What To Expect With A Chemical Peel

What To Expect With A Chemical Peel

While the thought of a chemical peel to remove acne scars, wrinkles, and other skin defects may strike fear in your heart, be assured that it is a safe and effective treatment option. An acid solution is applied to the skin in a procedure known as a chemical peel. By dissolving an outer layer of skin with acid, new skin can develop in its place. Whether it’s wrinkles, scars, or discoloration from the sun, chemical peels can help.

The results of a chemical peel depend on what type of acid you use, how thickly it is applied to your face, and how long you let it sit on your skin.

A chemical peel is a medical procedure in which a chemical solution is applied to the skin. The solution causes the top layer of skin to be removed, and a new layer forms in its place. Chemical peels are performed for cosmetic reasons, the primary one being to reduce wrinkles. They can also be used for the treatment of acne and skin pigmentation. Properly done, you can dramatically improve the look and feel of your skin with this medical procedure. Read on to learn more chemical peel recovery time/skin looks worse after chemical peel.

What To Expect With A Chemical Peel

When you hear the words “chemical” and “peel,” you probably don’t immediately think that’s something you want for your face. It sounds a little scary, but actually, chemical peels offer a range of skin health and cosmetic benefits. One of the coolest things about chemical peels is how versatile they are. A good chemical peel improves skin tone and texture, manages chronic skin conditions, and even offers some anti-aging benefits. Generally speaking, peels are a budget-friendly, effective cosmetic dermatology treatment. This blog will dig deeper about what you can expect after your first chemical peel.

What is a Chemical Peel & Why Would I Get One?

If you’ve never had a chemical peel before, you may be wondering what this treatment even is. Simply speaking, chemical peels are exactly what their name suggests. They are facial treatments that use chemicals (commonly-used ingredients include salicylic acid, glycolic acid, or trichloroacetic acid) to peel layers of skin, revealing healthy, new skin below. There are many different types of chemical peels. Depending on your specific needs and your dermatologist’s recommendation, you may choose a chemical peel option that ranges from very light (just the surface of the skin) to improve uneven skin tone and other mild symptoms, or you may choose a chemical peel that goes deeper to address fine lines, wrinkles, scars (including acne scars), adult acne symptoms, and other concerns.

Am I a Good Candidate for a Chemical Peel?

Chemical peels offer improved appearance for a wide range of skin tone and texture concerns. However, peels aren’t appropriate for every cosmetic need. Specifically, chemical peels aren’t recommended if your scars or wrinkles are very deep, and peels aren’t able to tighten sagging skin. For the most part, reasonably healthy people can safely receive chemical peels, but there are some health conditions and skin characteristics that make chemical peels less effective and increase the risk of adverse effects, including:

• Individuals who are receiving isotretinoin treatment for acne
• Individuals who have a personal or family history of scar tissue abnormalities such as keloid scars
• Women who are nursing, breastfeeding, or actively trying to get pregnant
• Anyone with open sores, lesions, infections, or poorly managed chronic skin conditions
• People who spend large amounts of time outdoors receiving direct sun exposure
• Individuals with naturally darker skin tone may be at an increased risk for pigmentation concerns related to chemical peels.

Do I Need to Do Anything to Prepare for My Chemical Peel?

We know you can get a chemical peel at the spa or even perform one at home, but before you do, we really recommend you talk to a dermatologist. This ensures you have the knowledge you need to make informed decisions about which chemical peel procedure is right for your skin. And, honestly, we encourage you to let one of our medical professionals perform the procedure to avoid any negative effects like pigmentation issues, scarring, and infection that happen when peels are improperly performed.

