Scope

This FAQ applies to adult patients aged 18 years and over in Australia who are considering non surgical neuromodulator treatments for facial expression lines and medically diagnosed localised sweating.^{1 2}

It is designed to support a consultation with a registered health practitioner and does not replace personalised medical advice or a formal clinical assessment.^{1 3}

Description

This document provides plain language answers about common treatment areas including frown lines, forehead lines, crow’s feet, bunny lines, masseter muscles, mouth corners, upper lip flip, neck bands and sweating.^{2 11}

It follows guidance from AHPRA, the Medical Board of Australia, the Therapeutic Goods Administration and NSW Health on cosmetic procedures, Schedule 4 prescribing and advertising of health services that involve prescription medicines.^{1 4}

No specific product names are used and no guarantees are made about cosmetic results, which is consistent with Australian rules for advertising and providing higher risk non surgical cosmetic procedures.^{5 7}

A. Frown lines between the eyebrows

Section scope: Adults seeking information about injections for frown lines between the brows in an Australian cosmetic practice setting.^{1 2}

Why do frown lines form between my eyebrows

Muscles and facial expression

Frown lines form because small muscles between the brows pull the skin inward and downward every time you frown, concentrate, squint or react to stress.^{2 8}

These movements create the familiar vertical “eleven” lines even in people who otherwise feel well and healthy.^{2 11}

Skin changes over time

Over many years this repeated folding weakens collagen and elastin in the skin so the crease can remain even when your face is relaxed.^{8 14}

Sun exposure, smoking, genetics and long periods of concentrating at screens can all speed up this breakdown and make lines appear earlier.^{8 14}

Impact on appearance and choice

Many people feel these lines make them look angry, worried or tired even when they feel calm, which is a common reason they ask about treatment.^{2 11}

These lines are still a normal sign of ageing and expression, and any decision to treat them should only be made after a proper medical discussion with a suitably qualified prescriber.^{1 3}

How do anti wrinkle injections work in the frown area

What the medicine does

Anti wrinkle injections for frown lines are Schedule 4 prescription neuromodulator medicines that must be prescribed by an authorised prescriber such as a doctor, dentist or nurse practitioner.^{2 17}

They work by blocking the chemical signal between the nerve and the muscle so the muscle cannot contract as strongly for several weeks to several months.^{8 12}

Effect on the skin and lines

When the muscle moves less, the overlying skin stops folding into the same deep groove hundreds of times a day and the line usually looks softer and less harsh.^{8 11}

Over repeated treatment cycles this reduction in mechanical stress can slow further collagen breakdown and may help deep lines to gradually appear less etched.^{8 12}

What stays the same

Sensation in the skin stays normal because the medicine affects movement rather than feeling, and other facial muscles still allow you to show emotion.^{2 11}

Your practitioner should explain that the effect is temporary, that responses vary between individuals and that not all lines will disappear, which is required under Australian cosmetic procedure and advertising guidance.^{1 5}

What result can I realistically expect for frown lines

Timing and visible change

Most people notice that the frown muscles feel weaker within a few days, with the main visible improvement usually seen at around two weeks.^{2 11}

The area often looks calmer and less severe, and the vertical lines typically appear softer both at rest and when you try to frown.^{2 8}

Limits and influencing factors

Deep, long-standing lines may only partially fade at first because the skin structure has been changed over many years, although they often improve further with repeated treatments and good skin care.^{8 14}

Your individual result will depend on muscle strength, skin thickness, age, sun history and overall health, so your practitioner must avoid promising a guaranteed cosmetic outcome.^{1 5}

Realistic expectations and follow up

Australian guidance states that cosmetic procedures should aim for realistic, natural looking changes and that patients must be told clearly that results can vary.^{1 4}

Good practice includes offering follow up, reviewing photos and adjusting future dosing gradually rather than over treating in a single session.^{1 3}

What are the main risks when treating frown lines

Common short term effects

All injections can cause small bruises, temporary redness, mild swelling, tenderness and short lasting headache even when the procedure is performed correctly.^{2 11}

There is also a small risk of local infection or allergy type reactions although this is uncommon when standard infection control and prescribing rules are followed.^{3 9}

Specific risks to eyes and brows

A specific risk in the frown area is drooping of the eyelid or eyebrow if the medicine spreads into muscles that normally lift the eyelid or brow, which can make one eye look more closed for several weeks.^{2 12}

Most cases are mild and temporary but can be upsetting, so guidelines expect practitioners to explain this risk in plain language and record informed consent before treatment.^{1 3}

Suitability and safety measures

People with certain neurological or eye conditions may be at higher risk or may not be suitable for treatment, so a careful medical and eye history is important before prescribing.^{3 11}

