly dissipate in about 20 minutes, so it truly is a “lunchtime procedure.”


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