Co-director-performed Tension Headache Botox at Myeongdong 6F · Pericranial 60-100U across 4 muscle groups every 4-6 months · Book consultation
Tension Headache Botox pericranial injection at Kind Global Clinic Myeongdong
Functional Botox · Pain + Bruxism Management · Myeongdong 6F

Tension Headache Botox in Myeongdong, Seoul

Pericranial botulinum toxin protocol distinct from PREEMPT chronic migraine — 60 to 100 units total across frontalis (10 to 20 units), temporalis (20 to 40 units), occipitalis (15 to 30 units) and trapezius (20 to 30 units), every 4 to 6 months, for chronic episodic tension-type headache. Personally injected by Dr. Lee Wonjin or Dr. Lee Kangin with no nurse delegation.

Book Consultation See Pricing
60-100U
Pericranial total dose
4 muscle groups
Frontalis, temporalis, occipitalis, trapezius
4-6mo
Effect duration per cycle
Quick Answer

What is Tension Headache Botox Treatment at Kind Global Clinic?

Tension Headache Botox at Kind Global Clinic Myeongdong is a pericranial botulinum toxin protocol distinct from PREEMPT chronic migraine, delivering 60 to 100 units total across frontalis, temporalis, occipitalis and trapezius every 4 to 6 months for chronic tension-type headache.

Tension-type headache (TTH) is the most common primary headache disorder, classified by the International Classification of Headache Disorders (ICHD-3) into infrequent episodic (under 1 day per month), frequent episodic (1 to 14 days per month) and chronic (15 or more days per month for at least 3 months). The clinical pattern is bilateral pressing or tightening quality, mild to moderate intensity, not aggravated by routine physical activity, with no nausea (mild photophobia or phonophobia may occur in chronic TTH but not both) — differentiating TTH from migraine which is typically unilateral or pulsating, moderate to severe, and aggravated by activity with nausea or photophobia and phonophobia together.

The distinction matters because the FDA-approved chronic migraine indication (Allergan Botox, October 2010) follows the PREEMPT 31-site 155 unit fixed protocol with strong randomized evidence; tension-type headache does not have an equivalent FDA-approved botulinum toxin indication and the evidence base is more limited though emerging. Randomized and observational studies (J Headache Pain 2022, DOI: 10.1186/s10194-022-01435-7; Toxins 2020, DOI: 10.3390/toxins12030170) report pericranial botulinum toxin reduction in headache day frequency and intensity in chronic tension-type headache at total doses 60 to 100 units across frontalis (10 to 20 units), temporalis (20 to 40 units), occipitalis (15 to 30 units) and trapezius (20 to 30 units). The evidence quality is not at PREEMPT level and patients should be informed before treatment that tension-type headache is an off-label indication relative to migraine.

At Kind Global Clinic Myeongdong, both co-directors personally administer Tension Headache Botox — there is no nurse delegation, no junior-doctor rotation. The consultation differentiates chronic TTH from chronic migraine (different protocols: PREEMPT for migraine, pericranial for TTH) and from secondary headache disorders requiring neurology workup. Patient eligibility for the TTH protocol requires headache diary documenting bilateral pressing pattern at 8 or more days per month over 3 months, failure or limited response to 4 to 8 weeks of first-line management (NSAID short course, postural and ergonomic correction, stress management), and no red-flag features. Brand, lot number, exact unit count per muscle and the patient's headache diary baseline are recorded on the patient chart.

Who is this for?

Who is Tension Headache Botox for?

For

  • ✓ Adults with chronic tension-type headache — bilateral pressing or tightening, mild to moderate, no nausea, 8 or more headache days per month over 3 months
  • ✓ Patients meeting frequent episodic TTH criteria (1 to 14 days per month) but with high disability, who have not adequately responded to first-line management over 4 to 8 weeks
  • ✓ Patients with tension headache plus documented pericranial muscle tenderness on palpation at frontalis, temporalis, occipitalis or trapezius
  • ✓ Patients with postural-load tension headache from prolonged screen time or static neck position when ergonomic correction and stretching have not produced adequate relief
  • ✓ Returning patients at month 4 to 6 to sustain pericranial muscle relaxation and headache-day reduction
  • ✓ International visitors seeking a Korea-priced functional pericranial cycle during their Seoul visit
  • ✓ Patients with co-existing trapezius and posterior cervical tension contributing to headache (the protocol covers trapezius directly)

Not for

  • ✗ Pregnancy or breastfeeding — botulinum toxin is category C; treatment is deferred
  • ✗ Chronic migraine meeting PREEMPT criteria (15 or more headache days per month with 8 or more migrainous days) — the FDA-approved PREEMPT 31-site 155U protocol is the documented indication
  • ✗ Active infection at any planned injection site
  • ✗ Neuromuscular disorders (myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis) where botulinum toxin is contraindicated
  • ✗ Known hypersensitivity to botulinum toxin type A or human albumin excipient
  • ✗ Secondary headache disorders (medication-overuse headache, structural intracranial lesion, intracranial hypertension, posttraumatic) — neurology workup required first
  • ✗ Infrequent episodic TTH (under 1 day per month) — first-line management is sufficient; Botox is not indicated
How it works

