Approximately 30% of patients either sneeze or feel like they want to sneeze when the frown or forehead is treated with anti-wrinkle injections. If you are one of those affected you may have a genetic predisposition to do so due to something called Autosomal Dominant Compelling Helio-Ophthalmic Outburst (ACHOO) syndrome or ‘photo-sneezia’1. ACHOO syndrome is characterized by uncontrollable sneezing in response to the sudden exposure to bright light, typically intense sunlight1. It is thought to occur in 16 – 35% of the population and it is unclear why we do it.
Why do we sneeze?
Before we look at anti-wrinkle treatment, lets have a brief recap of why we sneeze. Sneezes are triggered by stimulation of the trigeminal nerve, one of the cranial nerves which supplies the face (shown in the diagram below). Anything that stimulates branches of the trigeminal nerve can make you sneeze. Plucking eyebrows and nose-hairs are good examples of treatments that can trigger a sneeze. Eating strong mint or exposure to bright light can bring on a sneeze in some people.
Why people sneeze when frown lines are treated
When we treat the frown area, as shown in the diagram below, we are injecting small amounts of anti-wrinkle product into areas supplied by the trigeminal nerve. It is a very sensitive area, especially the injections at the outer part of the glabella (shown in the picture below as numbers ‘1’ and ‘2’. The illustration below shows treatment with 20 anti-wrinkle units to the glabella (frown lines). Injecting the frown with small needles can stimulate the trigeminal nerve and trigger a sneezing response. Some patient just feel an urge to sneeze or a tickle in the nose. This is normal.
How to prevent sneezing when you have anti-wrinkle treatment
Unfortunately there is no way that we can minimise the chances of you sneezing when you have anti-wrinkle treatment. It happens to some but not to others and this is just the way you are made. The good news is that it does not impact on your treatment or increase the risk of a lazy eye or brow droop.
1.ACHOO Syndrome: https://www.ncbi.nlm.nih.gov/books/NBK109193