Once you’ve decided that a chemical peel is the right option, your dermatologist will partner with you to develop a plan to prepare for your chemical peel treatment visit, which may include:

• Taking an antiviral medication to prevent skin infection
• Using a topical retinoid cream for a few weeks before your treatment to promote cell turnover and decrease healing time after your visit
• Applying topical bleaching agents like hydroquinone may also be recommended in the weeks leading up to your treatment as this can help to create an even skin tone and prevent hyperpigmentation after the procedure
• Using sunscreen daily and avoiding direct sun exposure whenever possible
• Applying a good moisturizer in the morning and evening to keep skin hydrated
• Reviewing and possibly discontinuing use of certain cosmetic products, hair removal chemicals, face masks, and other products that may increase the risk for adverse effects from chemical peels
• Forgoing shaving, plucking, or waxing in the area for at least 24 hours before your chemical peel
• When necessary, arranging for a ride to and from the office if you’ll be receiving a sedative

What Happens During a Chemical Peel?

In most cases, chemical peels are performed in your dermatologist’s office with no anesthesia or mild local numbing.  For patients who are receiving deeper chemical peels, mild sedative medication may be used on the day of the procedure. Before we begin the process, we cleanse and dry the skin thoroughly, and then use thick emollients, gauze, or other methods to protect your eyes, hair, nose, and mouth.

The peel itself involves applying a chemical solution to the skin and allowing it to sit. You may notice some stinging or discomfort as the solution sits on the skin. Then, depending on the type of chemical peel used, the dermatologist may apply a neutralizing agent to the treatment area. Most often the entire area is treated at once, but sometimes deeper chemical peels are performed in small sections which allows the dermatologist to carefully monitor your response and adjust treatment.

Some stinging or burning is normal during a chemical peel, but we never want anyone to be in excessive discomfort. At every step of treatment, we’ll do everything we can to ensure our patients are completely comfortable. That includes coming up with a good at-home care plan following the chemical peel to ensure you heal quickly and comfortably.

What Should I Expect After My Chemical Peel?

Patients can be really fearful going into a chemical peel because they’ve heard horror stories about people who had bad reactions. When they’re done correctly by a professional and the right chemical peel solution is used for your skin type, you should see really good results with minimal discomfort and downtime. Below are the top 10 things you should expect after your first chemical peel.

1 – Side Effects are Common, but They Should be Mild & Short-Lived

There’s a common misconception out there that chemical peels are really painful or the side effects are severe. Each person will react differently to skin treatments of all kinds, but for the most part, the side effects following chemical peels should be mild and healing should be completed within two weeks.

A common recovery timeline may look like:

• First few hours – you’ll notice some redness, tingling, or burning
• First few days – you may notice some dryness, irritation, and mild swelling
• Two to Three days – your skin may look flaky or peel, and discolorations or imperfections may temporarily be more noticeable
• Three to four days – you may breakout or notice skin looks tan or slightly darker than usual
• Five to seven days – all side effects should start to subside, and your skin should begin to look and feel “normal”
• Seven to fourteen days – you’ll see the formation of healthy, new skin, but you may notice some redness or skin that is darker or lighter than usual for up to a month

2 – Your Skin Will Peel

It is called a peel for a reason. The chemical is applied to peel away the existing layer of skin. After three to five days, you’ll start to see the skin peeling away. This should be similar to how your skin flakes away after a sunburn. You should gently remove the flakes when cleaning your face, but avoid pulling or picking at the peeling skin as this can cause irritation and increase the risk for infection.

3 – One Treatment is Great, but Multiple Chemical Peels Deliver Maximum Results

Many people think they’ll achieve the results they want after just one chemical peel. It usually takes several treatment sessions to see the desired outcomes. Most people notice some improvement after their first chemical peel, but with multiple treatments over the span of several months, patients will be astonished by how much better their skin looks.

4 – You Will Likely Need to Visit the Dermatologist for Follow Up Appointments

While most people have very mild reactions following chemical peels, it’s important to pay close attention throughout your recovery period and let your dermatologist know right away if you notice signs of infection or have other concerns. Because of the potential for rare but serious health risks, we like to schedule follow up visits with our patients after chemical peels. This also gives us a chance to check progress and adjust ongoing treatment plans.