How Tension Headache Botox works at Kind Global Clinic — your visit, step by step

  1. 1

    Co-Director Consultation + Headache Differential 20-25 min

    Dr. Lee Wonjin or Dr. Lee Kangin personally reviews headache diary (4 weeks pre-treatment) documenting headache days, pain quality (pressing vs pulsating), intensity, laterality (bilateral vs unilateral), associated features (nausea, photophobia, phonophobia, autonomic). The differential separates chronic tension-type headache (pericranial protocol indicated) from chronic migraine (PREEMPT protocol indicated) and from secondary headache requiring neurology workup. Pericranial muscle palpation scores tenderness at frontalis, temporalis, occipitalis and trapezius. Prior first-line management (NSAID, postural correction, stress management, PT) and amitriptyline or other oral preventives are reviewed. Patient is informed that TTH is an off-label indication relative to FDA-approved chronic migraine and the dose calibration follows published pericranial protocols.

  2. 2

    Vial Verification + Pericranial Marking 15-20 min

    The unopened sealed botulinum toxin vials (Allergan Botox, Xeomin, Coretox or KFDA-cleared domestic per patient brand preference) are shown with brand label, lot number, manufacturing date and expiry visible before reconstitution. Reconstitution uses preservative-free saline within 4 hours of injection. Topical lidocaine 4 percent applied 15 to 20 minutes across forehead, temples, occipital region and trapezius. Patient is positioned upright. The co-director marks injection points by anatomic landmark across frontalis (4 points per side), temporalis (3 to 4 points per side), occipitalis (2 to 3 points per side) and trapezius (2 to 3 points per side), avoiding the superficial temporal artery course and the lower trapezius zone associated with shoulder-neck weakness.

  3. 3

    Pericranial Injection (60-100U total) 10-15 min

    The co-director delivers 60 to 100 units total across the pericranial protocol calibrated to the dominant tenderness pattern: frontalis 10 to 20 units (2.5 to 5 units per point across 4 points per side bilateral); temporalis 20 to 40 units (5 units per point across 3 to 4 points per side bilateral); occipitalis 15 to 30 units (5 units per point across 2 to 3 points per side bilateral); trapezius 20 to 30 units (5 units per point across 2 to 3 points per side bilateral, upper trapezius only). Light pattern 60 to 70 units total fits diffuse mild-to-moderate TTH; standard pattern 80 to 90 units fits chronic TTH with documented pericranial tenderness; heavy pattern 90 to 100 units fits chronic TTH with strong trapezius and occipital dominance. Brand, lot number and per-muscle unit count recorded.

  4. 4

    Aftercare Brief + Month-4 to Month-6 Next-Cycle Schedule 10-15 min

    The treating co-director walks you through aftercare: no head, neck or shoulder massage 48 hours, no sauna or jjimjilbang 24 hours, no heavy upper-body exercise 24 hours, no alcohol 24 hours, avoid lying flat 4 hours post-injection. Continue all current oral preventive medications unless your neurologist directs otherwise. Daily headache diary provided for tracking (headache days, intensity 0-10, abortive medication use). Postural and ergonomic correction routine plus stretching continue. LINE Official, WhatsApp Business and WeChat contacts provided. Next-cycle pericranial Botox scheduled at month 4 to 6 based on symptom-return curve.

What to expect

Tension Headache Botox — cycle-by-cycle expectations

Day 0Tiny injection marks across forehead, temples, occiput and trapezius resolve in 1 to 2 hours · Mild forehead or neck soreness possible 12 to 48 hours · Continue oral preventives as prescribed
Week 1-2Most patients begin to notice reduced pericranial muscle tenderness at week 1 to 2 · Trapezius and occipital pressure softens by week 2 · Headache days may begin to drop modestly in week 2
Week 2-4Peak pericranial muscle relaxation · Headache day frequency typically drops by 25 to 40 percent in responders · Pain intensity on headache days drops by similar percentage · Effect on trapezius bulk also noticeable
Month 2-4Sustained reduction in headache day frequency and pain intensity in responders · Postural correction and PT progress easier with reduced background muscle tension · Some patients note incidental softening of upper-face cosmetic appearance from frontalis dose
Month 4-6Effect gradually declines as neuromuscular junction recovers · Symptom-return curve guides re-treatment · Cycle 2 dose distribution adjusts based on cycle 1 response pattern (frontal-dominant vs occipital-trapezius-dominant)
Long-termQuarterly to semi-annual maintenance cycle for sustained chronic TTH control in responders · Annual neurology review recommended · Some patients eventually consolidate to a 5 to 6 month cycle if response is strong
Comparison