Guidelines also recommend building dose slowly, avoiding frequent large top ups and giving patients clear instructions on when and how to seek review if they notice eye weakness or visual changes.^{1 6}

B. Forehead lines

Section scope: Adults asking about non surgical injections for horizontal forehead lines and brow position.^{1 3}

Why do I get horizontal forehead lines

Role of the forehead muscle

Horizontal forehead lines form because the frontalis muscle lifts the eyebrows and folds the skin every time you raise your brows.^{2 8}

People commonly use this muscle when they look surprised, emphasise facial expressions or unconsciously lift their brows to see better, especially with heavier eyelids or long hours at screens.^{3 11}

Ageing and skin quality

Over many years the same skin lines bend again and again, and the internal support fibres gradually weaken so the folds become fixed.^{8 14}

Sun exposure and smoking further reduce collagen and elasticity, so the lines start to remain visible even when you are not actively raising your brows.^{8 14}

Individual variation

Some people develop noticeable forehead lines in their twenties or thirties, while others only see them later in life, reflecting differences in genetics, facial habits and lifestyle.^{8 11}

Australian consumer information emphasises that these lines are a normal part of ageing and that cosmetic treatment is a personal choice rather than a medical necessity.^{2 8}

Why does my clinician say the forehead must be treated carefully

Effect on brow position and vision

The frontalis is the only muscle that lifts the brows, so if it is relaxed too much the eyebrows can drop and make the eyelids look heavier.^{3 12}

In people who already have loose eyelid skin or low brows this can make the eyes feel tired and may slightly reduce the upper visual field.^{3 16}

Assessment before treatment

For this reason guidelines recommend a full upper face assessment, including brow position, eyelid skin, eye symmetry and any eye disease history, before treatment is prescribed.^{1 3}

AHPRA and the Medical Board expect practitioners to discuss the risk of brow heaviness and record that the patient understood this as part of informed consent.^{1 4}

Dosing approach and reversibility

Clinicians are encouraged to use conservative doses and to balance forehead treatment with frown treatment so the downward pulling muscles do not dominate.^{1 3}

Patients should also be told that if their brows feel too heavy the effect cannot be reversed and will only improve gradually as the medicine wears off.^{2 12}

Can forehead injections still look natural?

Natural movement and softer lines

A natural result is possible when dose and injection points are tailored to your anatomy and the rest of the upper face is considered in the plan.^{1 3}

Most patients still have some forehead movement after conservative treatment, which allows them to show surprise and emotion while having softer lines at rest.^{2 8}

Gradual adjustment rather than over treatment

Good practice is to start with lower doses, review photographs at follow up and adjust slowly over time rather than aiming for a completely line free and motionless forehead in one session.^{1 3}

AHPRA and TGA guidance also warn against advertising images that suggest perfect or guaranteed results and emphasise realistic, balanced information about benefits and risks.^{5 7}

Patient preferences and goals

Patients should be encouraged to talk about how much movement they wish to keep and to understand that some fine lines may remain to preserve natural expression.^{1 4}

The focus is generally on a fresher, more relaxed look rather than an artificial or fixed appearance, which aligns with current Australian expectations for non surgical cosmetic care.^{1 12}

C. Crow’s feet around the eyes

Section scope: Adults considering neuromodulator treatment for lines at the outer corners of the eyes.^{1 2}

What causes crow’s feet

Movement and anatomy

Crow’s feet are the fine or deeper lines that radiate from the outer corners of the eyes when you smile, laugh or squint.^{2 8}

They form because the circular eye muscle squeezes the skin repeatedly and the skin here is thin and easily creased.^{2 8}

Sun and lifestyle factors

Unprotected sun exposure accelerates collagen breakdown and makes these lines appear earlier and more deeply.^{8 14}

Smoking, general health problems and poor skin care can also worsen the appearance of these lines over time.^{8 11}

How people feel about them

Some people see crow’s feet as a normal part of a warm genuine smile, while others feel the lines make them look older or more sun damaged than they would like.^{2 8}

Guidelines highlight that cosmetic decisions should be based on your own values and not on pressure from social media or advertising, which regulators have warned can be misleading.^{1 5}

How do anti wrinkle injections help crow’s feet

How the medicine works here

In this area, very small doses of neuromodulator are placed into the outer part of the eye muscle so it does not squeeze the skin as strongly when you smile.^{2 11}

When the muscle relaxes, the skin folds less and existing lines usually look softer while new lines are less likely to deepen during the active period of the medicine.^{8 12}

Goal of treatment

The aim is to reduce excessive crinkling while keeping a natural and friendly smile, so dosing is deliberately conservative and tailored to the person’s anatomy and eye function.^{1 3}

Because this is a delicate region, Australian guidance stresses the need for specific training, knowledge of eye anatomy and clear discussion of risks and benefits before treatment.^{1 11}