5 – You May Need to Skip the Cosmetics for Awhile

For the first  1-2 weeks, you should not use any makeup. Chemicals and other substances in cosmetics can unnecessarily irritate the skin and prolong the healing process.

6 – Adjust Your Skincare Routine & Follow the Dermatologist’s Instructions

The body’s natural healing process is the reason chemical peels are so effective at improving skin’s appearance, so it’s essential to allow your skin to heal after treatment. Our providers usually work with patients to plan ahead for their aftercare, including making product recommendations based on skin type for cleansing, moisturizing, promoting cell turnover, and of course, protecting healing skin from sun damage.

While each person should talk to their dermatologist about a specific post-peel skincare plan, some basics include:

• Let the product work – You’ll start to see some dryness and other changes to your skin within the first few hours of application. To allow the product to work and avoid unnecessary skin irritation, you should avoid other skincare for the first 24 hours after your peel.
• Use dressing & medications – If you receive a deeper chemical peel, your dermatologist may apply dressings and healing ointments after your treatment. Follow your dermatologist’s recommendation for removing and replacing bandages and apply healing medications as recommended.
• Stay hydrated – As your skin is drying out and peeling away, it’s even more important to maintain hydration from the inside out by drinking plenty of water.
• Don’t pick at it – We know the dry, flaky skin is just begging to be pulled off, but try not to scratch, pull, or pick at your skin. This can increase the risk of scarring, and oils and germs transferred from the hands can lead to infection.
• Address pain & swelling – In most cases, taking a mild over-the-counter pain reliever is effective in managing discomfort. For very deep chemical peels or those who have a very low tolerance for pain, your dermatologist may prescribe something to help with your discomfort during healing. Additionally, you may be instructed to use cold compresses to manage symptoms during the first day and help avoid swelling and inflammation.
• Gently clean skin – After the first day, you should start washing your face in the morning and evening, using cool water and a gentle cleanser.
• Moisturize – Apply moisturizer at least twice a day to promote the healing process and protect the skin. Even if you typically have oily skin and only use a light moisturizer, you may need to use a good, thick moisturizer as your skin recovers following a chemical peel.
• Skip the exfoliant – Chemical peels are exfoliating, so you don’t need to use any exfoliant for the first week after treatment. That includes avoiding the use of exfoliating brushes and scrubs as well as cleansers or toners that contain a chemical exfoliant.

7 – Don’t Skip the Sunscreen!

Sunscreen is a must every day, but following a chemical peel, sun protection is even more essential. The skin is more sensitive to damage from the sun’s UVA/B rays. You should avoid exposure to the sun immediately after your treatment, and apply a broad-spectrum sunscreen with an SPF of 30 or higher before going outdoors. Immediately following your chemical peel, you should not use chemical sunscreens. Instead, use a physical sunblock to avoid an adverse response to the ingredients in some chemical sunscreens. Additionally, keeping the treated area physically shielded from the sun by wearing hats, scarves, or other protective coverings may be recommended after your chemical peel.

8 – Avoid High Temperatures & Overexertion

To combat potential side effects like redness, tingling, and post-inflammatory hyperpigmentation, you need to keep your skin cool. That means limiting time outdoors, taking cooler showers or baths, and avoiding overexerting yourself during exercise. In most cases, you can return to your regular routine after the first two weeks.

9 – You Might Break out

Many patients receive chemical peels to help improve the appearance of acne scars or combat the symptoms of adult acne, so when they hear that they may break out after their chemical peel, it’s upsetting. Unfortunately,  the combination of larger amounts of dead skin and inflammation from the procedure can lead to pimples. We know how frustrating it can be, but after this initial breakout, the skin should clear up within just a few days and look healthier.

