As the needles will be injected into the skin, you can expect some bleeding to occur at the site where the injections were made. This can occur in a manner similar to hematoma formation. This can happen in a similar way to how bruises appear. The way bleeding can occur is from the moment the needle enters the skin. There may be cases where it moves against the capillary near the area and causes it to bleed a little.
Botox treatment may cause mild bleeding, similar to bruising. The needle may puncture a vein or a tiny capillary in the skin and cause blood to flow from the injection site. Bleeding should be mild and usually stops within a few hours. It also depends on the skill, technique and experience of the injector.
You may also be more likely to bleed if you're particularly prone. Tell your healthcare provider if you have received any type of Botox injection in the past four months. Also tell your healthcare provider if you take blood thinners. You may need to stop taking them several days before the injection to reduce the risk of bleeding or bruising.
Talk to the healthcare provider who prescribes these medications as soon as possible. Hematuria is a documented side effect of botulinum toxin injection and has only been reported when used to treat an overactive bladder. We report a rare case of hematuria after the injection of onabotulinum A (Botox) to treat upper limb spasticity in a 29-year-old male with a history of trauma cranioencephalic and hemophilia. The hematuria resolved without further complications after self-injection of factor VIII, as recommended by your hematologist.
Botulinum toxin binds to peripheral cholinergic nerve endings to prevent acetylcholine and norepinephrine exocytosis. Studies have shown that both compounds are involved in antifibrinolytic activation, suggesting that botulinum toxin may play a role in the coagulation cascade by preventing fibrin formation. This is also supported by the resolution of hematuria in our patient after self-injection of factor VIII. As such, botulinum toxin injection can cause mild spontaneous bleeding in patients with underlying hematologic deficiencies.
More studies are needed to elucidate its effects on coagulation.