Supportive skin care

Patients should be advised that injections do not replace sun protection, sunglasses and evidence based skin care, which remain important to slow further photoageing.^{8 14}

Your practitioner should also explain that effects are temporary and that repeat treatment is optional, based on your comfort, result and risk tolerance.^{1 2}

What are the main risks in the crow’s feet area

Common and minor effects

Minor effects such as small bruises, temporary redness or swelling are common and usually settle within a few days.^{2 11}

Because the skin around the eyes has many small blood vessels, bruises can happen even with careful technique and are not always avoidable.^{2 11}

Less common functional changes

Less common but more significant risks include slight changes in smile shape, lower eyelid position or eye closure if the medicine spreads into nearby parts of the eye muscle.^{2 12}

Patients must be told about these possibilities before treatment and clinics should have a clear process for review and support if a patient is worried about their result.^{1 3}

Suitability and documentation

People with dry eye, lid laxity or previous eye surgery may need more cautious dosing or may not be good candidates, so a thorough eye and medical history is important.^{3 11}

Guidelines also advise against repeated high doses without review and recommend careful documentation of consent, dose, product and injection sites in the medical record.^{1 3}

D. Bunny lines on the nose

Section scope: Adults seeking subtle treatment for nasal scrunch lines that appear on smiling or laughing.^{2 8}

Why do I have fine lines across the bridge or side of my nose

Muscle action and lines

Bunny lines appear when a small muscle over the upper nose and along the sides of the nose contracts and scrunches the skin during smiling or laughing.^{2 8}

These repetitive movements create diagonal or horizontal lines that may be faint at first but become more noticeable as the skin ages.^{8 14}

Link with other treatment areas

When frown lines are treated, some people unconsciously use their nose more to show expression, which can make bunny lines stand out more.^{2 11}

The lines are often more obvious in people with thin skin, strong expressions or heavy sun exposure.^{8 14}

Normal ageing and choice

Bunny lines are a normal pattern of movement and ageing rather than a sign of illness, and treating them is a personal aesthetic decision.^{2 8}

Guidelines encourage clinicians to ensure patients do not feel pressured to treat every visible line just because they have had other cosmetic procedures.^{1 4}

How does treatment work for bunny lines

Mechanism of action

To soften bunny lines, tiny doses of neuromodulator are injected into the nose muscle so it contracts less when you smile or make expressions.^{2 11}

This reduces the bunching of skin across the bridge and upper sides of the nose, producing a smoother and tidier appearance when you smile.^{8 11}

Dosing and balance

Because the muscle is small and close to other facial muscles, doses are kept low and placed carefully to avoid affecting the upper lip and cheek unnecessarily.^{1 3}

Your practitioner should explain that the aim is to refine and reduce the lines while keeping natural movement in the midface.^{1 2}

Time course and decision making

The effect builds over several days and you usually see the full change at around two weeks, similar to other facial treatment areas.^{2 11}

As with any cosmetic neuromodulator use, you should be given time to weigh benefits and risks, and the treatment must never be presented as essential for health or self worth.^{1 5}

What risks should I know about for bunny line injections

Typical short term effects

Most patients experience only brief effects such as small injection marks, mild tenderness or slight swelling at the injection sites.^{2 11}

There is a small risk of bruising because of small blood vessels in the region, which can be more visible in people on blood thinners or with lighter skin tones.^{3 11}

Specific functional risks

A specific risk is a subtle change in upper lip movement or smile shape if medicine spreads into nearby muscles that lift the lip.^{2 12}

Australian cosmetic guidelines require that these functional and appearance related risks are explained in clear language and that patients have the chance to ask questions before they consent.^{1 3}

Assessment and reversibility

People with complex dental, nasal or facial issues may need extra assessment before treatment, and sometimes referral is appropriate.^{3 11}

You should be told that any unwanted effect is temporary and will improve as the medicine wears off, but that there is no instant reversal for this area once injected.^{2 12}

E. Masseter treatment for jawline and clenching

Section scope: Adults considering jaw muscle injections for facial slimming or for symptoms related to teeth clenching and grinding.^{3 11}

Why are my jaw muscles so big or square

Muscle overuse and growth

The masseter muscles at the sides of your jaw work every time you chew, clench or grind your teeth.^{8 11}

In some people these muscles grow larger over time because of long standing night grinding, high stress clenching or frequent chewing of very firm foods.^{11 20}

Genetics and facial shape

Genetics also influence jaw shape, and some people naturally have a stronger, more square jawline even without obvious grinding habits.^{8 14}

As the masseter enlarges, it can make the lower face look broader and more angular, which some people like and others find too strong for their features.^{2 11}

