Do the injections hurt?

The needles are very fine, each puncture is a brief prick. Since several sites are treated depending on the application, some find the session uncomfortable but well tolerable; if desired, the skin can be anaesthetised or cooled beforehand.

How quickly and how long does botulinum toxin work?

The effect usually begins after two to seven days and reaches its maximum after about two weeks. It generally lasts three to six months and then slowly wears off, which is why the treatment is repeated.

The substance actually derives from a bacterial toxin, but is used in tiny, purified quantities specifically at local sites. In medical application by experienced doctors it is considered well researched and safe.

Does health insurance pay for the treatment?

For recognised medical diagnoses such as chronic migraine or dystonia, generally yes, in some cases after cost approval. You always pay for aesthetic treatments yourself. It is best if the practice clarifies this with your insurer before treatment begins.

Am I fit to drive afterwards?

Yes, as a rule there is nothing against driving immediately after the treatment. Should a drooping lid or double vision occur in the following days, which would be exceptional, refrain from driving and contact the practice.

Botulinum toxin (medical) — Procedure, Preparation & Cost

Botulinum toxin is far more than a remedy for wrinkles: in medicine, the substance is used specifically to relax overactive muscles or to dampen overactive glands and nerves. Injected in fine doses into the muscle or skin, it blocks signal transmission there for several months — for example in chronic migraine, involuntary muscle spasms or excessive sweating.

Typical Areas of Use

Chronic migraine with very frequent headache days
Muscle spasms such as torticollis (cervical dystonia)
Spasticity after stroke or in neurological diseases
Excessive sweating (hyperhidrosis), especially under the arms
Eyelid twitching and other involuntary muscle activity in the face

How It Works

1First, the neurologist or dermatologist clarifies the diagnosis and determines which muscles or skin areas are to be treated — the injection points and quantity depend on this.
2The injection sites are marked and disinfected; for deeper muscles, ultrasound or a measurement of muscle activity sometimes helps to find the right spot.
3Using a very fine needle, several small injections are administered — depending on the area of application, a few to several dozen punctures, each causing only a brief prick.
4You can then leave the practice immediately; the effect builds up over days and is checked at a follow-up appointment.

How to Prepare

Inform your doctor about blood thinners, muscle diseases, pregnancy or breastfeeding.
If you have migraine, bring your headache diary — it helps to assess the benefit of the treatment.
Come with clean skin without cream or make-up in the treatment area.

Side Effects & Risks

Small bruises or tenderness at the injection sites
Temporary weakness of adjacent muscles, e.g. a drooping eyelid with injections in the face
Flu-like feeling or headaches in the first few days
Rarely, temporary difficulty swallowing with injections in the neck
Declining effectiveness over time; very rarely the body forms antibodies against the substance

Afterwards — and When to Seek Help

After the treatment you can resume your everyday activities as normal; on the first day you should avoid vigorous rubbing or massaging of the treated areas as well as intensive sport and sauna. It is normal for the effect to take several days to develop and to wear off again after months. Contact your doctor if you experience difficulty swallowing or speaking, double vision, pronounced muscle weakness or breathing difficulties — such signs are rare but should be reported immediately.

Cost & Insurance

For recognised medical indications — such as chronic migraine, dystonias, spasticity or severe pathological sweating — basic insurance generally covers the treatment, in some cases subject to certain conditions or with prior cost approval from the insurer. Purely aesthetic applications, however, must always be paid for privately. The deductible and co-payment apply as usual; the treating practice usually clarifies the cost issue with the insurance company in advance — ask if you are unsure.

Frequently Asked Questions

Do the injections hurt?: The needles are very fine, each puncture is a brief prick. Since several sites are treated depending on the application, some find the session uncomfortable but well tolerable; if desired, the skin can be anaesthetised or cooled beforehand.
How quickly and how long does botulinum toxin work?: The effect usually begins after two to seven days and reaches its maximum after about two weeks. It generally lasts three to six months and then slowly wears off, which is why the treatment is repeated.
Isn't this a poison?: The substance actually derives from a bacterial toxin, but is used in tiny, purified quantities specifically at local sites. In medical application by experienced doctors it is considered well researched and safe.
Does health insurance pay for the treatment?: For recognised medical diagnoses such as chronic migraine or dystonia, generally yes, in some cases after cost approval. You always pay for aesthetic treatments yourself. It is best if the practice clarifies this with your insurer before treatment begins.
Am I fit to drive afterwards?: Yes, as a rule there is nothing against driving immediately after the treatment. Should a drooping lid or double vision occur in the following days, which would be exceptional, refrain from driving and contact the practice.