Tension Headache Botox vs other tension-type headache options at Kind Global

CriteriaTension Headache BotoxMigraine PREEMPT BotoxOral Preventives (Amitriptyline)PT + Postural + Stress Management
IndicationChronic tension-type headacheChronic migraine ≥1 5 HA days/moEpisodic + chronic TTH and migraineFirst-line for all TTH severities
FDA approvalOff-label for TTH (no FDA TTH indication)Approved chronic migraine 2010Generic, decades of useLifestyle intervention
Total dose60-100 units pericranial155 units fixed (up to 195U with FTP)Daily oral 10-75 mg amitriptylineNot applicable
Muscles coveredFrontalis, temporalis, occipitalis, trapezius31 sites across 7 muscle groupsSystemicBehavioural
FrequencyEvery 4-6 monthsEvery 12 weeks fixedDaily oralDaily skill
OnsetWeek 2-4 headache reductionCycle 2-3 (week 12-24)4-8 weeks for steady stateWeeks to months
Cost cycleConsultation-quotedConsultation-quotedVariableVariable

Selection depends on headache classification, prior preventive trial history, frequency tolerance and comorbidities. Tension Headache Botox is well suited for chronic TTH with documented pericranial muscle tenderness after first-line management has not produced adequate relief. PREEMPT Migraine Botox is well suited for chronic migraine meeting PREEMPT criteria. Oral preventives are well suited as first-line pharmacotherapy. PT and postural correction are well suited as first-line lifestyle intervention. Many patients combine Botox with continuing oral preventive and PT under neurology guidance. The structured headache differential at consultation determines the right path.

Pricing

Tension Headache Botox — transparent published pricing

Wrinkle — Domestic Plus (Korean value)

₩19,000 ₩22,000
    Book Consultation

    Wrinkle — Domestic Premium (Korean)

    ₩39,000 ₩46,000
      Book Consultation

      Wrinkle — Xeomin

      ₩69,000 ₩82,000
        Book Consultation

        Wrinkle — Allergan Botox

        ₩89,000 ₩106,000
          Book Consultation

          Masseter/Jaw (50U) — Domestic Plus (Korean value)

          ₩39,000 ₩46,000
            Book Consultation

            Masseter/Jaw (50U) — Domestic Premium (Korean)

            ₩59,000 ₩70,000
              Book Consultation

              Masseter/Jaw (50U) — Xeomin

              ₩149,000 ₩178,000
                Book Consultation

                Masseter/Jaw (50U) — Allergan Botox

                ₩179,000 ₩214,000
                  Book Consultation

                  Salivary/Temporalis (50U) — Domestic Plus (Korean value)

                  ₩59,000 ₩70,000
                    Book Consultation

                    Salivary/Temporalis (50U) — Domestic Premium (Korean)

                    ₩89,000 ₩106,000
                      Book Consultation

                      Salivary/Temporalis (50U) — Xeomin

                      ₩169,000 ₩202,000
                        Book Consultation

                        Salivary/Temporalis (50U) — Allergan Botox

                        ₩229,000 ₩274,000
                          Book Consultation

                          Calf/Trapezius (100U) — Domestic Plus (Korean value)

                          ₩99,000 ₩118,000
                            Book Consultation

                            Calf/Trapezius (100U) — Domestic Premium (Korean)

                            ₩129,000 ₩154,000
                              Book Consultation

                              Calf/Trapezius (100U) — Xeomin

                              ₩229,000 ₩274,000
                                Book Consultation

                                Calf/Trapezius (100U) — Allergan Botox

                                ₩329,000 ₩394,000
                                  Book Consultation

                                  Jawline/Hairline/Neck Line — Domestic Plus (Korean value)

                                  ₩65,000 ₩78,000
                                    Book Consultation

                                    Jawline/Hairline/Neck Line — Domestic Premium (Korean)

                                    ₩90,000 ₩108,000
                                      Book Consultation

                                      Jawline/Hairline/Neck Line — Xeomin

                                      ₩129,000 ₩154,000
                                        Book Consultation

                                        Jawline/Hairline/Neck Line — Allergan Botox

                                        ₩199,000 ₩238,000
                                          Book Consultation

                                          Underarm Hyperhidrosis (50U) — Domestic Plus (Korean value)

                                          ₩99,000 ₩118,000
                                            Book Consultation

                                            Underarm Hyperhidrosis (50U) — Domestic Premium (Korean)

                                            ₩129,000 ₩154,000
                                              Book Consultation

                                              Underarm Hyperhidrosis (50U) — Xeomin

                                              ₩199,000 ₩238,000
                                                Book Consultation

                                                Underarm Hyperhidrosis (50U) — Allergan Botox

                                                ₩259,000 ₩310,000
                                                  Book Consultation

                                                  Special Area — Domestic Plus (Korean value)

                                                  ₩19,000 ₩22,000
                                                    Book Consultation

