You invest time and money into neurotoxin injections to reap aesthetic or health benefits, so, of course, you want the results to be as good as they possibly can. “The first 24 hours after treatment matter. What you do—or don’t do—can directly influence your outcome,” says New York dermatologist Marina Peredo, MD. While Chapel Hill, NC dermatologist Sue Ellen Cox, MD notes that while aftercare for neurotoxins is relatively simple compared to many other aesthetic treatments, there are still some critical things you should avoid. “Rubbing, pressure, increased blood flow, heat or gravity too soon after treatment can cause the product to migrate to unintended areas,” warns Miami dermatologist Dr. Deborah Longwill. “This may result in uneven results, reduced effectiveness, increased bruising or unwanted effects such as drooping of the eyelids or eyebrows and facial asymmetry.”
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Don’t touch your face
“The most important rule is to avoid anything that puts pressure or causes swelling on the face for a period of time after injections,” says Dr. Cox. “This includes other facial massages, at-home tools such as jade rollers or gua sha and suction-based devices like HydraFacial.” Even actions as simple as rubbing the face or resting it firmly in your hands could be problematic, notes Dr. Longwill.
Dr. Peredo suggests avoiding any pressure, even including wearing helmets or tight headwear, for 24 hours. For more intensive high-touch treatments like “facials, facial massage or lymphatic treatments, patients should wait seven to 10 days to allow the neurotoxin to fully settle,” says Dr. Longwill. Dr. Peredo explains that “neurotoxins require time to bind to targeted neuromuscular junctions. Excess manipulation can increase the risk of unintended diffusion into adjacent muscles.”
Don’t lie flat or bend over
Dr. Longwill recommends patients avoid lying flat or bending forward excessively after getting neurotoxin injections. Basically, “Patients should remain upright for at least four hours after treatment,” she says. It might seem silly, but it’s better to be safe than sorry.
Don’t get any other treatments
Dr. Cox says patients scheduling multiple aesthetic appointments too close together or in the wrong order is a common issue. “For example, if you plan to have both a facial and neurotoxin injections on the same day, the facial should always be done first. Performing a facial afterward can disrupt the placement of the product,” she explains.
Dr. Peredo also urges patients not to schedule any laser or microneedling after neurotoxin injections. “Facial manipulation, external heat and prolonged reclining may interfere with early toxin localization.” She recommends waiting one to two weeks, depending on your doctor’s recommendations.
Don’t do strenuous exercise
“Strenuous activity increases blood flow and vascular dilation, which may promote early diffusion before the neurotoxin has fully localized,” explains Dr. Peredo; however, she notes light waking if fine. Dr. Longwill advises avoiding strenuous exercise for 24 hours post-treatment.
Don’t expose skin to heat
Avoid heat, including saunas, steam rooms and hot yoga for at least 24 hours after treatment, advises Dr. Longwill. “Heat increases circulation and may contribute to swelling or diffusion in the early phase,” explains Dr. Peredo, who recommends waiting two days if possible.
Don’t consume excessive alcohol
Dr. Longwill urges patients to skip consuming excess alcohol within 24 hours of getting neurotoxin injections. “Alcohol promotes vasodilation and increases the risk of bruising,” Dr. Peredo explains.
Don’t panic if you don’t see immediate results
This task might be the hardest since it’s all mental, but Dr. Peredo advises patients not to panic if they don’t see results immediately. “The biologic process requires time,” she explains, noting that initial softening tends to take three to five days with the full effect taking shape in 10 to 14 days.
Whatever you do, don’t seek out more injections out of sheer panic. “Over-treating too early can lead to heaviness, imbalance or an unnatural appearance,” says Dr. Peredo. She recommends reassessing at two weeks with your doctor to see if refinement is needed.