Symptoms and broader impact

Long term grinding can cause jaw pain, morning headaches, jaw clicking and wear or cracking of teeth, so it is often discussed with dentists as well as cosmetic practitioners.^{11 20}

Because of this mix of appearance and functional issues, neuromodulator treatment may be considered as one part of a wider plan that can include dental splints, stress management and other therapies.^{3 11}

How do injections into the masseter work

Effect on muscle function and shape

When neuromodulator is injected into the masseter, it reduces the strength of contraction by blocking nerve signals at the neuromuscular junction.^{2 12}

Over several weeks the reduced workload can lead to a gradual decrease in muscle bulk, which may slim the lower face and soften a very square jawline.^{8 11}

Effect on clenching symptoms

By lowering maximum clenching force, treatment may reduce grinding related pain, tension and tooth wear in some patients, although responses vary.^{11 20}

Because it does not correct underlying bite problems or stress causes, it is usually offered alongside, not instead of, other evidence based treatments.^{3 11}

Consent and expectations

This use is partly cosmetic and often off label, so guidelines expect explicit informed consent, including discussion of non drug options and likely degrees of change.^{1 3}

People should be advised that shape and comfort changes build over six to ten weeks and that repeat treatment is a choice based on their goals, not a requirement.^{2 11}

Are there specific risks with masseter treatment

Common sensations after treatment

Chewing tiredness is common in the first weeks, especially when eating very chewy foods, as the muscle adapts to reduced strength.^{11 20}

Most patients find this manageable and notice it improves as other chewing muscles share more of the load.^{11 20}

Possible changes in expression

There is a small risk of changes in smile shape or lower face movement if the medicine affects nearby muscles involved in facial expression.^{2 12}

Because masseter treatment often uses higher total doses than small facial areas, AHPRA and the Medical Board highlight the need for careful assessment, dose planning and detailed documentation.^{1 3}

Who needs extra caution

People with jaw joint disease, complex bite problems or significant dental issues may need collaborative care with a dentist or oral specialist before treatment.^{3 11}

Patients should be given realistic expectations that jaw shape will not change overnight and that further treatments depend on how they feel about both function and contour over time.^{1 2}

F. DAO treatment for downturned mouth corners

Section scope: Adults considering injections to soften a downturned or sad looking mouth at rest.^{2 8}

Why do my mouth corners look sad or pulled down

Muscle action and ageing

The depressor anguli oris muscle attaches near the mouth corner and pulls it downward during certain expressions.^{2 8}

With age, repeated use and reduced support in the lower face, this downward pull can dominate even when your face is relaxed.^{8 14}

Changes in support and shadows

Loss of volume in the cheeks, chin and jawline can deepen the shadow lines that run from the mouth corners to the chin, which many people read as sadness or tiredness.^{8 14}

Some people naturally have a more downturned mouth from early adulthood, while in others it becomes more noticeable with ageing and stress.^{2 8}

Emotional impact and discussion

Although this pattern is not a disease, it can affect self confidence and how others interpret your mood in social and work settings.^{2 11}

Guidelines stress the importance of exploring your concerns, motivations and expectations carefully before any cosmetic mouth procedure is offered.^{1 3}

How does DAO treatment help

How the medicine works

DAO treatment uses small doses of neuromodulator injected into the downward pulling muscle near the mouth corner.^{2 11}

By weakening this muscle, the naturally lifting muscles of the midface can have more influence, allowing the corners to sit in a more neutral or slightly uplifted position at rest.^{8 11}

Realistic aim and common combinations

The goal is to soften constant downward pull rather than create an exaggerated or fixed smile.^{2 8}

This treatment is often combined with other options such as filler for deep marionette lines and good dental support for optimal lower face balance.^{3 11}

Subtle change and decision time

Your practitioner should explain that results are usually subtle and that individual change varies, so this is not a substitute for surgical lifting when sagging is severe.^{1 3}

Patients should be given time and space to weigh up the benefit of a mild improvement against the risks of any treatment around the mouth.^{1 4}

What risks are there in the mouth corner area

Common local effects

The mouth area moves a lot, so temporary bruises, small lumps and mild tenderness are common and usually settle within a few days.^{2 11}

Because these muscles are used for speaking, eating and expressing emotion, even small changes in strength can sometimes feel noticeable at first.^{2 12}

Guideline expectations

High or misplaced doses could cause temporary difficulty with fine lip movements, which is why Australian guidelines stress the need for specific training and careful technique in the lower face.^{1 3}

Doctors and nurse practitioners must discuss these risks in clear, everyday language and record that the patient understood before proceeding.^{1 4}

Special situations and reversibility

People with speech problems, neurological conditions or previous surgery around the mouth may need extra caution or referral before treatment.^{3 11}

As with other neuromodulator uses, any unwanted effect is usually temporary and improves as the medicine wears off, but this takes time and cannot be reversed instantly once injected.^{2 12}

