What is Botox?
Botox is a purified form of the botulinum toxin that is obtained from bacteria. Though it is deadly in larger amounts, the tiny, regulated amount of Botox given to correct wrinkles has been used safely for decades.
Botox works by blocking nerve signals in the muscles where it is injected. When those nerve signals are interrupted, the affected muscle is temporarily paralyzed or frozen. Without movement of these selected muscles in the face, certain wrinkles may be softened, reduced, or even removed.
Botox and other treatments made with botulinum toxin are sometimes called neuromodulators or neurotoxins.
Treatments made with botulinum toxin are sold under the brand names Botox Cosmetic, Dysport, and Xeomin.
What can Botox correct?
Botox only works on wrinkles that are caused by muscle movement. These are known as dynamic wrinkles, and are often called "expression lines."
The most common dynamic wrinkles that Botox can treat are lines on the upper face, such as the "11" between the brows, horizontal lines on the forehead, and crow's feet around the eyes. These lines are caused by smiling, frowning, squinting, and other facial expressions.
Botox will not work on fine lines and wrinkles caused by sagging or loss of plumpness in the face. These are known as static wrinkles. Static wrinkles include lines in the cheeks, neck, and jowl areas.
Botox is not a permanent treatment. Repeated treatments are necessary for continued wrinkle-reducing effects. Most people find that the muscle-relaxing effect of Botox lasts for 3 to 4 months.
In order for muscles to contract, nerves release a chemical messenger, acetylcholine (a neurotransmitter), at the junction where the nerve endings meet muscle cells. Acetylcholine attaches to receptors on the muscle cells and causes the muscle cells to contract or shorten.
Injected botulinum toxin prevents the release of acetylcholine, preventing contraction of the muscle cells. Botulinum toxin causes a reduction in abnormal muscle contraction, allowing the muscles to become less stiff.
Botulinum toxin is predominantly used as a treatment to reduce the appearance of facial wrinkles and fine lines.
Beyond aesthetic applications, Botox is used to treat a variety of medical conditions, including eye squints, migraines, excess sweating, and leaky bladders.
Botulinum toxin is currently used to treat over 20 different medical conditions, with more applications under investigation.
Botulinum toxin is currently approved for the following therapeutic applications:
- Blepharospasm (spasm of the eyelids).
- Idiopathic rotational cervical dystonia(severe neck and shoulder muscle spasms).
- Chronic migraine.
- Severe primary axillary hyperhidrosis (excessive sweating).
- Strabismus (crossed eyes).
- Post stroke upper limb spasticity
- Detrusor (bladder wall muscle) overactivity -causing urinary incontinence.
- Overactive bladder.
- Hemifacial spasm.
- Glabellar lines (frown lines between the eyebrows).
- Canthal lines (crow's feet).
Botulinum toxin is also used off-label (not approved) for:
- Achalasia (an issue with the throat that makes swallowing difficult).
- Anal fissure and anismus (dysfunction of the anal sphincter).
- Sialorrhea (producing too much saliva).
- Allergic rhinitis (hay fever).
- Sphincter of oddi (hepatopancreatic) dysfunction (causes abdominal pain).
- Cerebral Palsy.
- Oromandibular dystonia (forceful contraction of the jaw, face, and/or tongue).
- Laryngeal dystonia (forceful contraction of the vocal cords).
Botulinum toxin is sold commercially under the names:
- Botox, Vistabel, Botox cosmetic (OnabotulinumtoxinA or botulinum toxin type A)
- Dysport (AbobotulinumtoxinA or botulinum toxin type A)
- Bocouture, Xeomin (IncobotulinumtoxinA or botulinum toxin type A)
- Myobloc (RimabotulinumtoxinB or botulinum toxin type B).
Possible side effects of Botox include:
- drooping of the eyelid or brow if injected near the eye
- weakness or paralysis of nearby muscles
- hives, rashes, or itching
- pain, bleeding, bruising, swelling, numbness, or redness
- dry mouth
- flu-like symptoms
- trouble swallowing, speaking, or breathing
- gallbladder problems
- blurry vision or vision problems
The treatment may also fail to work due to antibodies that fight the toxin. This happens in less than %1 percent of people who have repeated Botox treatments, however.
People not to rub or massage the area of the injection after having Botox treatment. This could spread the toxin to surrounding skin, causing muscle drooping and other problems.