Does Botox Help With Migraines? What You Need to Know

Written and verified by Holly Hazen

Does Botox help with migraines? If you live with chronic migraine and other treatments have failed, you may be considering Botox as a preventive option. Botox is FDA approved for chronic migraine and is used to reduce attack frequency and severity in adults who experience 15 or more headache days per month.

It is not a cosmetic procedure in this setting. It is a neurological treatment.

The real question is not whether Botox sounds scary.

The real question is whether it works, who qualifies, and what the risks actually are.

Let’s walk through it clearly.

Who Qualifies for Botox for Migraine?

Botox is approved for chronic migraine, defined as:

• 15 or more headache days per month
• At least 8 of those days meeting migraine criteria
• Symptoms lasting 3 months or longer

It is not typically used for occasional or episodic migraine.

Insurance coverage and government programs often require documentation of:

• Failed preventive medications
• Headache diary records
• Confirmation by a neurologist

If you are unsure whether you meet chronic migraine criteria, read → Types of Migraines

How Does Botox Help with Migraines?

Botox is a purified form of botulinum toxin type A.

In migraine treatment, it works by:

• Blocking release of pain-signaling neuropeptides
• Reducing activation in the trigeminal nerve system
• Decreasing peripheral sensitization

It does not cure migraine.

It reduces attack frequency and intensity for some people.

Clinical trials show about 50 percent of patients achieve a 50 percent reduction in headache days.

Some respond more. Some do not respond at all.

That is why doctors define success as reduction, not elimination.

If you want to understand the brain mechanisms behind migraine, read → Migraine Brain vs Normal Brain

Where Are Botox Injections Given?

Botox injections for migraines follow a standardized protocol developed specifically for chronic migraine prevention.

Typically:

• 31 injections
• Across 7 muscle areas
• Forehead
• Temples
• Back of head
• Upper neck
• Shoulders

Two approaches are used:

Fixed-site pattern
Standardized muscle groups are injected.

Follow-the-pain pattern
Additional injections target dominant pain areas.

The procedure usually takes 10 to 15 minutes.

Most people describe the discomfort as mild and brief.

Treatments are repeated every 12 weeks.

How Long Does Botox Take to Work?

Improvement may begin within:

• 3 to 7 days for some
• 2 to 4 weeks for others

Maximum benefit often appears after the second or third treatment cycle.

This is important.

Botox is not always dramatic after one session. Doctors typically evaluate response after two cycles.

What Are the Side Effects of Botox for Migraine?

Most side effects are mild and temporary.

Common:

• Injection site pain
• Neck stiffness
• Mild headache
• Temporary drooping eyelid

Less common but serious risks include:

• Muscle weakness
• Difficulty swallowing
• Difficulty breathing

These risks are rare when administered at recommended doses by qualified professionals.

Always seek treatment from a neurologist experienced in migraine Botox.

Is Botox Safe for Migraine?

When administered properly, Botox is considered safe and well studied.

It has been FDA approved for chronic migraine since 2010.

Safety depends on:

• Correct diagnosis
• Proper dosing
• Certified injection specialist

It should not be administered casually or cosmetically for migraine purposes.

Pregnant or breastfeeding women should avoid treatment.

Discuss full medical history with your provider before proceeding.

How Much Does Botox Cost?

Costs vary by country and insurance coverage.

In many countries, chronic migraine Botox is covered if eligibility criteria are met.

Documentation usually includes:

• Headache diary
• Failed preventive trials
• Neurologist confirmation

Check local coverage requirements before proceeding.

Does Botox Work for Everyone?

So, does Botox help with migraines for everyone?

No.

Response rates vary, and while many people experience meaningful reduction in attack frequency, others see only modest improvement or no change at all.

Roughly:

• 50 percent achieve meaningful reduction
• 20 to 30 percent see modest benefit
• 15 to 20 percent see little to no change

It is not a miracle.

It is one preventive layer.

Botox is often combined with:

• CGRP medications
• Lifestyle stabilization
• Trigger management
• Structured prevention planning

If you are exploring prevention strategies more broadly, read → Migraine Prevention

Should You Try Botox for Migraine?

Botox may be worth discussing with your neurologist if:

• You experience chronic migraine
• Preventive medications have failed
• Neck pain is a dominant symptom
• Attacks are frequent and disabling

It is not typically first-line therapy.

It is used when standard prevention has not been sufficient.

Learn Directly from Leading Migraine Specialists

Treatments evolve quickly. CGRP therapies, gepants, neuromodulation devices, and combination strategies can make it difficult to know what truly works — and when it’s time to adjust your approach.

Each year, the Migraine World Summit features interviews with over 30 leading neurologists, researchers, and headache specialists who share practical, evidence-based insights on managing migraine. They discuss including emerging treatments, the best prevention and medications, why certain approaches succeed or fail, and so much more.

The event streams free for one week each year, with optional lifetime access if you prefer to watch at your own pace.

→ Learn more about the Migraine World Summit

A Practical Next Step

If you are considering Botox, prepare by:

• Keeping a detailed headache diary
• Tracking medication timing
• Stabilizing sleep and routine
• Bringing clear documentation to your neurologist

Structured preparation improves treatment decisions.

If you want help organizing your prevention strategy, see → Migraine Pain Management Course

<< Go back to Migraine Prevention