Botox injections around the eyes can result in dry eyes. But in other cases, Botox may actually help treat eye dryness.

Share on Pinterest
Getty Images

Many doctors may inject Botox around the eyes for cosmetic reasons or to address eye health conditions. For some people, injections in this area can lead to a new eye condition: dry eye syndrome.

Dry eye syndrome can happen when doctors inject Botox into the:

  • lateral canthal (the crow’s feet region)
  • glabellar rhytides (the “eleven lines” region between the brows)
  • eyelids

But Botox injections around other areas near the eye may actually help treat existing eye dryness.

Here’s a closer look at what experts do — and don’t — know about Botox and dry eyes.

Injecting Botox around the eyes may indeed cause dry eyes in some instances.

Researchers note that injecting Botox in the glabellar rhytides may cause lacrimal (tear) gland paralyzation. As a result, they may not produce tears as usual, causing dryness.

They also say that injecting Botox into the lateral canthal area can cause eye dryness. The lateral canthus is on the outer corner of the eye. Doctors typically inject Botox here to address “crow’s feet.”

Keep in mind that some researchers mention these complications as potential outcomes, but they don’t mention how often they occur.

The effect of Botox on tear production is a topic of ongoing debate. But previous studies suggest that tear production may decrease when doctors inject Botox into the tear glands or the orbicularis oculi muscles. The orbicularis oculi are sphincter muscles that help your eyes open and close.

Is the dryness permanent?

Eye dryness may last 3–6 months, or more than a year in some cases, suggesting eye dryness is only a temporary health effect unless you continue receiving injections. The outcome largely depends on:

  • dosage
  • concentration
  • injection site

How common is it?

It’s unclear exactly how often eye dryness occurs following Botox injections. When doctors inject Botox into the crow’s feet area, persistent dry eye syndrome symptoms can occur more often.

The earliest symptoms include:

  • eye irritation
  • a sensation as though something’s stuck in the eye
  • mild intermittent tearing, especially in windy weather or in air-conditioned spaces
  • subtle difficulty blinking and closing the eyes fully

Some experts say that many people may ignore or self-treat these symptoms. But if you notice any of these symptoms, talk with a healthcare professional about treatment options.

If you continue to get injections despite these effects, symptoms may worsen and include:

  • eye redness
  • styes
  • moderate eye watering
  • lower scleral show (the whites of the eye showing more)

With continued injections, you may experience more severe symptoms, including:

  • excess eye watering
  • pain
  • light sensitivity
  • lower eyelid drooping
  • herniation of the lower lid
  • corneal erosion (breakdown of your eye’s outer layer)

If you stop receiving Botox injections, the symptoms may resolve on their own over time, but there’s not enough research to confirm this.

For a good outcome, consider getting an eye exam before receiving Botox. It’s worth noting that many experts consider Botox safe and effective when you receive it properly.

The effects of Botox on existing eye dryness are unclear.

Botox injections around the eye area may worsen existing eye health concerns, including eye dryness. Experts think this may happen due to the weakening of the orbicularis oculi muscles that help with eyelid closure. This can interfere with distributing a smooth, even tear film across the eye, leading to dryness.

But Botox injections in the middle part of the eyelid may improve dry eye syndrome symptoms and reduce inflammation.

In a small study from 2018, researchers found that Botox may improve eye dryness and light sensitivity symptoms. All participants had migraine symptoms, and researchers asked them about dry eye and light sensitivity symptoms before the study.

After receiving Botox, those with existing dry eye symptoms experienced significant improvements, even those with severe symptoms.

A small 2020 case report echoed these findings. Researchers followed people with dry eye syndrome who didn’t have migraine episodes. They found that Botox injected into the head and neck decreased eye dryness and light sensitivity in people with those health concerns.

While the research above suggests Botox may help relieve existing eye dryness, the sample sizes had fewer than 100 participants. So, experts need to perform more research before they can determine that Botox can help with dry eye syndrome, but it may be worth discussing with a healthcare professional.

Eye dryness isn’t the only potential side effect of Botox on your eyes.

Other potential effects include:

These effects may develop between 4 days and 2 weeks post-injection and last anywhere from 6 weeks to 3 months.

Botox injections around the eye area may cause eye dryness or worsen existing cases. But there’s some evidence that Botox may actually improve some existing cases of dry eye syndrome.

If you’re concerned about the potential side effects of Botox, talk with a healthcare professional about your options and ways you can reduce the risk of complications.