G. Lip flip

Section scope: Adults wanting subtle upper lip shape enhancement without adding filler volume.^{2 8}

What is a lip flip

Mechanism and appearance

A lip flip is a small neuromodulator treatment that relaxes the upper part of the circular lip muscle.^{2 11}

When this muscle is slightly relaxed, the upper lip rolls outward a little instead of curling in when you smile, so more of the pink lip is visible without adding filler.^{2 8}

Effect size and typical candidates

The upper lip can look slightly fuller and more defined even though the actual tissue volume has not changed.^{8 11}

This option is often chosen by people whose upper lip disappears when they smile or by those who want a gentle and reversible change before considering filler.^{2 11}

Duration and regulation

The effect usually builds over a few days, lasts for several weeks and then slowly wears off as the muscle regains its normal strength.^{2 12}

In Australia the medicine used is a Schedule 4 prescription product, so the same prescribing, storage and advertising restrictions apply as for other cosmetic neuromodulator treatments.^{2 5}

Platysma neck bands and jawline

Section scope: Adults considering neuromodulator injections to soften vertical neck bands or improve early jawline blurring.^{2 8}

Why do I have vertical bands or “strings” in my neck

Muscle action and ageing

Vertical neck bands appear when the thin sheet-like platysma muscle in the front of the neck becomes more active and stands out under the skin when you talk, tense, or clench.^{2 8}

As you age, the muscle edges can separate into visible bands and the overlying skin becomes thinner and less elastic, which makes the bands more obvious at rest.^{8 14}

Role of skin and support loss

Loss of collagen, sun damage and general skin ageing mean the neck skin no longer drapes smoothly over the deeper tissues.^{8 14}

At the same time, support from deeper ligaments and fat pads can weaken, allowing the platysma to pull the lower face and neck contours down more than before.^{8 11}

Appearance and perception

These bands can make the jawline look less defined and can contribute to a “turkey neck” or stringy appearance that some people find ageing or distracting in photos.^{2 11}

They are still a normal part of facial ageing, and Australian guidance emphasises that choosing to treat or not treat them is a personal decision that should not be rushed or pressured.^{1 4}

How can injections help with neck bands and jawline

How the medicine works in the neck

Neck band treatment involves placing small doses of neuromodulator along the visible platysma bands and sometimes along the jawline border.^{2 11}

This relaxes the platysma so it cannot contract as strongly, which reduces the appearance of vertical bands and softens downward pull on the lower face.^{8 12}

Effect on jawline and neck contour

When the platysma relaxes, the jawline can look cleaner and the transition from face to neck may appear smoother and more youthful in suitable patients.^{8 11}

This is sometimes referred to as a “Nefertiti” style lift and is most effective in mild to moderate neck ageing rather than in very loose or heavy skin.^{3 11}

Realistic expectations and combinations

Guidelines stress that this is a subtle non-surgical option and does not replace surgical lifting in people with significant skin laxity or heavy tissue descent.^{3 12}

Many patients see the best results when neck injections are combined with lifestyle measures, medical skin care or energy-based tightening treatments recommended by an appropriately qualified practitioner.^{3 11}

What extra risks do neck injections carry

Functional risks and swallowing

Because the platysma lies close to muscles that help with swallowing and stabilising the neck, there is a small risk of temporary swallowing tightness or neck weakness if the medicine spreads more widely than planned.^{11 12}

Most cases are mild and improve as the medicine wears off, but this possibility must be explained clearly as part of informed consent for higher risk areas.^{1 3}

Patient selection and training

Australian cosmetic guidelines state that higher risk zones like the neck should only be treated by practitioners with specific training, anatomy knowledge and access to appropriate supervision or support.^{1 3}

People with swallowing problems, significant neck disease, previous neck surgery or certain neurological conditions may not be suitable and may need specialist review before any cosmetic neck injections are considered.^{3 11}

Documentation and follow up

Clinics are expected to document baseline photos, injection patterns, doses and batch details in the medical record and to provide clear aftercare and review arrangements.^{1 3}

Patients should be given written information on when to seek urgent review, for example if they develop severe swallowing difficulty, breathing issues or unusual neck weakness after treatment.^{3 10}

I. Sweating and hyperhidrosis

Section scope: Adults considering neuromodulator treatment for troublesome localised excessive sweating that has not responded to simple measures.^{11 13}

How do injections reduce excessive sweating

Nerve and sweat gland mechanism

In sweat reduction treatments, neuromodulator is injected superficially into the skin where it blocks the nerve signals that normally stimulate local sweat glands.^{11 12}

By interrupting this cholinergic nerve supply, the glands in the treated area produce far less sweat while the medicine is active, although sweating elsewhere in the body continues as normal.^{13 14}