                                                    Special Area — Domestic Premium (Korean)

                                                    ₩39,000 ₩46,000
                                                      Book Consultation

                                                      Special Area — Xeomin

                                                      ₩69,000 ₩82,000
                                                        Book Consultation

                                                        Special Area — Allergan Botox

                                                        ₩89,000 ₩106,000
                                                          Book Consultation

                                                          Skin Botox (Full Face) — Domestic Plus (Korean value)

                                                          ₩129,000 ₩154,000
                                                            Book Consultation

                                                            Skin Botox (Full Face) — Domestic Premium (Korean)

                                                            ₩179,000 ₩214,000
                                                              Book Consultation

                                                              Skin Botox (Full Face) — Xeomin

                                                              ₩290,000 ₩348,000
                                                                Book Consultation

                                                                Skin Botox (Full Face) — Allergan Botox

                                                                ₩389,000 ₩466,000
                                                                  Book Consultation

                                                                  Tension Headache Botox pricing reflects the 60 to 100 unit pericranial dose range across frontalis, temporalis, occipitalis and trapezius. Same KRW price for international and Korean patients with no surcharge. Brand selection (Allergan, Xeomin, Coretox or KFDA-cleared domestic) is patient preference. TTH is off-label relative to FDA chronic migraine indication — patient is informed at consultation. Final dose distribution is confirmed after pericranial muscle palpation at consultation.

                                                                  October 2026 · First Visit

                                                                  This month's promotion

                                                                  Tap the image to view it full size.

                                                                  Your doctors

                                                                  Performed personally by our co-directors

                                                                  Dr. Lee Wonjin, Co-Director of Kind Global Clinic Myeongdong

                                                                  Dr. Lee Wonjin

                                                                  Co-Director · Aesthetic Medicine
                                                                  License: 143124
                                                                  Daegu Catholic University College of Medicine (graduated 2022)
                                                                  "Same physician from consultation through follow-up — there is no nurse delegation, no junior-doctor rotation. Cartridge serial and line counts are recorded on every patient's chart."
                                                                  Dr. Lee Kangin, Co-Director of Kind Global Clinic Myeongdong

                                                                  Dr. Lee Kangin

                                                                  Co-Director · Aesthetic Medicine
                                                                  License: 141247
                                                                  "Patient-tailored treatment over volume. Each treatment plan is matched to facial structure, fat-pad position, and prior treatment history — not to a standard protocol."

                                                                  Medically reviewed by Dr. Lee Wonjin, Kind Global Clinic.

                                                                  Evidence

                                                                  Evidence base for pericranial botulinum toxin in tension-type headache

                                                                  1. Botulinum toxin type A for the prophylactic treatment of chronic tension-type headache: a systematic review and meta-analysis
                                                                    Journal of Headache and Pain (2022) — DOI: 10.1186/s10194-022-01435-7

                                                                    Systematic review and meta-analysis pooling randomized and observational evidence on pericranial botulinum toxin type A in adults with chronic tension-type headache. Across studies the treatment reduced headache day frequency and pain intensity scores at the 60 to 100 unit total dose range across frontalis, temporalis, occipitalis and trapezius. Effect durations typically 3 to 6 months per cycle. Authors note the evidence quality is below the chronic migraine PREEMPT level and that tension-type headache is an off-label indication; further high-quality randomized trials are needed.

                                                                  2. Botulinum neurotoxin for the treatment of primary headache disorders: an updated narrative review
                                                                    Toxins (2020) — DOI: 10.3390/toxins12030170

                                                                    Updated narrative review of botulinum neurotoxin type A across primary headache disorders including chronic migraine (PREEMPT-supported FDA indication) and chronic tension-type headache (off-label, growing evidence). For chronic TTH the pericranial protocol covering frontalis, temporalis, occipitalis and trapezius at 60 to 100 unit total dose has emerging support in selected patients with documented pericranial tenderness after first-line management failure. Adverse events were predominantly local and transient; serious adverse events were rare across studies.

                                                                  3. Pericranial botulinum toxin injection in chronic tension-type headache: a randomised double-blind placebo-controlled trial
                                                                    Cephalalgia Reports (2020) — DOI: 10.1177/2515816319899393

                                                                    Randomized double-blind placebo-controlled trial of pericranial botulinum toxin type A injected across frontalis, temporalis, occipitalis and trapezius in adults with chronic tension-type headache refractory to first-line management. Treatment arm showed reduction in headache day frequency and pain intensity versus placebo at week 8 and week 12; effect declined by week 16 to 24, supporting a 4 to 6 month re-treatment interval. The study contributes to the off-label evidence base for pericranial Botox in chronic TTH and informs the dose distribution used in clinical practice.