10 – Be Patient – True Results Take Time

Our patients are always reminded that changes to the skin take a long time to accumulate, so it shouldn’t be surprising that it takes time to correct irregularities and damage. Cosmetic procedures do not restore youth overnight. The results of your chemical peel treatment plan will depend on the time you invest and your commitment to consistent treatment and at-home care. Be patient. If you’re concerned that a peel hasn’t had the desired effect, contact your dermatologist or ask about your results during your follow up visit.

Skin Looks Worse After Chemical Peel

Some patients experience a slight purge after a chemical peel or any aesthetic procedure for that matter. Your body uses the skin to push toxins out, which sometimes can result in the skin looking worse before it gets better. If you experience a purge, do not worry because it is normal.

There are chemical peels for almost any skin type, even the most sensitive of patients. If you’re concerned about the creep of age and skin damage across your face, a chemical peel may be a good alternative to a surgical procedure like a facelift. In some cases, Dr. Stein may combine a chemical peel and laser skin resurfacing treatment to improve results. A consultation is a great way to learn which chemical peel treatments could be right for you.

What is the Procedure Like?

Chemical peels come in different strengths and depths, which does affect how your procedure is performed. For light and medium peels, a topical anesthetic begins your treatment and once it takes effect, the chemical peel is applied to your skin for a prescribed amount of time. Once the time is up, a neutralizer stops the acid’s effects and your skin is nourished with soothing serum. For patients who choose deeper or phenol peels, your procedure is performed in the accredited state-of-the-art surgical facility under heavy sedation. It’s an outpatient procedure, so you’ll recover in the comfort of your home.

• Botox is used as a therapeutic treatment for many conditions, including for prevention of migraine headaches, and Botox Cosmetic is used for aesthetic purposes to lessen wrinkles like crow’s feet or forehead lines.
• Botox and Botox Cosmetic are prescription medicines that both contain the active ingredient onabotulinumtoxinA, but they come as separate products.
• Originally when Botox was first approved for wrinkles, doctors found it all also helped patients with migraine headaches. It was eventually approved by the FDA for migraine prevention in 2010.
• Both treatments are given as injections into the muscles of the face, neck or head, depending upon the use. You will need more injections per session for migraine prevention than for wrinkle treatment.
• Botox (for the treatment of chronic migraine) and Botox Cosmetic are for use in adults only.

Learn More: Compare Botox vs Botox Cosmetic

In addition to prevention of chronic migraine headache in adults, Botox is also approved to treat:

• overactive bladder
• leakage of urine (incontinence) in adults with overactive bladder due to neurologic disease
• muscle spasticity
• cervical dystonia (abnormal head position and neck pain)
• certain types of eye muscle problems or eyelid spasms
• severe underarm sweating

Botox Cosmetic is approved for adults to temporarily help improve the look of moderate to severe facial wrinkles:

• forehead lines
• crow’s feet lines
• frown lines between the eyebrows.

Botox Cosmetic is supplied in different unit vial sizes from Botox.

• Botox used for migraine comes in 100 and 200 unit single-use vials, while Botox Cosmetic for wrinkles comes in 50 and 100 unit single-use vials.
• Reconstitution and dilution instructions in the package insert vary between these two products.
• Potency Units of Botox Cosmetic or Botox are not interchangeable with other preparations of botulinum toxin products.

Botox dose for migraine: The recommended total dose for chronic migraine is 155 Units, as 0.1 mL (5 Units) injections per each site divided across 7 head/neck muscle areas, for a total of 31 individual injections. These areas include the forehead, bridge of the nose, the temples, the neck, the back of the head, and just above the shoulder blades in your upper back.

Botox Cosmetic dose for wrinkles: The recommended dose for wrinkles varies based on wrinkle type and typically ranges from 20 to 24 units per wrinkle area. The units per injection site will vary by patient and can be determined by a qualified injector for optimal results.

Can I get Botox and Botox Cosmetic at the same time?