Medical indication and place in care

This use is an accepted medical treatment option for some forms of primary focal hyperhidrosis, particularly when strong antiperspirants and other simple measures have not worked.^{11 13}

Australian health information sources emphasise that the decision to use neuromodulator for sweating should follow proper medical assessment, diagnosis, and discussion of other options.^{3 13}

Impact on daily life

When successful, many patients report major improvements in comfort, clothing choice, social confidence and work performance because visible or dripping sweat is much reduced.^{13 14}

It is important to understand that responses vary and that not every patient will achieve the same degree or duration of sweat reduction, so no guaranteed result should be promised.^{5 7}

Which areas of sweating can be treated

Common treatment sites

Commonly treated areas include the underarms, palms, soles, face and scalp when sweating is severe and significantly affects daily activities or quality of life.^{11 13}

These regions have dense sweat gland populations, and excessive sweating there can be particularly distressing or functionally limiting in work, sport or social situations.^{13 18}

Assessment and suitability

Your doctor should take a detailed history to check how long the sweating has been present, what triggers it, what treatments you have tried and whether any medicines or medical conditions might be contributing.^{3 13}

In some cases, blood tests or referral to a specialist may be required to rule out secondary causes of hyperhidrosis before cosmetic or elective treatments are considered.^{13 18}

Holistic management

Neuromodulator injections are usually offered as part of a broader management plan that may still include topical antiperspirants, clothing strategies, stress management or systemic treatments when appropriate.^{11 13}

Guidance stresses that people should understand the pros and cons of each approach, including costs, frequency of treatment and possible adverse effects, before deciding.^{3 13}

How long does sweat reduction usually last

Typical duration by area

For underarm treatment, many patients experience a strong sweat reduction lasting from six to nine months and sometimes up to around a year before sweating gradually returns.^{11 13}

For palms and soles, the duration is often shorter, frequently three to five months, due to the high nerve supply and heavy use of the hands and feet.^{11 14}

Variation between individuals

Duration can differ widely between individuals depending on factors such as dose, area treated, baseline severity, metabolism and any underlying health issues.^{11 13}

Australian resources recommend regular review to monitor response and to plan repeat treatment only when symptoms reappear and after re-discussing benefits and risks.^{3 13}

Long term planning

Patients should be informed that repeated treatments may be needed to maintain benefit and that long term cost and commitment should be considered before starting.^{11 13}

Good practice includes talking about lifestyle measures and alternative therapies so patients do not feel locked into injections if their situation or preferences change.^{3 18}

Are there special risks with sweat reduction treatment

Discomfort and local effects

Underarm treatment is usually well tolerated, although some people notice short lived stinging, mild bruising or tenderness after injection.^{11 13}

Palms and soles are more sensitive and can be painful to inject, so clinicians may discuss pain relief options, and the risk of temporary hand weakness or altered grip must be explained.^{11 14}

Systemic and regulatory considerations

Although serious systemic effects are rare when correct doses and techniques are used, all botulinum toxin products carry warnings about possible spread of effect and other adverse reactions, which patients should be told about.^{12 14}

Because these are Schedule 4 medicines, the TGA and state health departments expect strict compliance with prescribing, storage, record keeping and advertising rules when they are used for sweating.^{2 9}

Appropriate setting and follow up

Excessive sweating treatment should be performed in a suitable clinical environment with access to resuscitation equipment and staff trained in recognising and managing adverse reactions.^{3 10}

Patients should receive written aftercare advice and clear instructions about when to seek urgent help, for example if they develop muscle weakness, breathing difficulty, vision changes or signs of infection.^{10 12}

J. Governance, safety and questions to ask

Section scope: Adults wanting to understand how to check practitioner credentials, advertising rules and consent standards for cosmetic neuromodulator treatments in Australia.^{1 3}

How do I know my practitioner is properly qualified and regulated

Checking registration and scope

You can check if your doctor, nurse or other practitioner is properly registered by searching the public register on the AHPRA website, which lists health practitioners regulated under the National Law.^{1 2}

This register shows the person’s profession, registration status, conditions and any relevant restrictions so you can confirm they are permitted to practise in Australia.^{1 3}

Warnings about unregulated providers

NSW Health, other state health departments and complaint bodies have issued warnings about cosmetic injections being performed by unregistered or unauthorised people in beauty or home settings.^{9 15}

These warnings highlight risks such as infection, counterfeit products, dosing errors and even botulism when injections are given outside appropriate medical regulation.^{10 15}

What to look for at the clinic

A safe clinic should be able to tell you who the prescribing doctor is, what qualifications the injector has, and how they handle emergencies and follow up care.^{1 3}

You are entitled to ask about infection control, storage of Schedule 4 medicines and what happens if there is a complication, and a reputable service should answer these questions openly.^{3 9}

