FRIDAY, Jan. 16, 2026 (HealthDay News) -- Patients with chronic illnesses face a significantly higher risk for complications from cosmetic botulinum toxin (BoNT) injections, according to a study recently published in the Aesthetic Surgery Journal.

Roshan Ravindran, M.D., from KLNIK in Wilmslow, England, and colleagues investigated associations between existing medical conditions and the likelihood of adverse events. The analysis included survey results from 919 BoNT users.

The researchers found that several preexisting physical and psychiatric conditions were significantly associated with increased odds of specific post-BoNT adverse effects. Individuals with skin diseases (odds ratio [OR], 22.95), type 1 diabetes mellitus (OR, 110.34), chronic migraine (OR, 7.69), and thyroid disorders (OR, 6.18) had significantly higher odds of developing nausea following BoNT administration. Preexisting conditions were also associated with other complications, like headaches, bruising, muscle weakness, and persistent ptosis.

"This national study, the largest patient-reported botulinum toxin safety analysis to date, exposes the myth that botulinum toxin is a trivial cosmetic procedure," co-lead author Lee Smith, Ph.D., from Anglia Ruskin University in Cambridge, England, said in a statement. "Our data establishes that it is a complex medical intervention with complication profiles strongly influenced by chronic disease, psychiatric history, immune status, and anatomical risk factors."

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