Botox for Chronic Migraine
Botox (onabotulinumtoxinA) is a set of small injections around the head and neck, given about every 12 weeks, to help prevent chronic migraine.
What is Botox for migraine?
Botox is the brand name for onabotulinumtoxinA. It is a highly purified form of botulinum toxin. In tiny, carefully placed doses, it relaxes the injected muscles for a while, and it is thought to block signals involved in pain.
For migraine, Botox is a preventive treatment. That means it aims to lower how often attacks happen and how bad they are, rather than stopping an attack that has already started. The U.S. Food and Drug Administration (FDA) approved it for chronic migraine in 2010.
In clinical studies, people had about half as many headache days per month on average. After three rounds of treatment, the American Migraine Foundation reports, people may see about 8 to 9 fewer headache days a month. Results vary, and it does not work for everyone.
Who it is used for
Botox is FDA-approved for adults 18 and older with chronic migraine: headache on 15 or more days a month. It is not recommended for people with fewer headache days than that. According to the American Migraine Foundation, it is approved for any form of migraine as long as it is chronic, including hemiplegic migraine.
Experts suggest considering it for people with chronic migraine who:
- Have tried two or three other preventive medicines that did not work well or caused side effects they could not tolerate, or
- Are tired of trying daily pills and would like a treatment aimed at a specific area.
Botox is not a fit for everyone. Sources say it is not appropriate for people who:
- Have an infection where the injections would go
- Have a nerve-and-muscle disorder, such as myasthenia gravis or ALS, or have trouble breathing
- Have had an allergic reaction to Botox or similar products
- Are pregnant, trying to become pregnant, or nursing (the National Headache Foundation says use in pregnancy is decided case by case, since data are limited)
Botox does not interact with other medicines, so it can be part of a wider treatment plan.
What to expect at the visit
- Where: treatment is done in the office.
- How: a small needle places a tiny amount of medicine at about 31 set points across the forehead, temples, back of the head and top of the neck. These spots are where nerves are active during migraine.
- How long: about 15 to 20 minutes.
- How often: about every 12 weeks. Going much longer between rounds can make it work less well, so it helps to book your next visit before you leave.
Side effects and safety
The American Headache Society and the American Migraine Foundation describe Botox for chronic migraine as safe and well tolerated by many people. Side effects reported in the sources include:
- Neck pain or stiffness in the week after treatment, the most common side effect (about 9% in one study). Nearby muscles working harder to make up for the relaxed ones may cause it. An ice pack may help.
- A headache on the day of or the day after treatment. About 4 to 5% of people had a short-term rise in headache days.
- Changes in appearance from forehead injections, such as smoother wrinkles or a different eyebrow arch.
- Drooping eyelid or brow (ptosis) in about 4%. This goes away as the Botox wears off.
- Rarely, flu-like symptoms such as muscle aches, fever and feeling unwell.
How long relief may last
Each round lasts about 10 to 12 weeks, which is why treatment repeats every 12 weeks. Some people notice changes within a couple of days, and studies show benefit can start as early as 4 weeks. But the full effect can take up to six months.
The first sign of progress is often milder attacks, not fewer of them. You might find your rescue medicine works better or you miss fewer workdays. Bigger drops in attacks tend to show up after the second and third rounds. If nothing has changed after three rounds, the American Headache Society suggests talking with your doctor about adding or switching to another treatment.
Cost
At Park Your Headache, please call (856) 783-7392 for current Botox pricing. See Botox injection fees on our services page. Every patient starts with a 90-minute new patient consultation ($520). We are direct pay, so there is no insurance billing and no referral needed. For questions about HSA or FSA payments, see our FAQ.
How Dr. Park can help
Dr. Hannah Park is a dual board-certified, fellowship-trained headache medicine neurologist, Ivy League educated, with over 10 years of specialized experience. She is a lifelong migraine sufferer herself, and she treats episodic, chronic and hemiplegic migraine, among other headache conditions.
Your first visit is a 90-minute consultation with Dr. Park: a full history review, a neurological exam, a diagnosis and a personalized treatment plan. The practice focuses on targeted in-office injection treatments, such as Botox, occipital nerve blocks and SPG blocks, rather than a cycle of prescription medicines. Dr. Park does not prescribe opioids. Appointments are Monday to Friday, 9 a.m. to 6 p.m., usually within days.
Related
Sources
This page summarizes patient information from these organizations, in our own words. It is general education, not medical advice.
- FAQ: How is Onabotulinum A (Botox) used for migraine?, American Migraine Foundation
- Botox for Migraine, American Migraine Foundation
- Treatment of Chronic Migraine Using Botox: Facebook Live Recap, American Migraine Foundation
- Interventional Headache Procedures, American Migraine Foundation
- OnabotulinumtoxinA as a Treatment for Chronic Migraine, American Headache Society
- The Complete Headache Chart, National Headache Foundation
- Pregnancy, National Headache Foundation
Last updated October 27, 2026.
Headaches on 15 or more days a month? Ask about Botox.
Every patient starts with a 90-minute new patient visit with Dr. Park.