Pimples after Botox

I attempt to answer another public forum question about Botox.  This question comes closer to my office in Modesto, California – it is from San Jose, California!

Why do I break out since having Botox?

In the exact same area where the injection was; is where i break out. As if causing a “man made pore” from the needle which then does not close up and gets filled causing an ongoing blemish effect. I ONLY break out now where I’ve had the injections. But why??

My Pimples and Botox Answer:

Wonderful question.  I’ve encountered this question about having breakouts in the area of Botox injections in my own practice in Modesto, California about 3 times.  So this is rare.  The world of medicine is complex, and sometimes it seems strange.  I have not had a case of the “man made pore” – so I can’t address that question except to speculate that it may be a scar of sorts or somehow related to a cyst?   I’ve had an experience where there was a reddish – pimple like reaction to only one of my needle pokes.  I suspect in that patient that there was an underlying infection in that area – such a pimple – which then got exacerbated when I decided to inject Botox too close to that area.  Botox injections are tricky, we want our injections to be in strategic places, but sometimes in our patients, blemishes and veins get in the way of an ideal placement – and thus I have to compromise in my decision and Botox strategy.

​Regarding the break-outs in the Botox areas.  For some of my patients, I’ve come to realize that they are sensitive to some of the antiseptic methods I use to help prevent infections from the Botox procedure.  Sometimes they are allergic to the antiseptic.  There are various ones available out there and perhaps switching to a different antiseptic could help.  Meaning, having your injector/surgeon/doctor/nurse switch to a different agent.  And there’s the possibility that the actual needle poke – which is a very mild form of skin trauma – could incite a inflammatory process.

​Ironically (to your question of why does Botox cause more blemishes), I’ve found most of the time that Botox helps calm down inflammation in an area of skin. This may be due to reduced sweating or a direct effect on rashes and pimples by Botox.  Also, Botox sometimes shrinks pores as with what we’ve seen with meso-Botox.

​Thank you for your question, I’m just answer from my own personal experience as a Botox injector. Without having seen you in person, I’m answering the best I can without physical examination info. My comments are meant for a general public discussion to help others who may have similar concerns. I’m also using my answers to build up library of information for my own patients and also to see how my answers compare with other doctors. There is always much for us to learn from each other. My answers are generalized medical information only, not directed medical advice. For medical advice please see your doctor/surgeon in person.

​I hope this discussion is somewhat helpful.

​Calvin Lee, MD – Botox Surgeon
Botox injections ​Modesto, California

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