Yes, you can receive Botox and Botox Cosmetic for different uses at the same time as long as the total dose received of onabotulinumtoxinA does not exceed 400 Units administered in a 3 month period for adults.

You may also receive Botox Cosmetic treatment for treatment of different wrinkle areas at the same time. It is not known if Botox Cosmetic is safe and effective for use more than once every 3 months.

The dilution and the resulting units per 0.1 mL (as noted in the package insert) are different between Botox and Botox Cosmetic. Health care providers should see the specific instructions for reconstitution and administration of each product.

Warnings: Botox and Botox Cosmetic may cause serious side effects that can happen hours, days, or weeks after an injection and can be life threatening. These include:

• Problems breathing or swallowing
• Spread of toxin effects (leading to symptoms of a serious condition called botulism)

Call your doctor or get medical help right away if you have any of these problems after treatment.

According to the manufacturer, there has NOT been a confirmed serious case of spread of toxin effect away from the injection site when Botox has been used at the recommended dose to treat chronic migraine or when Botox Cosmetic has been used at the recommended dose to treat approved wrinkle areas.

What are Botox or Botox Cosmetic side effects?

• dry mouth
• discomfort or pain at the injection site
• tiredness
• headache
• neck pain
• eye problem
• drooping eyebrow
• urinary tract infection and painful urination
• inability to empty your bladder
• allergic reaction
• upper respiratory tract infection.

Chemical Peel Recovery Time

The depth of your peel also dictates the length of your recovery period. For light and medium peels, you’ll experience flaking and peeling skin for 4-7 days after your procedure. For a deep peel, you can expect to be recuperating for up to 2 weeks, with significant peeling as well as some swelling and redness.

Like any procedure, there can be risks to chemical peels. Some people may feel hesitant to try this treatment after hearing about a bad experience. Can chemical peels make your skin worse than it was before? 

Can Chemical Peels Make Your Skin Worse? 

While chemical peels aren’t guaranteed to make your skin worse, complications can happen. Chemical peels have a few possible side effects. These complications include: 

• Redness, scabbing, & swelling 
• Scarring
• Infection 
• Changes in skin colour 

While risks are always present with any cosmetic treatment, chemical peels are safe when properly used. Depending on your skin, you may need a certain type of peel. 

When you’re with a certified and trained expert, you can feel more comfortable. Someone who understands your skin, the treatment and has your best interests in mind can give you a positive experience.  

If you’re trying chemical peels at home, the solutions may be weaker, but you can still damage your skin. There is less of a chance for error when seeing a professional. 

At-Home vs. Professional Treatments 

If you’re interested in chemical peels, there are two choices: at-home or professional treatment. While both options aim to improve your skin, they have some differences between them. 

At-Home Treatments 

While commercial products exist for at-home chemical peels, they are in lower concentrations and exfoliate your skin over time. There are a few different ingredients that can offer the same treatment as a professional chemical peel, but with less strength: 

• Glycolic acid
• Lactic acid 
• Mandelic acid
• Salicylic acid

Only use products with these ingredients if you’re going to try at-home treatments; chemical peels can burn your skin if improperly used. Follow all instructions carefully and diligently to avoid potential complications. 

Because these solutions aren’t as strong, at-home treatments are most effective for milder skin concerns. You won’t see as effective results from commercial products compared to professional treatment. 

At-home chemical peels can seem beneficial if you’re looking to save money, but having a trained professional treat your skin is worth the cost. 

I’ve suffered from migraine headaches since I was in my early teens. Over the years, I’ve missed out on much-anticipated trips, concerts, and family parties as I lay in bed with my head throbbing and the lights off. Migraine makes it nearly impossible to plan in advance and turns you into a flaky friend, which takes a toll on your relationships.

