Botox Pre Treatment Checklist: What to Do Before Your Appointment

botox pre treatment checklist

The consultation and injection are only part of the Botox experience. What patients do — and do not do — in the days leading up to their appointment has a measurable impact on how smooth their recovery is, how little they bruise, and how satisfied they feel walking out. When I evaluate patient journeys for medspa practices, the pre-treatment communication gap is one of the most consistent weak spots I find. Providers who send a thorough botox pre treatment checklist to patients before every appointment see fewer same-day cancellations, fewer bruising complaints, and higher review scores.

This guide is the checklist I recommend. It is written for patients, but medspa owners and clinical directors are welcome to adapt it for their own pre-appointment communications.

One Week Before Your Botox Appointment

Seven days out is when preparation starts for patients who want the cleanest possible outcome.

Medications and Supplements to Pause (With Provider Approval)

• NSAIDs: Ibuprofen (Advil, Motrin), aspirin (unless cardiac-prescribed and your cardiologist says to continue), naproxen (Aleve). These thin the blood and significantly increase bruising risk.
• Vitamin E: High-dose vitamin E supplements act as a blood thinner. Pause for est. 7 days prior.
• Fish oil / omega-3 at doses above 1,000 mg/day: High-dose fish oil has a measurable anticoagulant effect. Pause for est. 7 days.
• St. John’s Wort, ginkgo biloba, garlic supplements, ginseng: All have mild blood-thinning properties. Pause for one week.
• Turmeric / curcumin supplements at therapeutic doses: Pause for one week if you are taking more than culinary amounts.

Always get explicit clearance from your prescribing physician before stopping any prescribed medication. This checklist does not replace medical advice — it supplements the conversation you should be having with your Botox provider at booking.

Skincare Adjustments One Week Out

• Continue your normal skincare routine through this week.
• If you have an upcoming peel, dermaplaning, or microneedling session, schedule it for after your Botox — not before. Allow at least two weeks between any ablative treatment and Botox.
• Do not start any new prescription skincare (tretinoin, topical antibiotics) within two weeks of your appointment.

The 48-Hour Botox Pre Treatment Checklist

Two days before is when the most actionable items kick in.

• No alcohol starting 48 hours before your appointment. Alcohol is a vasodilator — it expands blood vessels and significantly increases both bruising severity and swelling. This is the single most impactful dietary change you can make before Botox.
• Increase your water intake. Staying well-hydrated improves tissue quality and makes the injection experience more comfortable.
• Pause retinol, AHAs (glycolic, lactic acid), and BHAs (salicylic acid) on the treatment area for 48 hours before your appointment to reduce skin sensitivity at injection sites.
• If you are prone to cold sores (herpes simplex) and you are having Botox near the mouth or lips, talk to your provider about an antiviral prescription. Injection trauma can trigger an outbreak in susceptible patients.
• Confirm your appointment, arrive time, and parking so the day-of is stress-free — elevated cortisol and rushing both affect your experience.

The 24-Hour Botox Pre Treatment Checklist

• No alcohol for the 24 hours immediately before treatment.
• No intense exercise the day before your appointment — vigorous activity the day prior can elevate baseline inflammation.
• Get a good night of sleep. Fatigued skin responds differently to injections, and fatigue lowers pain tolerance.
• Avoid direct sun exposure and tanning beds — sunburned or tanned skin is more reactive post-injection.
• Lay out comfortable clothing that does not require pulling over your face or head (if you are having facial Botox). A zip-front top or button-down is ideal.
• Review the informed consent documentation your provider sent so you are not reading it cold in the office.

Day-of Botox Pre Treatment Checklist

The morning of your appointment matters. Here is a hour-by-hour guide for the day-of experience.

Morning Of

• Eat a light meal within two hours of your appointment. Low blood sugar increases lightheadedness and can make the experience less comfortable. You do not need to fast before Botox.
• Take only medications you have confirmed with your provider are safe to continue. Take acetaminophen (Tylenol) if you anticipate discomfort — not ibuprofen.
• Arrive with a clean, makeup-free face. Your provider needs to see the treatment areas clearly and will cleanse the skin regardless, but arriving clean saves time and reduces the number of products on your skin pre-injection.
• No vigorous exercise before your appointment. A gentle walk is fine.
• Avoid caffeine in excess — while the evidence on caffeine and bruising is modest, high caffeine intake raises heart rate and blood pressure, and some patients report increased sensitivity.

What to Bring to Your Appointment

• A list of all current medications and supplements (even over-the-counter)
• Your photo ID and insurance card if applicable
• A list of questions for your provider — write them down so you do not forget in the moment
• Cash or your preferred payment method if you have not prepaid
• Before photos on your phone if you want to compare your natural expression for future reference

At the Appointment

• Communicate your aesthetic goals clearly and specifically. “I want to look refreshed but still expressive” is more useful to your injector than “I want to look natural.”
• Mention any prior Botox history, the product used, units received, and how long results lasted.
• Tell your provider about any facial procedures scheduled in the coming weeks — dental work, facials, RF treatments, or IPL.
• Ask about the post-treatment restrictions before you leave so you are not Googling at midnight.

After Your Botox: What to Do in the First Hours

Your botox pre treatment checklist does not end at injection — the first few hours post-treatment are a direct extension of your preparation.

• 0–4 hours: Do not lie down flat. Stay upright. Do not rub, touch, or massage the injection sites. Avoid heat in all forms — hot showers, saunas, heated blankets.
• 4–24 hours: No vigorous exercise. No alcohol. No makeup on treated areas for a minimum of 12 hours. Sleep on your back if you can.
• 24–48 hours: Botox begins working for most patients. Results build gradually over est. 3–7 days and typically reach full effect at est. 10–14 days.

Red-Flag Side Effects After Botox

Expected and Normal

• Small bumps or swelling at injection sites that resolve within hours
• Minor bruising at needle entry points (can take est. 5–10 days to fully fade)
• Mild headache in the first 24–48 hours
• A heavy or tight sensation in treated muscles as Botox begins to work

Call Your Provider If You Experience

• Eyelid or brow ptosis (drooping) — this is rare but can occur if Botox spreads beyond the intended muscle
• Double or blurred vision
• Difficulty swallowing, speaking, or breathing (extremely rare — seek emergency care)
• Severe headache that is unlike your normal headaches and does not respond to acetaminophen
• No results whatsoever at 14 days — this can indicate that a touch-up is needed or, rarely, that neutralizing antibodies are present

Why Medspa Practices That Send This Checklist Win

I have run medspa marketing audits for practices in more than a dozen states, and the ones with the highest patient satisfaction scores share one trait: they over-communicate at every touchpoint before treatment, not just after. Sending a botox pre treatment checklist via email or SMS the day before an appointment takes three minutes to set up as an automation and pays back in fewer complaints, fewer bruising photos sent to your inbox, and consistently stronger reviews.

If you want to evaluate how your practice’s patient journey stacks up against top-performing medspas, the medspa marketing resources on this site are a strong starting point. Or you can skip directly to a free consultation where I will look at your specific gaps and give you a prioritized action list.