What to know about Botox

Botox is a medication which weakens or paralyzes the muscle. It can reduce skin wrinkles in small doses, and help to treat certain muscle disorders.

Botox is a protein formed by the bacterium Clostridium botulinum made from botulinum toxin. This is the same toxin which is responsible for botulism.

Botox is a poison but it has a number of medical and cosmetic applications when people use it properly and in small doses.

Botox procedures are likely best known for growing wrinkles in the skin. Botox can also help treat crossed eyes, spasms of the eyelids, excessive sweating and some disorders of the bladder.

We’ll explain in this article how Botox operates, its applications, possible risks and side effects.

What is Botox?

Botox may help reduce skin wrinkles.

Botox is derived from Clostridium botulinum, a bacterium. This bacterium is present in many natural settings, including soil, lakes, trees, and in mammalian and fish intestinal tracts.

Clostridium botulinum bacteria and spores that do occur naturally are generally harmless. Problems arise only when the spores turn and the population of cells develops. The bacteria at some stage begin to produce botulinum toxin, the deadly neurotoxin that is responsible for botulism.

The toxin botulinum is extremely toxic. Yes, some scientists claimed that 1 gram (g) of crystalline toxin could kill 1 million people, and that a few kilograms could destroy every human on earth.

However, Botox is safe and has few side effects when used in a medical sense, according to the American Osteopathic College of Dermatology, (AOCD).

Manufacturers injecte Botox from very small doses of botulinum toxin. The drug can temporarily paralyze muscles which can help a range of disorders related to the muscles and nerves.

Commercial versions of Botulinum toxin include:

  • Botox (onabotulinumtoxin A)
  • Dysport (abobotulinumtoxin A)
  • Xeomin (incobotulinumtoxin A)
  • Myobloc (rimabotulinumtoxin B)
  • Jeuveau (prabotulinumtoxin A)

People use the term Botox interchangeably for these various products, though “Botox” is the registered trademark of Allergan Inc.

How does it work?

Botox, that’s a neurotoxin. These substances penetrate the nervous system, disrupting processes of nerve signaling that cause contraction of the muscle. So the drug causes temporary paralysis of the muscle.

Nerves release a chemical messenger called acetylcholine at the junction where the nerve endings cross muscle cells in order to contract muscles. Acetylcholine binds to receptors on the muscle cells and causes contraction or shortening of muscle cells.

Botox injections inhibit the release of acetylcholine, which prevents muscle cells from contracting. The toxin decreases the unnecessary contraction of the muscle, allowing the muscles to become less rigid.

Uses

The primary use of Botox is reducing the appearance of facial wrinkles.

According to the American Board of Cosmetic Surgery, Botox injections are the most popular cosmetic procedure nationwide. In 2016, over 7 million people had Botox treatments.

The effects of Botox are temporary, lasting 3–12 months, depending on the treatments.

Common facial areas people use Botox on include:

  • frown lines, also called glabellar lines or “elevens”
  • wrinkles around the eyes, known as crow’s feet
  • horizontal creases in the forehead
  • lines at the corners of the mouth
  • “cobblestone” skin on the chin

Beyond cosmetic treatments, healthcare professionals are using Botox to treat a variety of muscle-related medical conditions.

Botox has been approved for the following uses according to the AOCD, by the Food and Drug Administration (FDA):

  • crossed eyes, or strabismus
  • eyelid spasms, or blepharospasm
  • a neurological movement disorder called cervical dystonia
  • excessive sweating, known as primary focal hyperhidrosis

According to an article in the journal Toxins, evidence shows that Botox can help treat an overactive bladder.

Some people also use Botox injections for off-label, or not approved, uses, including:

  • alopecia
  • psoriasis
  • dishidrotic eczema
  • post-herpetic neuralgia
  • vulvodynia
  • Raynaud syndrome
  • achalasia, an issue with the throat that makes swallowing difficult
  • anismus, a dysfunction of the anal muscle
  • sialorrhea, a condition where the body produces too much saliva

Procedure

We use Botulinum toxin by diluting and then injecting the substance into the neuromuscular tissue in the saline.

The botulinum toxin takes 24–72 hours to take effect. Rarely, the full effects will take as long as 5 days to take place.

Depending on the treatment the effects can last for 3–12 months.

People should avoid using Botox during pregnancy or breastfeeding, or if the drug or any of its ingredients is previously allergic to them.

Risks and side effects

Botox injections are generally well tolerated by people and side effects are uncommon.

Botulinum toxin may cause some unwanted effects, in addition to its intended effects. These might include:

  • mild pain, swelling, or bruising around the injection site
  • flu-like symptoms
  • a headache
  • an upset stomach
  • temporary eyelid drooping
  • numbness
  • malaise, or feeling generally unwell
  • temporary unwanted weakness or paralysis in nearby muscles

In rare cases, the individual may have a genetic predisposition leading to a mild, temporary, irregular drug response.

Some people who receive botulinum toxin type A injections produce toxin antibodies that ineffect subsequent treatments.

Summary

Botox is a drug that can reduce skin wrinkles in small doses and help in the treatment of certain muscle disorders.

If someone wants to try Botox, they can discuss the safety, dangers, costs and other concerns with their healthcare provider.

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