Azzalure© is the brand of botulinum toxin that I use, sourced from reputable pharmacies.

As a qualified doctor, I am legally able to prescribe this medication after a face-to-face consultation to determine if the treatment is appropriate for you.

Botulinum toxin is injected using a fine needle, similar to the size used on an insulin pen. It is generally not painful, & most patients will only experience minor discomfort. Some people describe the sensation like plucking an eyebrow.

If you are worried about pain, please take 1g of paracetamol 1 hour before the procedure.

Generally, side effects are uncommon, often mild & usually resolve within a few days of treatment, although drooping of the eyebrow or eyelid may take several weeks to recover.

Possible side effects include:

• Injection site pain

• Bleeding &/or bruising at the injection sites

• Redness, itching or irritation at the injection sites

• Swelling, including under-eye puffiness

• Headache, which may last several days

• Nausea &/or hot flushes

• Poor cosmetic results

• Uneven effect on one side

• Drooping or heaviness of the eyebrow or eyelid (ptosis)

• Abnormal appearance of the brows (Spock brow)

• Blepharitis (inflammation of the eyelids)

• Eye pain or visual disturbance

• Paraesthesia (abnormal sensation)

• Muscle twitching

• Flu-like symptoms

• Anxiety symptoms

• Allergic reactions

• Rarely, muscle or joint pains

There are no known long-term side effects from having repeated treatments, although there may be some muscle wasting (atrophy) over time.

Botulinum toxin is not suitable if you:

• Are less than 25 or over 65

• Are pregnant, breast-feeding or trying to conceive

• Have certain neurological disorders (such as myasthenia gravis)

• Are currently taking certain medications (including antibiotics, such as clindamycin)

• Have previously experienced adverse reactions to any botulinum toxin treatment

• Have an active skin infection in or near the treatment area, including cold sores

• Are currently unwell, including coughs & colds

• Are currently taking any medications which affect bleeding e.g. aspirin or warfarin

• Have had a COVID vaccination in the previous 2 weeks

Before your treatment:

• Avoid taking anti-inflammatories (including aspirin, ibuprofen & naproxen) for 3 days before treatment (unless it has been prescribed by your GP) as this increases the risk of bruising

• Alcohol, fish oils, St. John’s Wort, Gingko Biloba, garlic & vitamin E should also be avoided for 3 days before treatment to reduce the risk of bruising

• If you are prone to bruising, taking arnica orally for a few days before treatment may reduce the risk

• If you are unwell on the day of your appointment, please contact me to reschedule

• Please inform me if there are any changes in your medical history or medication before receiving any treatment

Where possible, please arrive for your appointment with the treatment area free from makeup.

Do not plan to have treatment within 2 weeks of an important social event or holiday as this might not allow enough time to have some correction if the desired result is not achieved

After treatment, most people can resume their normal daily activities.

After your treatment:

• Avoid lying flat for at least 4 hours

• Avoid wearing makeup for 12 hours

• Avoid alcohol, exercise & extremes of heat or cold for at least 24 hours

• Avoid touching or rubbing the areas that have been injected for 24 hours

You will be invited to a follow-up appointment at 2-3 weeks, when the effects of treatment can be reviewed. Additional botulinum toxin might be given at this time if needed.