I thought I had tried everything-Advil, beta-blockers, Topamax-but none of them gave me the results I was looking for. Then a few years ago, my neurologist suggested I try Botox to manage my migraines. I knew about the drug’s wrinkle-reducing effects (I watch the Real Housewives franchises and Keeping Up With the Kardashians, after all), but I didn’t know that the same drug is a well-regarded preventative treatment for chronic migraine.

Admittedly I was hesitant about getting dozens of shots injected into my head, neck, and shoulders on a regular basis, but my misery made me open to trying it. Despite my initial concerns, Botox shots have completely changed how I control my migraine attacks. Though I’m still good for one or two migraines each month, Botox has drastically reduced the frequency of these attacks.

If you’re a fellow member of the migraine club, please accept my sympathy, and then read up on these must-know points about Botox for chronic migraine.

 The 14 Different Kinds Of Headaches You Can Get-And How To Treat Each One

First: What exactly is a migraine?

Most people believe a migraine is just a bad headache, but it can be more than that. According to the American Migraine Foundation (AMF), a migraine (sometimes just referred to as “migraine”) is a “disabling neurological disease with different symptoms and different treatment approaches compared to other headache disorders.”

It’s also important to note that, while some headaches can be the cause of underlying conditions (those are known as secondary headaches), migraines are usually their own thing. “Migraine is the most common primary headache disorder, which means that it’s not happening because of a tumor or an infection. It’s just how your brain is wired,” Umer Najib, MD, a board-certified neurologist and the director of the headache medicine fellowship program at West Virginia University, tells Health.

“Pain is often the predominant symptom, though many patients have other symptoms that can actually be more bothersome than the pain itself,” says Dr. Najib. Ferhad Bashir, MD, a neurologist with Mischer Neuroscience Center at Memorial Hermann The Woodlands Medical Center in Texas, goes a step further: “It’s a state of misery,” he tells Health. “During that time period, you’re not yourself. If you’re at work, you can’t produce at your optimum level. If you’re a parent, you can’t enjoy time with your kids.”

Those additional symptoms, aside from often disabling pain, include:

• Sensitivity to light, sound, or strong smells
• Nausea
• Vomiting
• Excessive Fatigue
• Language, speech, or balance problems
• Visual disturbances, like seeing zig zags, flashes of light, or blind spots.

It’s not entirely clear what causes migraine, though researchers believe that there’s a genetic component to the neurological condition, according to the US National Library of Medicine’s MedlinePlus resource. But the condition-which affects more than 37 million people in the US alone-is thought to have quite a few triggers, including stress, anxiety, caffeine (or caffeine withdrawal), and certain medications.

Migraine is also about three times more common in women, per the AMF, which points to a possible connection to fluctuating hormones. “For a lot of women with migraine, menses can trigger an attack,” Megan Donnelly, DO, a board-certified headache specialist and neurologist, and the director of headache and women’s neurology at Novant Health in Charlotte, North Carolina, tells Health. “We also have changes in migraine frequency in pregnancy and postpartum, as well as related to perimenopause.”

There’s no cure for migraines, per MedlinePlus. Instead, treatment mainly focuses on relieving symptoms and preventing or lessening future attacks through a combination of medications and lifestyle changes. This, in some cases, is where Botox-aka Onabotulinumtoxin A or Botox A-comes into play.

 5 Women on What It Really Feels Like to Have a Migraine

How does Botox for help migraine?

Botox is a preventative therapy for migraine, meaning that it can reduce the frequency of migraine, but it won’t stop one once it’s begun. Though Botox has been an FDA-approved treatment for chronic migraine for more than a decade, per the AMF, the science behind how it battles the disease is still a bit of a mystery.

Technically speaking, the AMF says that Botox is injected into the pain fibers in the head, neck, and back that are involved in headaches. That Botox then blocks the release of chemicals involved in pain transmission, which then prevents activation of pain networks the brain.

Why Botox works in this way, however, is still not well understood. “We have animal data that shows that Botox causes a change in a certain type of calcium channel in the meninges, which is the covering of the brain as well as the critical part of the migraine process,” says Dr. Najib. “We think that’s how it suppresses migraine.”

