What Not to Do After Botox

Written and medically reviewed by Parveen Sangha, NP. Updated 12 August 2026.

AFTERCARE

The First Four Hours

This is the only genuinely strict window. Stay upright, keep your hands off the treated area, and skip anything that raises your heart rate substantially. The reasoning is mechanical: the product needs a short period to bind where it was placed, and pressure or gravity before that is complete is the one thing that could move it.

In practice this means no lying flat, no face down naps, no massage or facials, and no gym. A reclined chair is fine. A brief bend to tie your shoes is fine. We cover the reasoning in more depth in our guide to the 4 hour rule for Botox.

The First 24 Hours

The restrictions loosen but do not disappear. Most injectors extend the exercise ban to a full day rather than four hours, because sustained elevated blood pressure and flushing are a different proposition from a short walk.

Alcohol is worth skipping on treatment day. It dilates blood vessels, which makes bruising more likely and more noticeable, and bruising is by far the most common complaint after an otherwise uneventful appointment.

Heat is the other one people forget. Saunas, steam rooms, hot tubs and very hot showers all increase blood flow to the face. None of this is dangerous, but it makes swelling and bruising worse for no benefit.

Sleeping position matters for one night. Sleeping on your back rather than face down keeps sustained pressure off the treated areas while everything settles.

The First Two Weeks

Hold off on facials, microdermabrasion, chemical peels, microneedling and energy based treatments over the treated areas. The concern is not that they undo the Botox; it is that vigorous manipulation of the same tissue while the product is settling is an unnecessary variable.

If you have dental work booked, it is worth mentioning to both providers. Extended time lying back with your jaw held open is not a problem in itself, but it is the kind of thing worth sequencing sensibly rather than doing the same afternoon.

Long haul flights are frequently listed as a risk. Cabin pressure has no meaningful effect on injected product. The reason to think about flights is far more ordinary: if something needs reviewing at two weeks, you want to be in the same city as the person who treated you.

Things That Do Not Actually Matter

A great deal of aftercare advice circulating online is invented. Wearing a hat does not affect your result. Nor does washing your face gently, applying moisturiser, or drinking coffee. Makeup is fine after a few hours; the caution is about the pressure of applying and removing it, not the product itself.

You do not need to avoid smiling, frowning or talking. Facial expression does not displace anything. If anything, using the treated muscles gently on day one is occasionally suggested as mildly helpful, though the evidence for that is thin too.

We would rather tell you which rules are real than hand you a long list and let you worry about all of it equally.

When to Call the Clinic

Mild swelling, small bruises and a light headache on treatment day are ordinary. Bruises typically fade within seven to ten days and swelling within a day or two.

Call the same day if you develop drooping of an eyelid or eyebrow, difficulty swallowing or breathing, blurred or double vision, or pain and swelling well beyond what a routine appointment would explain. These are uncommon, but they warrant a phone call rather than waiting to see whether they pass.

The Ones That Catch People Out in Vancouver

Hot yoga is the big one here. It is everywhere in this city, and it manages to combine the three things aftercare asks you to avoid on day one: sustained heat, an elevated heart rate, and long stretches spent inverted or face down. If you have a class booked for the evening of your appointment, move it.

The same logic applies to a Grouse Grind attempt, a hard seawall run, or the steam room at your downtown gym. None of these are dangerous, they simply stack heat and blood flow into the exact window when the product is settling. Vancouver winters help more than people expect: a cold, flat walk home is close to ideal.