Why are there strict rules about advertising and social media posts for cosmetic injections

Risks and prescription status

Cosmetic neuromodulators are high-risk Schedule 4 prescription medicines that can cause harm if misused, so they cannot be directly advertised to the public in the same way as simple over-the-counter products.^{5 6}

The TGA’s advertising rules and AHPRA’s cosmetic procedure guidelines both require balanced, factual information rather than promotional or glamourised content that could mislead consumers.^{1 5}

Banned advertising practices

Clinics must not use testimonials, star ratings, or before and after images in ways that promote a specific prescription medicine or imply guaranteed outcomes.^{5 7}

They also must not offer time-limited discounts, competitions or inducements that pressure people to make quick decisions about cosmetic injectables.^{5 7}

Social media and influencers

Paid or gifted influencer posts that promote prescription cosmetic injections as lifestyle products can breach advertising laws, and regulators have taken action against some examples in Australia.^{5 19}

Patients are encouraged to be cautious of social media content and to rely instead on independent information and direct discussions with registered practitioners when considering treatment.^{1 19}

What should good informed consent look like for these treatments

Information and discussion

Before any neuromodulator treatment, you should have a clear discussion about your goals, your medical history, possible options, likely benefits, limitations and all common and serious risks.^{1 3}

This information must be given in plain language, with time for questions, and you should not feel rushed or pressured to decide on the spot.^{1 4}

Cooling-off and documentation

For some higher risk cosmetic procedures, guidelines recommend or require a cooling-off period between consultation and treatment, especially for new patients or more invasive work.^{1 3}

Even when a formal cooling-off period is not mandated, good practice is to offer time to reflect, particularly if you are uncertain or have complex motivations.^{3 4}

Written records and follow up

Your practitioner should document the consent discussion in your clinical record, including the area to be treated, the general type of medicine, key risks covered and your agreement.^{1 3}

You should also receive information about aftercare, what is normal, what is not, and how to contact the clinic or emergency services if you are concerned after treatment.^{3 10}

What questions should I ask at a cosmetic injectables consultation

About the practitioner and product

You can ask who will be doing the injections, what their qualifications are, and who the prescriber is for the Schedule 4 medicine being used.^{1 2}

It is also reasonable to ask whether the product is obtained through approved Australian supply channels and recorded according to state medicines regulations.^{3 9}

About safety and outcomes

You should ask what side effects are common, what serious risks you should know about, and what will be done if you do not like your result or have a complication.^{1 3}

You can also ask to see examples of typical outcomes for people of a similar age and face shape, but you should be told that results cannot be exactly predicted or guaranteed.^{5 7}

About alternatives and costs

Good practice includes explaining non-injectable options, such as skin care, lifestyle changes or other therapies, and discussing whether doing nothing is a reasonable choice.^{1 3}

You should be given a clear breakdown of fees, follow-up arrangements and long term cost implications, especially for treatments that need repeating.^{3 18}

When should I seek urgent review after treatment

Red flag symptoms

You should seek urgent medical review or emergency care if you develop symptoms such as difficulty breathing, swallowing problems, severe or spreading swelling, chest pain, or sudden vision changes after treatment.^{10 12}

Severe headache with neck stiffness, signs of infection such as fever and spreading redness, or marked muscle weakness in areas far from the injection sites also need urgent attention.^{10 12}

Who to contact and where to go

Your clinic should give you clear instructions about how to contact them during and after hours and what to do if they cannot be reached.^{3 10}

If you cannot contact the clinic and you are worried about serious symptoms, you should attend an emergency department or call emergency services rather than waiting for a cosmetic review.^{10 18}

Routine follow up

For non-urgent concerns such as mild asymmetry, small lumps, or questions about your result, it is usually appropriate to book a standard follow up consultation.^{1 3}

Guidelines encourage practitioners to provide non-judgemental review and to avoid simply offering more product without re-assessing the underlying issue and your expectations.^{1 4}

