Botox Aftercare: What to Do and What to Avoid
By Mohsan Maan, Prescribing Pharmacist & Clinical Director, The Aesthetics Suite · 6 minute read
- Quick Answer
Good Botox aftercare is simple. Stay upright for 4 hours and do not rub or massage the treated areas for 24 hours. Avoid strenuous exercise, saunas, steam rooms and sunbeds for 24 hours, and skip alcohol for the rest of the day. The effect starts to show after 3 to 7 days and settles fully at around two weeks.
The appointment itself is quick. What you do in the hours afterwards matters just as much.
I am a prescribing pharmacist, and this is the aftercare advice I give my own patients. I have written it down because people often leave a clinic with a leaflet they never read, then search for answers at ten o’clock that night.
A quick note on the name. Botox is one brand of anti-wrinkle injection. Most people use the word for all of them. The aftercare below applies whichever brand your prescriber used.
If your own practitioner gave you different instructions, follow theirs. They know what was done and where.
What is the 4-hour rule for Botox?
For the first 4 hours, stay upright and leave the treated areas alone.
- Stay upright. Do not lie flat or bend over for long periods. No naps and no yoga
- Hands off. Do not touch, rub or press on the treated areas
- Leave make-up off if you can, so you are not pressing on the skin
The reason is simple. The treatment needs time to settle into the muscle it was placed in. Pressure and lying flat are thought to raise the chance of it moving to a muscle nearby.
You can go back to work, drive and carry on with a normal day.
What should you not do after Botox?
For the first 24 hours, avoid:
- Strenuous exercise. A gentle walk is fine. The gym, running and hot yoga can wait until tomorrow
- Rubbing or massaging your face. Wash it gently with your fingertips and pat it dry
- Alcohol, for the rest of the day. It can make bruising more likely
- Saunas, steam rooms, sunbeds and very hot baths
- Retinol and exfoliating acids
- Sleeping face down. Try to sleep on your back for the first night
For the first two weeks, avoid facials, facial massage and skin devices.
What is the best thing to do after Botox?
Very little. That is the honest answer.
- Stay upright for 4 hours
- Keep your hands away from your face
- Have a quiet evening without alcohol or the gym
- Be patient. Do not judge the result for two weeks
- Go to your review appointment if you were offered one
Your Botox aftercare timeline at a glance
What to do at each stage after your appointment.
| When | What to do |
|---|---|
| 0 to 4 hours | Stay upright. Do not touch the area |
| Rest of the day | No alcohol, no exercise, no heat |
| 24 hours | Back to exercise, make-up and your usual skincare |
| 3 to 7 days | You start to see the lines soften |
| 2 weeks | Full effect. The right time for a review |
| 3 to 4 months | The effect gradually wears off for most people |
The Aesthetics Suite, Wilmslow
How long does it take to look normal after Botox?
Most people look normal straight away. You may have small raised bumps where the needle went in. These usually settle within an hour.
You might also notice:
- Slight redness for a few hours
- A small bruise. This is less common and fades over a few days
- A mild headache or a tight feeling in the first day or two
If you have a headache, paracetamol is fine. Take it as directed on the pack.
The treatment itself takes longer to show. Expect the first changes after 3 to 7 days and the full effect at around two weeks.
Botox aftercare for the forehead and the jaw
Forehead, frown lines and around the eyes. This is where the 4-hour rule matters most. Avoid hats, headbands, swimming goggles or anything tight across the area for the first day.
Jaw (masseter). The same rules apply. It is also sensible to avoid chewing gum and very chewy food for the first 24 hours.
Can I go on a sunbed after Botox?
Avoid sunbeds, saunas and steam rooms for 24 hours. Heat increases blood flow to the skin and may make bruising and swelling more likely.
Normal daylight is fine. Wear SPF, as you should every day.
And despite what you may have read, a sunbed does not dissolve Botox. The issue is the heat in the first 24 hours.
When should I get advice?
Contact the practitioner who treated you if you notice a drooping eyelid or eyebrow, a result that looks uneven after two weeks, or anything that worries you. Most of these are temporary, and a good clinic would always rather you asked.
Seek urgent medical help if you have difficulty breathing, swallowing or speaking, or signs of an allergic reaction. This is very rare.
How long will it last?
For most people, around 3 to 4 months. Aftercare will not make it last longer than that, but poor aftercare can spoil a good result in the first day.
I have written a separate guide on how long anti-wrinkle injections last and what affects it.
About the author
I am Mohsan Maan, a GPhC-registered Pharmacist Independent Prescriber and Clinical Director of The Aesthetics Suite in Wilmslow, Cheshire. Botox is a prescription-only medicine. It should only ever follow a face-to-face consultation with a prescriber. You can read how I approach anti-wrinkle injections in Wilmslow on the clinic website.
Frequently Asked Questions
What should you not do after Botox?
Do not lie flat for 4 hours. For 24 hours, do not rub or massage your face, do strenuous exercise, or use saunas, steam rooms or sunbeds. Avoid alcohol for the rest of the day. These steps help the treatment settle in the right place and reduce bruising.
What is the 4-hour rule for Botox?
The 4-hour rule means staying upright and not touching the treated areas for 4 hours after your appointment. No lying down, no bending over for long periods and no pressure on the skin. It gives the treatment time to settle into the right muscle.
How long after Botox can I lie down?
Wait 4 hours before lying flat. After that you can go to bed as normal. On the first night, try to sleep on your back so you are not pressing your face into the pillow.
Can I exercise after Botox?
Wait 24 hours before the gym, running or any hard exercise. A gentle walk on the day is fine. Exercise raises your heart rate and blood flow, which may increase bruising in the first day.
Can I drink alcohol after Botox?
Avoid alcohol for the rest of the day. Alcohol widens the blood vessels and can make bruising more likely. You can drink as normal from the following day.
Can I wash my face or wear make-up after Botox?
Yes. Wash your face gently with your fingertips and pat it dry, without rubbing. It is best to leave make-up off for at least 4 hours, and ideally until the next day. Your usual moisturiser is fine if you apply it lightly.
Can I fly after Botox?
Yes. Leave 24 hours if you can, so you can stay upright for the first few hours and are near your clinic if you have a question. If you have a holiday or an event planned, have treatment at least two weeks before so the effect has fully settled.
