Exercise increases circulation in the body, including the face, which is why your face flushes and gets red when you work out.
This increased circulation is great for your skin, but it does increase the risk that the Botox will be taken away from the injection zone before it gets fully absorbed into the neuromuscular junction.
Strenuous exercise increases cardiac output and systemic blood flow. this has the potential to increase blood flow to the injection site and remove botox from this location. This ultimately diminishes the response to botox and increases the potential for migration of botox and secondary complications.
“The point of all this is to allow the Botox to bind and enter the nerve and get the best effect possible. Exercise, hanging upside down, and putting your head down all increase blood flow to your face and have the potential of "washing out " the Botox and lessening the effect. Rubbing the area may cause the Botox to spread to an area that was unintended. We suggest working at before your Botox treatment and by the next day, all activities can be resumed.”
Dr. Stratton Douglas