Botox Aftercare: What to Do and What to Avoid After Treatment

The short answer

After Botox you can usually return to normal life the same day, because downtime is minimal. Common precautions are to keep your hands off the treated area, stay upright for a few hours, and skip intense exercise, saunas and hot baths for about 24 hours. A 2025 retrospective study and a 2016 expert consensus found little trial evidence behind these rules, so treat them as cautious defaults, and follow the written instructions your doctor gives you. Report a drooping eyelid, double vision or trouble swallowing straight away.

What the first hours look like

Small injection marks, slight redness or swelling are common and usually settle within hours. Bruising is possible, especially if you take blood thinners. Headache in the days after treatment is the most frequently reported side effect on the clinic’s botulinum therapy page, and the US prescribing information lists headache in 9% of people treated for forehead lines in its clinical trials.

The usual advice for the first hours, as the clinic’s treatment page words it, is to stay upright for a few hours, to avoid rubbing or massaging the treated area, to skip intense sport, saunas and hot baths for about 24 hours, and to wait with makeup until the next day. Facial massage, microcurrent, radiofrequency and other facial treatments are postponed for the period your doctor specifies.

The doctor gives written aftercare and can review you at a follow-up visit. If those instructions differ from anything you read online, including this article, follow your doctor.

What the evidence says about the usual rules

Most after-Botox rules came from habit and theory. A 2025 paper in the journal Toxins states that the usual four-hour instructions (avoiding facial expressions, staying upright, avoiding physical activity, avoiding direct sun and heat) are largely based on anecdotal evidence, and the authors found no clinical trials testing them. The 2016 Global Aesthetics Consensus, written by a multinational group of plastic surgeons and dermatologists, reached a similar view on several points.

The same 2025 study followed 5,014 patients treated for upper-face lines at six Italian centers between 2015 and 2020. After only a 10-minute observation, patients got no further restrictions and went back to normal life. Among the 4,000 patients seen at the two-week follow-up, none had upper eyelid ptosis. Bruising appeared in 3.00%, temporary headache in 1.80% and eyebrow ptosis in 0.40%. Of the 2,010 patients who completed a satisfaction questionnaire, 50% were very satisfied and 40% satisfied.

The authors list their own limits: a retrospective design, no control group, no statistical analysis and short follow-up. One study cannot prove that the traditional rules do nothing. Its authors concluded that omitting extended post-injection instructions did not worsen satisfaction or complication rates in their series, and they call for controlled studies.

A practical plan for day one and the first two weeks

These are general pointers from the sources above. Your doctor sets the exact instructions for your treatment.

• Day one. Keep your hands away from the treated area, stay upright for the first hours and plan light activity. Apply makeup the next day unless your doctor says otherwise.
• The first 24 hours. Skip intense sport, saunas and hot baths. Do not schedule a facial, massage, microcurrent or RF session until your doctor says when it is safe.
• Days 1 to 7. The effect builds. The US prescribing information says that, for frown lines, chemical denervation typically begins one to two days after injection and increases during the first week.
• Around day 14. The clinic’s treatment page describes the full effect as settling over about two weeks, which is when a doctor can review the result and decide whether a muscle needs more. If movement has not changed at that point, read why Botox sometimes seems not to work before arranging a top-up somewhere else.
• Next treatment. The label states that dosing more often than every three months has not been clinically evaluated.

Medicines also matter. Do not stop a prescribed blood thinner on your own. The 2016 consensus calls it desirable, not essential, to avoid anticoagulants, anti-inflammatory painkillers and fish oil before injections, and says using them is not a contraindication. Discuss any medicine with your doctor before the appointment.

Downtime and recovery: what is normal and what is not

Downtime is minimal for most people, and the treatment page says most patients return to normal activity the same day. Normal effects include injection marks, redness, slight swelling, bruising and a headache in the following days. The Medication Guide also lists dry mouth, tiredness, neck pain and pain at the injection site among the possible side effects of Botox and Botox Cosmetic.

Less common effects need a call to your doctor, even if they seem small:

• A drooping eyelid or eyebrow, or a brow that sits unevenly. The 2025 study records eyebrow ptosis in 0.40%, and the authors note that an uneven (“cocked”) brow can be corrected with a small touch-up.
• Double or blurred vision, or eye dryness, irritation or sensitivity to light. The prescribing information advises reporting these symptoms.
• Marked asymmetry that does not settle as the effect develops.

The prescribing information also advises that if you notice loss of strength, muscle weakness, blurred vision or drooping eyelids, you should not drive or do other hazardous activities until they pass.