Botox Aftercare: What to Do After Your Treatment

By Sarah Walker, FNP-C · March 2026 · 8 min read

You just got Botox. Or maybe you're planning to, and you want to know exactly what to do afterward so nothing goes sideways. Either way, good. Aftercare is simple, but it matters more than most people realize.

I perform tox injections (Xeomin and Jeuveau) every week at Oak City MedAesthetics in North Raleigh, and the aftercare conversation is one I have with every single client. Not because the rules are complicated. They're not. But because following a few basic steps in the first 24 hours can genuinely affect how well your results turn out.

Here's exactly what I tell my clients when they leave our office on Falls of Neuse Road.

The First 4 to 6 Hours

This is the most important window. The product is settling into the targeted muscles, and you want to keep it right where we put it.

• Don't touch the injection sites. No rubbing, no massaging, no pressing. It's tempting to feel around the area, especially if there's a tiny bump at an injection point. Leave it alone. Those bumps go away on their own within 15 to 30 minutes.
• Stay upright. Don't lie down or bend over for at least 4 hours. No napping, no yoga, no bending down to pick things up off the floor repeatedly. Gravity helps the product stay in the right muscles.
• Skip the hat or headband. Anything that puts pressure on your forehead or around your eyes can push the product around. Sunglasses are fine. Tight headbands, hats with snug brims, not so much.
• You can gently make facial expressions. Some injectors tell you to "exercise your face" by raising your eyebrows and squinting. Honestly, you don't need to force it. Just go about your day normally. The product will find its way into the muscle fibers regardless.

One thing I always mention: your treatment area might look a little red or have small raised dots where the needle went in. Totally normal. This fades within an hour for most people.

What to Avoid the Day Of

The day of your appointment isn't the time to stack a bunch of other activities on top. Keep it low-key.

• No alcohol. Alcohol thins your blood and increases the chance of bruising. If you can, skip it the night before too.
• No blood thinners. If you take aspirin, ibuprofen (Advil, Motrin), fish oil, or vitamin E, ideally stop these a few days before your appointment (check with your prescribing doctor first if they're medically necessary). If you forgot to stop them, it's not the end of the world, but you may bruise more.
• No heavy exercise. Even a brisk evening run counts. Increased blood flow and body heat can cause the tox to spread beyond where it was placed. A walk around the neighborhood? Totally fine.
• No facials, peels, or other skin treatments. Don't schedule a facial, microneedling, or chemical peel on the same day as your Botox. Give it at least two weeks before any treatment that involves pressure or manipulation of the face.
• No hot tubs, saunas, or steam rooms. Heat dilates blood vessels and increases circulation to the face. Hold off for 24 hours.

The First 24 Hours

By the next morning, you're through the most critical stretch. A few things still apply though.

Sleep on your back if you can. I know, I know. Not everyone can control how they sleep. But for the first night, try propping yourself up slightly and staying face-up. Pressing your face into a pillow within hours of your treatment isn't ideal.

You can wash your face, but be gentle. No scrubbing, no exfoliating tools, no aggressive cleansing. A soft cleanser and a light touch. Pat dry. That's it.

You might notice some minor bruising. Small bruises at injection points happen to maybe 10 to 15% of clients, and they usually fade within a few days. Arnica cream or tablets can help speed that along. If you have a bruise you want to cover, mineral makeup is fine to apply after 6 hours.

The First Week

After 24 hours, most of the strict aftercare rules are behind you. But your results are still developing during this first week, so here's what to keep in mind.

You probably won't see full results yet. Tox doesn't work instantly. Most clients start noticing changes around day 3 to 5. You might see one side kick in before the other. That's normal. Full results settle in around the two-week mark. Don't panic if things look uneven at day 4.

Resume your normal skincare routine. By day 2 or 3, you're good to use retinol, vitamin C, exfoliants, all of it. Just be mindful not to aggressively rub the treated areas for the first few days.

Exercise is fine after 24 hours. Go back to the gym, go for a run, do your hot yoga class. The product has had time to bind to the muscle receptors and it's not going anywhere.

