BOTOX injections could be offered to migraine sufferers to end their pain.
However, patients will have to pay privately at Sunderland Royal Hospital – up to £700 per session – after the NHS decided not to fund it in the North East.
The city neurology department could offer the treatment, 31 injections around the head in a single session, which can ward off attacks for three months, next year.
Research has shown the procedure can give patients long-term relief.
Health bosses believe people could need up to five sessions, but say some people will notice an improvement in the early stages.
It will only be offered to chronic sufferers, when they have the condition for 15 days or more a month, or eight days for those with aura, where vision or hearing is affected or unusual sensations are felt.
Medics stressed it should only be used as a last resort to end pain and asked sufferers to seek support through the health service rather than the beauty industry.
The treatment is offered by the NHS in cities including London and Leeds, but an application for funding was turned down by the North East Treatment Advisory Group because of cost and efficiency concerns.
Negotiations are ongoing between the hospital and suppliers of the botulism toxin, as it moves forward with private proposals.
Dr Jitka Vanderpol, consultant neurologist at the Royal, said: “The most recent new treatment is unfortunately not offered by the NHS for chronic migraines.
“It’s quite expensive at the moment, but we’re to offer it as a private treatment.
“We know from research it is helpful and it is done under licence in the UK.
“About 10 to 20 per cent of the patients we have got could qualify for botox.”
Charges for the treatment are expected to range between £550 and £700.
Dr Vanderpol added: “We try some medication as a preventative measure and if that fails, we can try something else.
“This is really for the end of the road, both for them and for use.”
An NHS spokesman said: “An application for this treatment was considered by the North East Treatment Advisory Group (Netag), which decided that it should not be provided by the NHS due to issues about the clinical efficacy and cost effectiveness of this treatment.
“In considering any request for treatment, this group looks at the all of the latest evidence available.
“Its decisions are accepted by primary care trusts across the North East to ensure a consistent approach to the provision of new treatments.
“Nice is expected to issue guidance on the use of botox in chronic migraine in June 2012 and NHS organisations within the North East will reconsider Netag’s recommendation in the light of any guidance issued by Nice.”