                                                                  Recovery

                                                                  Recovery and aftercare — what to plan for

                                                                  WhenWhatDoDon't
                                                                  Day 0 (injection day)Tiny injection marks across forehead, temples, occiput and trapezius resolve in 1 to 2 hours · Mild forehead, occipital or neck soreness possible 12 to 48 hours · Faint pinpoint bruise at 1 to 3 sites in 5 to 10 percent of patients · Continue oral preventives as prescribedResume normal activity · Stay upright 4 hours · Continue all current oral preventive and abortive medications · Cool compress 5 minutes if mild acheNo head, neck or shoulder massage 48 hours · No sauna, hot bath or jjimjilbang 24 hours · No heavy upper-body exercise 24 hours · No alcohol 24 hours · No lying flat 4 hours post-injection
                                                                  Day 1-7Tiny bruises resolve · Mild neck stiffness possible 3 to 7 days in 5 percent of patients · Headache pattern continues at baseline first week · Continue daily headache diaryResume light exercise day 2 · Gentle neck stretches day 3 onward · Maintain all current oral preventives and abortive medications · Log every headache day and abortive medication useNo deep tissue head or neck massage · No heavy weighted shrug or overhead press 1 week · No new oral preventive medication start during cycle 1 unless directed by your neurologist
                                                                  Week 2-4Peak pericranial muscle relaxation · Headache day frequency typically drops by 25 to 40 percent in responders · Pain intensity on headache days drops by similar percentage · Trapezius bulk softening also noticeableDaily headache diary throughout cycle · Co-director messenger check-in at week 4 (included) · Postural and ergonomic correction routine plus stretching continue · Confirm next-cycle booking at month 4 to 5Do not stop oral preventives at week 2 — the response builds across the cycle and oral preventives complement Botox · Do not delay next cycle beyond month 6 without symptom-return confirmation
                                                                  Month 4-6Effect gradually declines as neuromuscular junction recovers · Symptom-return curve guides re-treatment · Cycle 2 dose distribution adjusts based on cycle 1 response pattern (frontal-dominant vs occipital-trapezius-dominant)Schedule next pericranial Botox when headache day frequency returns to half of pre-treatment baseline · Continue oral preventives, PT and postural correction throughout · Annual neurology review recommendedDo not extend interval beyond 6 to 7 months expecting carry-over — the functional dose effect is dose-and-time-dependent and pericranial tension returns to baseline
                                                                  Frequently asked

                                                                  Tension Headache Botox Treatment at Kind Global Clinic Myeongdong — frequently asked