Sources

1. Australian Health Practitioner Regulation Agency 2025, Guidelines for registered health practitioners who perform non-surgical cosmetic procedures (guidelines topic page), AHPRA, viewed 15 November 2025, https://www.ahpra.gov.au/Resources/Cosmetic-surgery-hub/Cosmetic-procedure-guidelines.aspx. ↩
2. Australian Health Practitioner Regulation Agency 2025, Thinking about cosmetic injectables (fact sheet for the public), AHPRA, viewed 15 November 2025, https://www.ahpra.gov.au/Resources/Cosmetic-surgery-hub/Information-for-the-public/Thinking-about-cosmetic-injectables.aspx. ↩
3. Medical Board of Australia 2023, Guidelines for medical practitioners who perform cosmetic surgery and procedures (codes and guidelines topic page), Medical Board of Australia, viewed 15 November 2025, https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Cosmetic-medical-and-surgical-procedures-guidelines.aspx. ↩
4. Australian Health Practitioner Regulation Agency 2025, Putting patients first: new guidelines for cosmetic procedures (news explainer), AHPRA, viewed 15 November 2025, https://www.ahpra.gov.au/News/2025-09-02-New-guidelines-for-cosmetic-procedures.aspx. ↩
5. Therapeutic Goods Administration 2025, Advertising health services and cosmetic injections: frequently asked questions and answers (online guidance page and PDF), Department of Health and Aged Care, Canberra, viewed 15 November 2025, https://www.tga.gov.au/sites/default/files/2024-04/advertising-health-services-cosmetic-injections-faqs.pdf. ↩
6. Therapeutic Goods Administration 2024, Advertising a health service (guidance for advertisers), Department of Health and Aged Care, Canberra, viewed 15 November 2025, https://www.tga.gov.au/resources/guidance/advertising-health-service. ↩
7. Therapeutic Goods Administration 2024, Referring to cosmetic injectables in advertising (media release and topic summary), Department of Health and Aged Care, Canberra, viewed 15 November 2025, https://www.tga.gov.au/news/media-releases/referring-cosmetic-injectables-advertising. ↩
8. Therapeutic Goods Administration 2019, Cosmetic injections (consumer information topic page), Department of Health and Aged Care, Canberra, viewed 15 November 2025, https://www.tga.gov.au/resources/explore-topic/cosmetics/cosmetic-injections. ↩
9. NSW Health Pharmaceutical Services 2024, Cosmetic treatment by unauthorised persons: administration and supply of injectable botulinum toxin or hyaluronic acid dermal fillers (regulatory information page), NSW Health, Sydney, viewed 15 November 2025, https://www.health.nsw.gov.au/pharmaceutical/Pages/cosmetic-treatment.aspx. ↩
10. NSW Health 2025, Public health alert: likely case of botulism linked to unregulated anti-wrinkle injections (public warning page), NSW Health, Sydney, viewed 15 November 2025, https://www.health.nsw.gov.au/news/Pages/20250124_01.aspx. ↩
11. Queensland Health 2025, Beginner-friendly guide to cosmetic injectables (consumer information article), Queensland Government, Brisbane, viewed 15 November 2025, https://www.health.qld.gov.au/newsroom/news/beginner-friendly-guide-to-cosmetic-injectables. ↩
12. NPS MedicineWise 2025, Botulinum toxin type A: consumer medicine information and clinical use overview (medicine information and education pack), NPS MedicineWise, Sydney, viewed 15 November 2025, https://www.nps.org.au/assets/medicines/923b1908-f8ab-4083-af88-a53300fedb65-reduced.pdf. ↩
13. Healthdirect Australia 2024, Excessive sweating (hyperhidrosis) – causes and treatments (patient information topic page), Healthdirect, viewed 15 November 2025, https://www.healthdirect.gov.au/conditions/excessive-sweating-hyperhidrosis. ↩
14. Skin Hospital 2024, Excessive sweating (hyperhidrosis) (clinical and patient information page), Skin Hospital, Sydney, viewed 15 November 2025, https://skinhospital.edu.au/skin-conditions/excessive-sweating-hyperhidrosis/. ↩
15. Health Care Complaints Commission 2017, Unsafe and illegal practices at beauty and cosmetic clinics (public warning under s 94A), HCCC NSW, Sydney, viewed 15 November 2025, https://www.hccc.nsw.gov.au/public-warnings/public-warning-under-s94a-of-the-health-care-complaints-act-unsafe-and-illegal-practices-at-beauty-and-cosmetic-clinics. ↩
16. Industrial Chemicals Environmental Management Standard 2023, Cosmetics and therapeutics – cosmetic injectables (regulatory explainer), Australian Industrial Chemicals Introduction Scheme, Canberra, viewed 15 November 2025, https://www.industrialchemicals.gov.au/cosmetics-and-soap/cosmetics-and-therapeutics. ↩
17. Therapeutic Goods Administration 2019, Cosmetic injections checklist (consumer checklist), Department of Health and Aged Care, Canberra, viewed 15 November 2025, https://www.tga.gov.au/sites/default/files/cosmetic-injections-checklist.pdf. ↩
18. Better Health Channel 2024, Sweat and excessive sweating (patient information page), Victorian Department of Health, Melbourne, viewed 15 November 2025, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sweat. ↩
19. Operation Redress 2025, ‘Shocking: Cosmetic injectors breach TGA ad rules thousands of times’ (media release/report summary), Operation Redress, via Australian media, viewed 15 November 2025, https://www.opred.com.au/10/06/2025/mass-breaches-report. ↩