If you're getting a facial or any other skin treatment, wait at least two weeks. We want the tox fully settled before anyone is pressing on or manipulating the tissue.

When to Expect Results (and What's Normal)

Here's the timeline I share with all of my Raleigh clients so you know what to expect:

• Day 1: No visible changes yet. Maybe some redness or tiny bruises at the injection points.
• Days 3 to 5: You'll start to notice the muscles relaxing. Lines soften. Movement starts to feel restricted in the treated areas. This is the product beginning to work.
• Days 7 to 10: Significant improvement. Most clients see a clear difference by now. Lines at rest are smoother, and the muscles that create wrinkles aren't firing as hard.
• Day 14: Full results. This is when I like to see clients for their complimentary follow-up appointment. We'll assess the results together and decide if any touch-up is needed.

A few things that are completely normal during this window: mild tightness or heaviness in the forehead, slight asymmetry that resolves by week 2, and a sensation that your eyebrows feel "different." All of this settles.

When to Call Your Provider

Most Botox aftercare is smooth and uneventful. But there are a few things that warrant a call.

• Significant drooping of an eyelid or eyebrow that doesn't seem to be resolving. A slight heaviness is normal. A full droop that impacts your vision is not. This is rare but treatable.
• Severe headache that doesn't respond to Tylenol and lasts more than a day or two.
• Signs of infection at an injection site: increasing redness, warmth, swelling, or pus. This is extremely uncommon with Botox, but it's worth knowing the signs.
• Difficulty swallowing or breathing. Exceedingly rare and almost always related to very high-dose treatments near the neck. If you experience this, seek medical attention immediately.

For anything else that seems off, just reach out. We'd always rather hear from you and put your mind at ease than have you worry. Text, call, email. Whatever works. Sarah and the Oak City team are here for you between appointments, not just during them.

Long-Term Tips to Protect Your Results

Once your tox has fully kicked in, you'll want to make it last. Here's what I recommend to my clients across North Raleigh, Wake Forest, and the Triangle.

• Wear sunscreen every day. SPF 30 minimum. UV damage breaks down the skin and makes wrinkles come back faster, even with Botox on board. We carry ZO Skin Health sunscreens that feel great under makeup.
• Stay on schedule. The best thing you can do for long-term results is rebook before the product fully wears off. Around the 3-month mark, even if you still feel like things look good. Consistency trains the muscles to stay relaxed.
• Keep up with a solid skincare routine. Retinol, antioxidants, hydration. Good topical care and good injectables support each other. If you're not sure where to start, take the Skin Type Solutions quiz and we'll build a routine for you.
• Stay hydrated and manage stress. Chronic stress and dehydration both affect your metabolism and can shorten how long your results last. Simple stuff, but it adds up.

Your treatment at Oak City takes about 10 to 15 minutes. Xeomin and Jeuveau are $11 per unit ($10 for loyalty members). And the aftercare? It's really just a few hours of being mindful, followed by common-sense skincare habits you're probably already doing.

Frequently Asked Questions

Can I wash my face after Botox?

Yes, just wait 4 to 6 hours and keep it gentle. Skip the scrubs and exfoliating cleansers for the rest of the day. By the next morning you can go back to your normal routine.

When can I exercise after Botox?

Wait at least 24 hours before anything strenuous. Light walking is fine the same day, but hold off on the gym, running, and hot yoga until the next day. The concern is increased blood flow pushing the product away from the targeted muscles.

Can I sleep on my face after Botox?

Try to sleep on your back the first night. After 24 hours, go back to whatever position is comfortable. One night of careful sleeping helps, but accidentally rolling onto your side isn't going to ruin your results.

Is it normal to have a headache after Botox?

A mild headache is pretty common, especially after forehead treatments or if it's your first time. Tylenol works well. Avoid ibuprofen and aspirin for the first 24 hours since they thin the blood and increase bruising risk. If the headache persists beyond a day or two, give us a call.

What happens if I accidentally rub my Botox?

One quick touch isn't a problem. The concern is sustained rubbing or pressure that could spread the product into unintended muscles. If you brushed the area briefly, don't stress. Just be mindful going forward for the rest of the day.