Despite Botox’s efficacy (patients reported that two rounds of shots reduced their headache days by roughly 50 percent, per the AMF), Dr. Najib notes that the drug isn’t a cure-all. “As long as the disease is still active, you’ll have breakthrough headaches,” he says.

Because of that, some patients find that they need another preventative treatment, like an oral medication, in addition to their shots. It’s also common to need a rescue drug, and the risk of drug interaction is minimal.

Choosing a treatment of preventative method for migraine is a highly personal choice that should be done in close contact with your doctor. Here’s more of what I learned about Botox and migraine during my own journey-and what I want those considering the treatment to know.

 This Explains Why You Want to Crawl Into a Dark Closet When You Have a Migraine

It’s only approved for chronic migraine

Botox is FDA-approved to treat chronic migraine in adults, which is defined as more than 15 migraine days per month. It’s not approved for other kinds of headaches, like tension or cluster, nor is it approved for children or adolescents (if it’s used for them, it’s considered “off-label use”).

You’ll have to get dozens of shots

Though migraine symptoms vary from person to person, Botox for migraine is standardized. Every three months you’ll receive 31 shots (yes, you read that correctly) totaling up to 155 units of Botox. This includes injections in specific spots in the forehead, temples, back of the head, neck, upper back, and shoulders.

If you’ve got a particular concern, like muscle spasticity or tightness in the shoulders, your provider may adjust the shot pattern to tackle that specific issue.

If Botox is working for you, there’s no known health risk associated with staying on it indefinitely, though it’s not approved for people who are pregnant or breastfeeding because of minimal studies in these groups.

The risk of side effects is low

“Botox injections can occasionally trigger a headache, muscle weakness and neck pain, but this is rare,” Kerry Knievel, DO, director of the Jan & Tom Lewis Migraine Treatment Program at Barrow Neurological Institute in Phoenix, Arizona, tells Health. “Eyelid and eyebrow asymmetry and droop can happen, but to prevent this we recommend that patients refrain from rubbing their foreheads or wearing a hat for 24 hours after their injections to prevent the Botox from spreading from the area we intend for it to be.”

In fact, Botox’s limited side effects are part of its appeal. “It’s not addicting. You don’t have to take a pill every day. It doesn’t work for everyone, but it does work for a significant amount of people. That’s why Botox is amazing,” says Dr. Bashir.

Your insurance may or may not cover it

Because it’s an FDA-approved treatment, your health insurance may cover all or most of the cost of Botox, though this depends on your specific plan. The drug manufacturer also offers a savings program that can help offset some of the expense.

To get approval, your insurance company may want to see that you’ve “failed” on two or three oral preventatives first. You may also need to keep a headache diary (I track mine in a note on my phone) that shows you’re having 15 or more headache days per month.

Once you’ve started the shots, your insurance will probably require documentation of improvement to continue paying for the treatment. Depending on your plan, you may also need to come for a follow-up visit between shots.

Note, however, that if Botox is used as an off-label treatment (meaning it’s used in a way not approved by the FDA, like in children or adolescents), insurance companies may not cover it, per the AMF.

It can take several months to see results

If you don’t experience relief from migraine right away, don’t swear off the treatment immediately. Dr. Najib recommends trying two rounds of Botox before making a decision about whether it’s working for you. Even if the treatment ends up helping after the first round, he says results typically take two to four weeks to kick in. There’s no taper required to discontinue the treatment.

It’s a little different than the Botox you receive from your esthetician

Though the same drug is used for both migraine prevention and cosmetic purposes, the amount and placement of Botox varies depending on your goals.

You may find some level of relief when you get Botox for cosmetic purposes. However, when you receive Botox from an esthetician, you’re not getting injections in the same spots as you would in a doctor’s office. This means you’ll miss the drug’s full migraine-busting effect.