Botox for Beginners: A Guide to Your First Treatment

Everything you need to know about caring for your skin before, during, and after your first round of Botox.

by Michelle Rostamian

Linda Evangelista photographed by Steven Klein for W Magazine, 2012
Linda Evangelista photographed by Steven Klein for W Magazine, 2012

Slathering on moisturizer, staying loyal to SPF, drinking plenty of’s safe to say there isn’t much we don’t do in the name of keeping our skin as youthful-looking as possible. While all of the aforementioned product types can, in fact, yield a healthier complexion, there’s nothing quite like Botox if you’re looking for a tried-and-true cosmetic treatment that is sure to garner smooth, line-free skin. But how long do results last? What’s off-limits after a treatment? And most importantly, is it painful? If you’re new to injectables, you (justifiably) may have a lot of questions. We tapped skin experts who perform Botox treatments on the regular for details on what to expect before, during, and after a treatment.

What Is Botox?

According to SkinSpirit aesthetic physician’s assistant Jennifer Corbett, Botox is a prescription medication derived from the botulinum toxin type A. “When injected into a muscle, it blocks the ability for the nerve to tell the muscle to move,” says Corbett. “Once the muscle is ‘relaxed’ and no longer moving or ‘wrinkling’ the skin, lines that appear deep or evident at rest will soften and the skin will appear smoother.” Essentially, Botox “freezes” your muscles, which can minimize the appearance of wrinkles along the most common areas they form—laugh lines, forehead lines, “the elevens” (the area between your eyebrows), and crow’s feet (the area on the side of your eyes).

Benefits of Botox

Beyond softening the appearance of existing fine lines and wrinkles, Botox can also be used as a preventative measure. “I typically talk to my patients about avoiding wrinkles that get ‘etched’—these are the wrinkles that exist even when the face is at rest,” says Dr. JoAn Monaco, a New York City-based plastic surgeon. “Doing treatments regularly will prevent some wrinkles from becoming etched [into the skin] which, when this happens, can be more stubborn to treat.”

Botox can also be used for non-cosmetic treatments, and some of them have had FDA approval longer than some of the treatment’s cosmetic uses, says Monaco. Some of these uses include treatment of “chronic migraines, bladder spasms, cervical dystonia, hyperhidrosis (aka severe sweating of the armpits), and TMJ pain,” Monaco explains.

You should avoid Botox if you’re pregnant or breastfeeding. Also, keep in mind that if you have a muscle disorder such as Lou Gehrig’s disease, myasthenia gravis or Lambert-Eaton syndrome, you may have serious side effects from Botox, says Monaco.

How to Prepare for Botox

Botox doesn’t require too much prep. You should avoid wearing makeup on the areas to be treated (though your injector should wipe the area clean with alcohol prior to injecting). It’s also best to avoid alcohol as well as blood thinning agents (like Advil, Ibuprofen, Aleve, Motrin, garlic supplements, and fish oil) for 24 hours prior to your appointment, as these can up your chances of bruising. And, if you have a rash or blemish on the area to be treated, it’s best to reschedule your appointment once they’ve cleared up.

What to Expect During Your Botox Treatment

After reviewing your medical history with your injector, you’ll look into a mirror and discuss your areas of concern. No two treatment plans are alike, and it’s important to spend time with your injector pointing out the areas you’d like to improve to ensure you leave the office with desired results. The skin is then thoroughly cleaned and ice is applied to the treatment area to minimize bruising. Then, all of the muscles will be injected and sunscreen will be reapplied to the skin. An average treatment takes about 10 to 20 minutes—just enough time to get a jab done during your lunch break.

As far as the ouch-factor, Botox is known to be one of the most well-tolerated cosmetic procedures. “I compare its discomfort to that of having a brow wax,” says Corbett. “Topical lidocaine can be used on more sensitive areas such as the upper lip, but the application of ice prior to injection can help ‘numb’ the skin as well.”

Botox After-Care

After your Botox treatment, you should sit upright for four hours and avoid exercise for 24 hours. Also, if you’ll be out in the sun after a treatment, Monaco recommends wearing sunglasses to prevent squinting, as “the more a muscle group is used, the quicker the Botox can wear off. Wearing sunglasses to avoid squinting from the sunlight can ‘prolong’ the effect of Botox.” This means you should also avoid having the treatment area manipulated (by way of a facial, massage, or eyebrow wax) for one week, adds Corbett.

In terms of side effects, not everyone will bruise, but Monaco notes that bruising can occur even in the most experienced provider’s hands, simply because some patients have small vessels under the surface of the skin. Also, Monaco says that if a patient has had aspirin in the seven days leading up to an appointment, she likes to give them topical or oral arnica, which is an herbal supplement that can reduce the likelihood of bruising (and speed the healing of an existing bruise).


Corbett says that the results of a Botox treatment can take up to 14 days for full effect—however, patients typically notice changes within five to seven days (with results lasting up to three to four months). All in all, Botox is one of the most popular aesthetic treatments on the market because of its safety, efficacy, and ability to produce quick results with little to no downtime.