What is Botox?
The brand name of a toxin produced by the bacterium Clostridium botulinum, Botox is used medically to treat certain muscular conditions, and cosmetically to remove fine lines and wrinkles by temporarily paralyzing muscles. Clostridium Botulinum is derived from natural settings such as soil, lakes and forests, even intestinal tracts of mammals and fish as well as gills and organs of crabs and other shellfish.
How does Botox work?
Botox blocks the signal from the nerve to the muscles, thereby paralyzing them. The injected muscle can no longer contract as forcefully, causing the wrinkles to relax and smoothen as a result. Although Botox is a powerful poison, when used correctly, it has a number of therapeutic applications. Despite it being so toxic, Botox is still in huge demand.
Botulinum toxin is predominantly used as a treatment to reduce the appearance of fine lines and deep facial wrinkles – at the top half of the face to smoothen glabellar lines (frown lines) and forehead wrinkles, prominent lower eyelids, canthal lines (crow’s feet), bunny lines (beside the nose), as well as lower half of the face including perioral lines (around the lips), marionette lines (corners of the mouth), chin creases and neck folds.
Botox only works on dynamic wrinkles also known as “expression lines” – those that are caused by muscle movement. Common dynamic wrinkles that can be treated by Botox are those lines on the upper face, such as the "11" or horizontal lines between the brows on the forehead and crow's feet around the eyes.
Botox will not work on static wrinkles or fine lines and wrinkles caused by sagging or loss of plumpness in the face, such as lines in the cheeks, neck and jowl areas.
Beyond aesthetic applications, Botox can be used to treat over 20 different medical conditions including eye squints, strabismus (crossed eyes), blepharospasm (spasm of the eyelids), chronic migraines, severe primary axillary hyperhidrosis (excess sweating), post-stroke upper limb spasticity, incontinence and overactive bladder.
Procedure and Treatment
Botox is administered by diluting the powder in saline and is injected with a fine needle directly into the neuromuscular tissue, with only minor discomfort. The procedure takes only a few minutes and 24 to 72 hours for the botulinum toxin to take effect. In very rare circumstances, it may take as long as three to seven days or even as long as two weeks to take full effect.
As Botox is not a permanent treatment, repeated treatments are necessary. Depending on individuals and area of administration, the muscle-relaxing effect of Botox last three to four months.
Risks and Side Effects
Injections with botulinum toxin are generally well tolerated and there are few side effects. But in rare cases, an individual may have a genetic predisposition towards the drug, resulting in a mild, transient response.
It is best to avoid alcohol at least one week before treatment. Painkillers and anti-inflammatory medications should also be stopped two weeks before treatment in order to reduce the risk of bruising. Common side effects like bruising and slight pain with injection may be experienced but are temporary. Headaches can also occur but this is rare and it usually goes away in 24 to 48 hours. A very small percentage of patients may also develop eyebrow or eyelid drooping, drooping of the corner of the mouth, or inability to use a straw, depending on where the Botox is injected. Do not try to rub the treated area, and avoid lying down for three to four hours after injection. There may be other side effects, but it is very rare for anyone to experience all of them.
How to avoid Botox side effects?
Make sure your medical doctor is very experienced at Botox injections. Avoid going to a beauty salon as they may not have the necessary emergency equipment or sufficient medical knowledge when something goes wrong. There have been reports of some disreputable people who administered injections that were over- or under-diluted with saline, as well as counterfeit solutions that didn't contain Botox at all!
Be truthful. Before having injections, inform your medical doctor about any health problems (no matter how mild) you have. Tell your medical doctor about medications, or any supplements that you are taking, especially injected antibiotics, muscle relaxants, allergy or cold medicines and sleep medicines because some combinations of these medication and supplements with Botox could cause serious side effects.
Take your medical doctor's pre- and post-injection instructions very seriously. Report any side effects that are bothering you or that won't go away.
Who is not suitable for Botox?