Concurrent Use of Cefaly Device with Botox is Not Recommended

A user on the Remedy Health - Health Central Facebook site recently asked if it was okay to get Botox while using the Cefaly device.  (www.cefaly.us)

I have been using both for about 3 years now, and wasn't sure, so I emailed the folks at Cefaly. Their response was surprising.

Me:  "Is there any reason to avoid using the Cefaly after getting Botox?"

Von (customer service rep): "Botox and the Cefaly device work by different mechanisms. Botox paralyzes the nerves, and the Cefaly stimulates them. As the results obtained with the Cefaly device could be altered if you have Botox injections at the same time, we generally recommend our patients to use the device at least 4 months after Botox injections, so that they can better see the result they will obtain with the device."

I requested further clarification. The response: "To clarify, you can use Cefaly if you've ever used Botox at all in the past -- but we advise not to use the two treatments at the same time (my italics and bolding).  Meaning, if you've had a recent Botox injection, you should wait at least 4 months before trying Cefaly, so you can see accurate results."

I asked about 4 specific scenarios that others might like to see addressed. These are below, along with their attendant responses from Adeline at Cefaly.

1. A New Cefaly user who is already successfully using Botox. 
Given the opposite actions of Botox and Cefaly, a successful Botox patient would probably not benefit from the Cefaly device. But if they still want to try it they need to wait at least 4 months after their last Botox injection. 

2. A New Cefaly user who would also like to begin using Botox.
Same here: they can use Botox but wait 4 months after the injection to start using the device again. If the Botox therapy works, then they will probably not need the cefaly device anymore (like for scenario 1).

3. An Experienced Cefaly user having positive results, who would like to begin using Botox. 

Again, given the opposite actions of Botox and Cefaly, a successful Cefaly patient would probably not benefit from Botox. However if they want to try, there is no need to wait after using the Cefaly to start Botox.

4. Someone like me, who has been using both for a while because I did not know about the recommendations. 

In your case, if you did not wait 4 months after Botox to use the Cefaly device, the action of the device probably was not as efficient as it could have been. Botox is a pretty radical treatment whereas Cefaly is a gradual one, so if you use the device on the same day you got a Botox injection, it will be overpowered by the Botox and not work as well. If you want to try the device fully, you need to wait around 4 months after your latest injection.

These recommendations were not found on the Cefaly website, nor were they mentioned by the Cefaly reps in the exhibit hall at a recent AHS conference. I suggested that they make sure it is addressed by both in the future.