Beware of migraines in fluctuating weather: Botox injections also effective, experts say

Professor Kim Won-joo / Courtesy of Gangnam Severance Hospital

As spring brings sharp differences between morning and evening temperatures, experts are warning that the sudden changes could trigger or worsen migraines — especially for those already prone to the condition.

Migraines are often thought to affect only one side of the head, but according to medical experts, this isn’t always the case. In fact, only about 50 percent of migraine sufferers report pain on one side. The remaining half experience bilateral headaches. Furthermore, even one-sided headaches may be linked to other conditions, such as neuralgia or vascular inflammation, which is why a precise diagnosis is crucial.

Kim Won-joo, a professor of neurology at Gangnam Severance Hospital, said, “Migraines typically begin in youth and tend to recur frequently. From 2021 to 2023, an average of around 600,000 people suffered from migraines each year. Women are three times more likely than men to experience migraines, and those with a family history are at a higher risk.”

Among the various theories behind how migraines work, the most widely accepted one is the trigeminovascular theory. “Blood vessels inside the cranial cavity are connected to a nerve called the trigeminal ganglion. When triggered, this nerve releases pain-inducing neurotransmitters, leading to migraine attacks,” Kim said.

The spring and fall seasons, when temperature swings and pressure shifts are common, pose particular risks. “The ideal indoor-outdoor temperature difference for the human body is between 5 and 7 degrees Celsius,” Kim said. “During seasonal transitions or in environments with air conditioning or heating, such as summer or winter, migraines may be triggered by sudden temperature changes.”

For instance, stepping from bright sunlight into a cool, air-conditioned space can cause rapid blood vessel constriction in the brain, which may lead to a headache. Conversely, when blood vessels that have constricted in cold air return to normal, headaches can also occur. Additionally, frequent atmospheric pressure changes in spring and fall are another potential cause.

While there is currently no cure for migraines, oral medication remains the most accessible form of treatment. Kim cautioned against waiting until the pain becomes unbearable before taking medication, as some patients worry about building tolerance. Recently developed medications that inhibit a molecule called CGRP — which causes blood vessels to dilate — have shown promising results. Botox injections have also proven effective, especially for chronic migraine patients.

“The Botox method involves injecting small doses along nerve pathways from the forehead to the shoulders. It helps calm the nerves responsible for triggering migraine pain,” Kim said.

As for prevention, he emphasized that there are many migraine triggers, and controlling them can reduce both frequency and intensity. “Blocking sunlight with sunglasses or a parasol and engaging in 30 to 40 minutes of aerobic walking on a daily basis can significantly help,” he said.

Mental health also plays a significant role. “Depression and anxiety disorders are closely linked to migraines. Stress and depressive moods can trigger or worsen migraines, and chronic migraines can, in turn, lead to depression,” Kim added.

This article from the Hankook Ilbo, the sister publication of The Korea Times, is translated by a generative AI system and edited by The Korea Times.