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Migraine Treatment
  • Aesthetic Medicine
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  • Migraine Treatment

Botox® Injection Therapy for Chronic Migraine

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Woman in pink jacket holds her temples against pink backdrop, symbolic image for Migraine Treatment at BONITAS in Nuremberg

Chronic migraine is more than “just a headache”. It is debilitating, isolating, exhausting. It takes away your days. Quality of life. Freedom. And often it is resistant to pills, injections, or alternative methods.

The good news: Botox® is an officially approved migraine therapy – scientifically proven, gentle in application, and often highly effective. At BONITAS we perform the treatment with precision and personal care – for everyone who wants to reclaim a life free from pain

At a glance: Chronic migraine can be significantly reduced with Botox following the PREEMPT protocol (a medically indicated treatment).

  • Treatment time: 20–30 minutes
  • Method: botulinum toxin following the PREEMPT protocol (31 points)
  • Indication: chronic migraine (>15 days/month)
  • Onset of effect: after 2–4 weeks
  • Duration of effect: 3 months, repeat treatment recommended
  • Prices: in our price overview

How does Botox® work for migraines?

Botulinum toxin (Botox®) blocks the release of pain messengers at the nerve endings. This leads to:

  • interruption of pain transmission
  • reduced activity of overstimulated muscle and nerve zones
  • the entire migraine system in the head is calmed and relieved

This means: fewer attacks, shorter duration, lower intensity – often from the first treatment.

Who is a candidate for migraine treatment with Botox®?

  • You suffer from chronic migraines
  • You have at least 10 headache days per month, 5 of which are migraine-like.
  • Medications are only partially effective or cause side effects
  • You are looking for a long-term solution

BONITAS checks in a detailed consultation whether you are medically suitable for Botox migraine treatment – and develops a clear treatment plan.

How the treatment at BONITAS works

  • Medical History & Documentation of your symptoms
  • Precise injection of Botox® at 31 points in the head, forehead, temple, and neck area (according to PREEMPT protocol)
  • Outpatient, without anesthesia, approx. 20 minutes duration
  • No downtime – you can immediately resume normal activities
  • Repeat every 3 months, individually tailored

The injection is performed with very fine needles – almost painless. BONITAS ensures a relaxed, calm atmosphere.

Effects & Results

  • Significant reduction in migraine days (often by 50% or more)
  • Lower pain intensity
  • Shorter attacks & fewer accompanying symptoms
  • More energy, better quality of life
  • No habituation effect – Botox® also works long-term

First effects noticeable after 7–14 days, the full effect usually after 2–3 treatments.

Advantages over classic therapy

Botox®

  • Local & targeted
  • No liver/stomach burden
  • Works independently of triggers
  • Long-lasting (3 months)
  • Easily combinable

Medications

  • Systemic throughout the body
  • Frequent side effects
  • Dependent on time of administration
  • Short-term, often daily
  • Interactions possible

Why BONITAS?

  • Treatment by a specialist– medically & aesthetically experienced in handling Botox®
  • Empathetic support – you are taken seriously
  • Transparent treatment plan & progress monitoring
  • Discreet and modern clinic
  • Focus on your quality of life – not just on symptoms

BONITAS combines medical knowledge with genuine care – for a result that you not only feel, but can finally live again.

Frequently asked questions (FAQ)

Costs vary depending on the practice and the number of injections. An up-to-date price list can be found here.

Yes – the effect of botulinum toxin lasts for approximately 12 weeks on average. To control migraines long-term, regular repetition of the treatment is necessary. Many patients report a significant reduction in headache days and noticeable relief in daily life after just 2 to 3 treatment cycles. In the long term, this can also significantly reduce the medication burden.

Yes – Botulinum toxin A (OnabotulinumtoxinA) was approved by the EU in 2011 for chronic migraines and often reduces the number of headache days.

Common options include acute medications (triptans, NSAIDs), prophylaxis (beta-blockers, anticonvulsants, CGRP antibodies), and Botox. Alternatives include biofeedback, muscle relaxants, neuromodulation (e.g., occipital nerve stimulation), or in individual cases, invasive procedures.

The “10-20 rule” states: If there are more than 10 migraine days per month and/or over 20 headache days per month, preventive therapy is recommended – for example, with botulinum toxin, CGRP antibodies, or prophylactic medication.

Smiling man with dark hair and beard in white coat against light background: Alejandro Marti, specialist in plastic and aesthetic surgery, BONITAS Nuremberg
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Scientific References

  1. Dodick DW et al. „OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program.“ Headache. 2010. PubMed PMID 20487038
  2. Lanteri-Minet M et al. „Effectiveness of onabotulinumtoxinA (BOTOX®) for the preventive treatment of chronic migraine: A meta-analysis on 10 years of real-world data.“ Cephalalgia. 2022. PubMed PMID 36081276
  3. Ornello R et al. „Early Management of OnabotulinumtoxinA Treatment in Chronic Migraine: Insights from a Real-Life European Multicenter Study.“ Pain and Therapy. 2021. PubMed PMID 33778933
  4. Frank F et al. „CGRP-antibodies, topiramate and botulinum toxin type A in episodic and chronic migraine: A systematic review and meta-analysis.“ Cephalalgia. 2021. PubMed PMID 34130525

Medically reviewed and written by
Specialist in Plastic and Aesthetic Surgery 🇩🇪 🇪🇸 · Consulting surgeon
With more than 1,000 plastic and aesthetic treatments performed, both surgical and minimally invasive. Comes from a family with a long tradition in Plastic and Aesthetic Surgery.
Last reviewed: May 2026