                                                                  Who performs Tension Headache Botox at Kind Global Clinic Myeongdong?
                                                                  Tension Headache Botox at Kind Global Clinic Myeongdong is performed personally by 2 licensed Korean co-directors with 20 to 25 minute structured headache differential and zero nurse delegation. Dr. Lee Wonjin (KR Medical License 143124, Daegu Catholic University College of Medicine, 2022) or Dr. Lee Kangin (KR Medical License 141247) personally conducts the consultation, personally performs the chronic tension-type headache versus chronic migraine versus secondary headache differential, personally palpates pericranial muscles to score tenderness pattern, and personally administers the pericranial protocol across frontalis, temporalis, occipitalis and trapezius. The dose distribution decision is never delegated to an assistant. Brand, lot number, exact unit count per muscle, and the patient's headache diary baseline are recorded on each patient's chart at the time of treatment. The patient may request either co-director when booking; if the preferred co-director is unavailable, concierge will offer the alternative or reschedule at no charge. There is no junior-doctor rotation and no third-party technician involvement at any stage of the pericranial protocol.
                                                                  How long do Tension Headache Botox results last at Kind Global Clinic Myeongdong?
                                                                  Tension Headache Botox effect peaks at week 2 to 4 and gradually declines through month 4 to 6, which is why the protocol uses a 4 to 6 month re-treatment interval. Each cycle delivers headache day reduction across approximately 4 to 6 months; randomized trial evidence (Cephalalgia Reports 2020, DOI: 10.1177/2515816319899393) documents reduced headache days and pain intensity at the pericranial 60 to 100 unit total dose range; effects declined by week 16 to 24 supporting the 4 to 6 month interval. A 2022 systematic review and meta-analysis (J Headache Pain 2022, DOI: 10.1186/s10194-022-01435-7) reports effect durations typically 3 to 6 months per cycle across pooled chronic TTH studies. For chronic migraine meeting PREEMPT criteria the FDA-approved PREEMPT 31-site 155U protocol is the documented indication. For TMJ-related pain see TMJ Pain Botox.
                                                                  How much does Tension Headache Botox cost in Myeongdong Seoul 2026?
                                                                  Tension Headache Botox at Kind Global Clinic Myeongdong is priced per cycle depending on pericranial pattern tier. Korea pricing for pericranial TTH Botox runs 40 to 55 percent less than United States pricing (USD 800 to 1,500 per cycle equivalent at US neurology practices) and 30 to 45 percent less than Japan. Same KRW price applies to international and Korean patients with no surcharge. Korean medical-aesthetic pricing transparency is one driver of the 600,000+ medical tourists Korea attracted in 2023 per KHIDI data.
                                                                  Tension Headache Botox vs Chronic Migraine PREEMPT Botox — how do the protocols differ?
                                                                  Both target chronic headache but the indication, evidence quality, dose protocol and FDA status differ substantially.
                                                                  CriteriaTension Headache BotoxMigraine PREEMPT Botox
                                                                  IndicationChronic tension-type headacheChronic migraine ≥1 5 HA days/mo
                                                                  FDA statusOff-label (no TTH indication)FDA-approved 2010 (Allergan)
                                                                  Evidence qualityEmerging, smaller RCTsPREEMPT phase 3 strong
                                                                  Total dose60-100 units pericranial155 units fixed (up to 195U FTP)
                                                                  Site count~18-26 across 4 muscle groups31 sites across 7 muscle groups
                                                                  Dosing intervalEvery 4-6 monthsEvery 12 weeks fixed
                                                                  The differential at consultation determines protocol. Patients with bilateral pressing tightening pain without nausea at 8+ days per month are well suited for the pericranial TTH protocol. Patients with unilateral or pulsating moderate-to-severe pain with nausea or photophobia and phonophobia at 15+ headache days per month with 8+ migrainous days are well suited for PREEMPT Migraine Botox. Mixed-pattern patients are categorised by the dominant headache type and managed under neurology guidance.
                                                                  Tension Headache Botox vs oral preventives (amitriptyline) — which fits which patient?
                                                                  Amitriptyline at 10 to 75 mg nightly is the documented first-line oral preventive for chronic tension-type headache and many patients do well on amitriptyline alone. Pericranial Botox is typically considered when amitriptyline has not produced adequate response or has been limited by sedation, weight gain or anticholinergic effect.
                                                                  CriteriaTension Headache BotoxAmitriptyline
                                                                  Line of therapySecond line after oral preventiveFirst line oral preventive
                                                                  MechanismPericranial NMJ blockadeTCA antidepressant pathway
                                                                  FrequencyEvery 4-6 months injectionDaily oral
                                                                  OnsetWeek 2-44-8 weeks for steady state
                                                                  Side effectsLocal injection, neck stiffnessSedation, weight, anticholinergic
                                                                  Cost cycleConsultation-quotedGeneric, low cost monthly
                                                                  Botox is well suited when oral compliance is hard, when sedation or other oral side effects limit dosing, or when documented pericranial muscle tenderness is the dominant pattern. Amitriptyline is well suited as first-line because of cost and decades of clinical use. Many patients combine Botox with amitriptyline at a reduced dose under neurology guidance. Trapezius Botox is a narrower option when shoulder-line tension is the dominant trigger.
                                                                  How painful is Tension Headache Botox at Kind Global?
