Botulinum toxin in Valencia

Botulinum toxin type A is a purified neurotoxin that, in very small doses, temporarily blocks the signal from nerve to muscle (acetylcholine release). The treated muscle contracts less strongly, softening wrinkles caused by that movement. The effect is localised, dose-dependent and, above all, reversible: the nerve-muscle connection gradually recovers and movement returns. Two points should be clarified from the outset. The name many people search for is a brand name rather than the treatment name: several medicines containing botulinum toxin type A are available in Spain. Their units are not interchangeable between brands, so a number of units only has meaning for a specific product. It is also an authorised medicine and must be used according to its product information, or expressly documented as off-label use.

The main cosmetic indication is dynamic wrinkles, lines appearing or deepening with expression: vertical frown lines, “crow’s feet” when smiling and horizontal forehead lines. Other facial uses (slimming the masseter muscle, lifting mouth corners, treating the chin, etc.) are usually off-label and require clinical justification, specific consent and anatomical expertise.

Beyond aesthetics, toxin has medical uses. The most studied is axillary hyperhidrosis (excessive underarm sweating) unresponsive to topical treatments: injections into the skin temporarily reduce signalling to sweat glands, with improvement usually lasting several months. Before treatment, we rule out causes of secondary sweating. It is also used off-label for bruxism (clenching or grinding teeth), reducing muscle force, although long-term evidence is limited and it does not replace dental assessment or a splint when indicated.

Before injecting, we assess the face at rest and in movement: eyebrow position and strength, pre-existing asymmetry, whether you rely on the forehead muscle to keep your eyelids open, and your medical history. Toxin is administered through a very fine needle at several points according to each muscle’s anatomy and activity; for hyperhidrosis, into the underarm skin. Discomfort consists of brief pinpricks and injection takes a few minutes, although the full appointment includes assessment and photographs. We always record the product, batch and units. An important point: we do not perform early “top-ups”; the full effect should be allowed to develop, and we leave a minimum interval of around three months between treatments, as shorter intervals or accumulated doses increase unwanted effects.

The effect is not immediate: it usually starts after two or three days, improvement is visible during the first week and results are assessed around two to four weeks. For frown lines, forehead lines and crow’s feet, effects typically last around four months; some people retain a partial response for five or six months, but this cannot be promised as an average outcome. There is no obligation to repeat every three months: treatment is reconsidered when movement returns and the effect fades. A “natural” appearance cannot be measured or promised; it depends on anatomy, baseline expression, dose and distribution. Conservative dosing preserves some movement; excessive dosing causes stiffness, eyebrow drooping or a muted expression. Results cannot be reversed immediately: muscle activity must recover over time.

What toxin cannot do

Toxin is not a filler: it does not add volume or fill folds, for which hyaluronic acidis used. Nor does it reliably eliminate deep static wrinkles, visible when the face is completely relaxed: reduced movement may soften them somewhat, but established skin lines persist. It does not correct laxity, excess eyelid skin, volume loss, pigmentation or skin quality, and does not stop ageing or prevent dynamic wrinkles returning when it wears off. Perfect symmetry (faces are naturally asymmetrical) or complete absence of movement cannot be promised, and the latter should not be the goal. For hyperhidrosis, it does not cure the tendency to sweat or promise complete dryness, and its effect fades over time. Explaining these limits allows an honest outcome aligned with expectations.

The most common effects are injection-site discomfort (pain, redness, small bruises), headache or tightness, and sometimes temporary asymmetry. The best-known unwanted effect is temporary eyelid or eyebrow drooping (ptosis), which is uncommon and occurs through diffusion or unsuitable injection-point selection. It recovers over weeks because it is reversible, although no antidote neutralises it instantly. Serious complications — difficulty swallowing, speaking or breathing due to toxin spread — are very rare in properly performed cosmetic treatments, but are documented and should be understood. Toxin is contraindicated with product allergy, infection in the area and neuromuscular conditions such as myasthenia gravis, and should be postponed during pregnancy and breastfeeding. Caution is needed with some medicines (certain antibiotics, muscle relaxants) and anticoagulants because of bruising risk.

Who is a suitable candidate

A suitable candidate is an adult with dynamic upper-face wrinkles, eyelid function compatible with safe treatment and realistic expectations, who accepts temporary effects. It is unsuitable when the main concern is a deep static wrinkle without a muscular component, very lax skin, volume loss or marked eyebrow drooping, or when the forehead muscle compensates to open the eyes. It should be postponed or ruled out during pregnancy and breastfeeding, with local infection, significant neuromuscular disease or unrealistic expectations such as extreme immobilisation.

At the first consultation, we assess your specific concern, medical and neurological history, previous treatments, and the area’s anatomy and function, taking photographs at rest and in movement. We explain authorised indications and off-label use. Botulinum toxin is a medicine that must be administered by a doctor with specific training: it requires diagnosis, prescription, knowledge of muscular, vascular and nerve anatomy, identification of contraindications and interactions, and the ability to manage complications. Patients should not purchase it themselves or receive it at home or in non-medical premises. Botulinum toxin aesthetic treatment is part of our aesthetic medicine and laser service in Valencia, available in Spanish, English and Italian.

You can meet the medical team before your visit.

As a cosmetic treatment, it is not usually covered by insurance policies and is paid for separately. You can check our indicative prices on the Fees page. A registered dermatologist recommends and performs it, and we provide a quote at the assessment consultation before any treatment.