Headaches / Migraines

Botox for chronic migraine at Gambhir M.D. on Central Park South, New York City. FDA-approved preventive treatment given every 12 weeks.

For people who live with frequent migraines, the burden is real. Botox is a well-established, FDA-approved treatment for chronic migraine, in use since 2010, and for the right patient it can meaningfully reduce how often headaches strike. It works as a preventive treatment, not a cure. Placed at specific points around the head, neck, and shoulders every 12 weeks, it quiets the pain nerves before a migraine can start. Most patients begin to feel a difference within two to four weeks of their first treatment, but the full benefit usually takes two or three cycles, so it is worth giving it about six months before deciding if it is working for you. In clinical studies, patients with chronic migraine averaged eight to nine fewer headache days per month by the six-month mark, and about half had a fifty percent or greater reduction in headache days. It is a real change in quality of life, but it is not zero headaches. It has been an amazing tool to improve quality of life for many of our patients across New York City.

Services

Botox

Placed in specific points around the head, neck, and shoulders, Botox calms the nerves that drive migraine pain. The dose varies by patient, typically ranging from 20 to 190 units, with the goal of the minimum effective amount. Treatment is given every 12 weeks and takes about 15 minutes in the office. Most patients describe each injection as a quick pinprick. There is no anesthesia and no sedation, and you can drive yourself home and go on with your day.

Common side effects are usually mild and short-lived: neck pain, brief muscle stiffness or weakness in the treated area, occasional eyelid drooping, and soreness or bruising at the injection sites. Serious side effects are rare. Botox is preventive, not a rescue medication. Most patients continue their other migraine treatments alongside Botox, and we coordinate with your neurologist or primary care doctor.

Botox is not recommended during pregnancy or breastfeeding, and is not appropriate for people with certain neuromuscular conditions or active skin infections at the injection sites. We review your full history at your consultation.

Alongside preventive treatment, steady daily habits can meaningfully reduce how often migraines strike.

Track your triggers

Common migraine triggers include poor sleep, dehydration, skipped meals, alcohol (especially red wine), certain foods (aged cheeses, cured meats, MSG), strong smells, weather changes, and hormonal shifts. A simple headache diary for a few weeks often reveals the patterns that matter most for you.

Steady sleep and hydration

Consistent sleep, both timing and duration, is one of the most reliable levers. Aim for the same bedtime and wake time daily, including weekends. Drink water steadily through the day.

Screen and posture breaks

Long hours at a screen tighten the neck and shoulders and can set off migraines. Take a real break every 30 to 60 minutes. Bring the screen up to eye level. Notice a forward head posture and reset.

Coordinate with your neurologist

Botox is preventive, not a rescue. Most patients continue their other migraine medications, and we coordinate with your neurologist or primary care doctor so your plan works together.

About Gambhir M.D.

Gambhir M.D. is led by Vibha Gambhir M.D. and Anshul Gambhir M.D., a physician team practicing cosmetic medicine together since 2005. Across more than 200,000 patient visits, they have given over six million units of Botox and performed more than 60,000 filler treatments. The facial nonsurgical cosmetic medicine experts.

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