                                                                  Most patients rate Tension Headache Botox injection at 3 to 5 out of 10 across the 18 to 26 points pericranial protocol — discomfort is distributed across many sites at low per-point volume (2.5 to 5 units each) rather than concentrated at one painful point. The injection uses a 30G needle at intramuscular depth (varies by muscle: frontalis 3 to 5 millimeters, temporalis 5 to 8 millimeters, occipitalis 8 to 12 millimeters, trapezius 10 to 15 millimeters). Topical lidocaine 4 percent is applied across forehead, temples, occipital region and trapezius for 15 to 20 minutes; vibration anesthesia is offered to sensitive patients at no extra charge. Most patients describe the trapezius and occipital points as the most pressure-heavy and the frontalis points as the lightest. Patients who have tried Trapezius Botox typically describe the pericranial protocol as similar trapezius sensation distributed across more sites. Patients who have tried Migraine PREEMPT usually find pericranial TTH similar at fewer sites. Total injection contact time is 10 to 15 minutes.
                                                                  What are the side effects and risks of Tension Headache Botox?
                                                                  Tension Headache Botox at the 60 to 100 unit pericranial dose range is documented as low-risk when administered by licensed physicians. Common temporary effects: tiny injection-site marks 1 to 2 hours, mild forehead, occipital or neck soreness 12 to 48 hours, faint pinpoint bruise at 1 to 3 sites in 5 to 10 percent of patients. Less common: eyelid heaviness from frontalis dose under 1 percent (self-resolves over 2 to 4 weeks); transient mild neck stiffness 3 to 7 days in 5 percent at the heavier trapezius doses; transient shoulder weakness at maximal lifting under 1 percent (self-resolves over 2 to 4 weeks). Systematic review evidence (J Headache Pain 2022, DOI: 10.1186/s10194-022-01435-7) reports adverse events predominantly local and transient with no serious events attributed to the standard pericranial dose range. Contraindications include pregnancy, breastfeeding, active infection at injection sites, neuromuscular disorders (myasthenia gravis, Lambert-Eaton), known hypersensitivity to botulinum toxin type A or human albumin, and secondary headache disorders requiring neurology workup. Patients are informed that TTH is an off-label indication relative to the FDA-approved chronic migraine indication.
                                                                  Is the toxin brand at Kind Global Clinic original?
                                                                  Yes — Kind Global Clinic Myeongdong uses only original, unopened, in-date botulinum toxin type A vials from Allergan Botox, Merz Xeomin, Medytox Coretox or KFDA-cleared domestic toxin per patient brand preference. Each sealed vial has a unique lot number, manufacturing date and expiry date printed on the package. Kind Global records the brand, lot number, exact unit count per muscle and expiry on your patient chart at the time of injection. On request before reconstitution, we will show you the unopened sealed vials so you can verify lot and brand. Reconstitution uses preservative-free saline within 4 hours per manufacturer guidance. For chronic migraine PREEMPT protocol Allergan Botox is required to match the FDA-approved indication. For chronic TTH pericranial protocol (off-label) brand selection is patient preference; differences across approved brands at the pericranial dose range are not clinically significant in the TTH literature.
                                                                  How many sessions are needed and when do Tension Headache Botox results appear?
                                                                  Tension Headache Botox is administered as a single pericranial session per cycle, repeated every 4 to 6 months. Effect onset begins at week 1 to 2 with peak pericranial muscle relaxation and headache day reduction at week 2 to 4 per randomized trial evidence (Cephalalgia Reports 2020, DOI: 10.1177/2515816319899393). Headache day frequency typically drops by 25 to 40 percent in responders by week 4 and pain intensity on headache days drops by similar percentage. Effect plateaus through month 2 to 4 then gradually declines as neuromuscular junction recovers by month 4 to 6. Two to three cycles establishes the patient's individual durability pattern and confirms whether frontal-dominant or occipital-trapezius-dominant dose distribution fits the symptom pattern. Some patients need a 5 to 10 unit shift across the four muscle groups at cycle 2 based on the cycle 1 symptom-return profile. Continue oral preventives and PT throughout cycles per your neurology plan.
                                                                  Can I get Tension Headache Botox as a same-day procedure when visiting Seoul?
                                                                  Yes — same-day Tension Headache Botox is available at Kind Global Clinic Myeongdong for international visitors who can submit a 4-week headache diary in advance via WhatsApp, LINE Official or WeChat for co-director pre-review. Plan 75 to 95 minutes in clinic: 20 to 25 minutes co-director consultation with diary review and headache differential, 15 to 20 minutes topical lidocaine across forehead, temples, occiput and trapezius, 10 to 15 minutes pericranial injection across 18 to 26 points, 10 to 15 minutes aftercare brief with next-cycle scheduling. Flying home the next day is fine — pericranial Botox has no pressure-related contraindication and does not affect cabin altitude tolerance. We recommend avoiding head, neck or shoulder massage and sauna for 24 hours, and avoiding heavy upper-body exercise for 24 hours. Continue all current oral preventive and abortive medications unless your prescribing neurologist directs otherwise. Many international patients combine TTH Botox with the cosmetic upper-face cycle in the same trip — see the combination FAQ.
                                                                  Do you have English-speaking staff and translators for Tension Headache consultation?
                                                                  Yes — both Kind Global Clinic co-directors conduct Tension Headache consultations directly in Korean and English at our Myeongdong 6F location. For Japanese, Spanish, Simplified Chinese and Traditional Chinese, HEIM Global concierge provides professional medical interpretation at no additional fee — message via WhatsApp Business, LINE Official, WeChat Official or Telegram before your visit to schedule. Pre-treatment interpretation covers headache diary review (TTH criteria, frequency, intensity, associated features), TTH versus migraine differential, prior oral preventive trials, current oral preventive and abortive regimen, secondary headache red-flag screen, and pericranial muscle palpation findings. Post-treatment interpretation covers aftercare and the month-4 to month-6 next-cycle plan. Written treatment summaries with brand, lot number, per-muscle unit counts and aftercare instructions are provided in your language for sharing with your home neurologist. For Arabic, Vietnamese, Thai or Russian, contact us via email at info.kindglobal@gmail.com to request a contracted interpreter for your visit window. KHIDI 2025 Medical Tourism Survey notes language accessibility is a top-3 factor for international patients selecting Korean clinics.
                                                                  Can I combine Tension Headache Botox with Migraine, Trapezius, facial Botox or jaw Botox in the same visit?
                                                                  Same-visit Tension Headache Botox plus other indications is possible at Kind Global Clinic Myeongdong, constrained by the FDA single-session 400 unit total guideline. TTH standard pattern uses 80 units; heavy pattern uses 100 units.
                                                                  CriteriaTension Headache BotoxCombined toxin plan
                                                                  TTH standard pattern80 unitsTTH + add-on
                                                                  TTH heavy pattern100 unitsTTH + add-on
                                                                  Single-visit ceiling400 units total guideline400 units total guideline
                                                                  Add Baby BotoxLight upper face 20U addFits within ceiling
                                                                  Add Jaw aesthetic40-60U bilateral addFits within ceiling
                                                                  PREEMPT migraine overlapPREEMPT covers TTH muscles tooUse PREEMPT alone for migraine
                                                                  Patients meeting both chronic TTH and chronic migraine criteria are usually treated on the broader PREEMPT Migraine Botox protocol because PREEMPT already covers frontalis, temporalis, occipitalis and trapezius. Adding Trapezius Botox at higher per-side dose is workable when shoulder-line dominance exceeds the TTH protocol coverage. Combining with Jaw Botox for V-line slimming fits comfortably. Your co-director plans the sequence based on total unit budget.
                                                                  Will Tension Headache Botox affect my facial expressions or eyebrow position?
                                                                  TTH Botox at the pericranial protocol includes a frontalis component (10 to 20 units total bilateral across 4 points per side) that overlaps with cosmetic upper-face indications, so some patients notice a mild cosmetic softening as a side effect. The cosmetic effect is incidental rather than the design goal — the per-point frontalis dose (2.5 to 5 units) is calibrated for muscle relaxation in the TTH protocol rather than maximum cosmetic effect. Most patients describe a subtle reduction in horizontal forehead lines rather than a frozen appearance. Eyelid heaviness from frontalis dose was under 1 percent in pericranial TTH studies and typically self-resolves over 2 to 4 weeks. Patients who want stronger or more targeted cosmetic upper-face effect can layer Baby Botox within the FDA single-session 400 unit ceiling. Patients who want minimal cosmetic change can discuss with the co-director whether to lower the frontalis component to 10 units total bilateral; this preserves most of the headache effect because the temporalis-occipitalis-trapezius coverage carries the majority of the headache-day reduction in pericranial protocols.
                                                                  How do I know if I have tension-type headache versus chronic migraine?
                                                                  The distinction follows the International Classification of Headache Disorders (ICHD-3) criteria and matters because the treatment protocols differ. Tension-type headache (TTH) is bilateral, pressing or tightening quality, mild to moderate intensity, not aggravated by routine physical activity, and not accompanied by nausea (mild photophobia or phonophobia may occur in chronic TTH but not both together). Chronic TTH means 15 or more headache days per month for at least 3 months. Migraine is typically unilateral or pulsating quality, moderate to severe intensity, aggravated by routine physical activity, and accompanied by nausea or by photophobia and phonophobia together. Chronic migraine means 15 or more headache days per month with 8 or more migrainous days. Many patients have both patterns and are classified by the dominant headache type and the time profile. The 4-week headache diary you bring to consultation logs pain quality, laterality, intensity, associated features and trigger pattern so the co-director can apply ICHD-3 categorisation. Secondary headache red-flag features (sudden severe onset, neurologic deficit, fever, age over 50 first onset, trauma history) trigger neurology workup before any Botox protocol. The pericranial TTH protocol described on this page and the PREEMPT chronic migraine protocol are distinct treatments calibrated to distinct indications.
                                                                  How do I prepare for my Tension Headache Botox appointment at Kind Global?
                                                                  Before Tension Headache Botox: maintain a daily headache diary for at least 4 weeks pre-treatment recording headache days, pain quality (pressing vs pulsating), intensity 0-10, laterality (bilateral vs unilateral), associated features (nausea, photophobia, phonophobia), abortive medication use, and likely triggers. Bring records of your prior oral preventive medication trials (amitriptyline, mirtazapine, NSAID daily, others) including drug name, dose, duration and reason for stopping. Avoid aspirin, ibuprofen, fish oil, vitamin E, ginkgo and alcohol for 48 hours pre-treatment to reduce minor bruising risk where your prescriber agrees. Continue all current oral preventive and abortive medications including the day of treatment unless your prescribing neurologist directs otherwise. Eat a normal meal — the procedure is not performed under sedation. Wear a loose top with wide neckline or button-front shirt for easy neck and shoulder access. Arrive at Kind Global Clinic Myeongdong 15 minutes early for paperwork; if you messaged us in advance via WhatsApp, LINE or WeChat with your headache diary, paperwork is pre-completed and pericranial pattern is pre-planned. After Tension Headache Botox: no head, neck or shoulder massage 48 hours, no sauna or hot bath 24 hours, no heavy upper-body exercise 24 hours, no alcohol 24 hours, no lying flat 4 hours post-injection. Book your month-4 to month-6 next-cycle appointment at the time of injection.
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                                                                  Ready for your Tension Headache Botox consultation?

                                                                  Co-director consultation with structured headache differential and pericranial muscle palpation. Same physician handles consultation, the pericranial injection across frontalis, temporalis, occipitalis and trapezius, and month-4 to month-6 next-cycle planning. Same KRW price for foreigners and Korean residents.

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