Botulinum Toxins

What is Botulinum Toxin?

Botox is a brand/commercial name of botulinum toxin A, produced by the bacterium Clostridium botulinum, which is one of the eight neurotoxins produced by the bacteria.

This commercially available botulinum toxin, when used for cosmetic purposes is known as Botox.

FDA approved such usage of Botulinum Toxin in the late 1980s, when it was found out that Botox could treat certain muscular ailments such as blepharospasm (uncontrolled blinking) and strabismus (lazy eye).

BOTOX is onabotulinum toxin A. FDA approved its use in 2002 for glabellar wrinkles and in 2004 for severe underarm sweating.

It is being used for years by cosmetic physicians to successfully treat wrinkles and facial creases.

How does Botox work?

Small and diluted amount of Botox is injected into specific muscles with only minor discomfort, thus, temporarily paralyzing them. The injected muscle can no longer tighten or contract, causing the wrinkles to soften and relax. It is very important to note that Botulinum Toxin is not facial filler; it just relaxes the muscles that are creating wrinkles. This procedure can be performed in a few minutes without anaesthesia.
The full impact of this paralytic effect is seen in about 4-7 days after injection. The toxin takes about 2-3 days to produce an effect, results are likely to be seen in about 3 days, but full effect can be seen in about 7-10 days after treatment. This function recovers only from sprouting of new nerve terminals, thus forming new synaptic contacts. This takes about 4 months on an average, which is why Botox is said to last for about 4-6 months.
This treatment can be used on the frown lines,forehead lines, crow’s feet, bunny lines (lines in the nose, etc.

How does Botox Work to stop sweaty underarms?

Sweat glands can be controlled by the use of Botulinum toxin A, which works, not only on the neuromuscular junction to treat wrinkles but also on parasympathetic and sympathetic nerve endings. To treat this, the toxin is injected into the sub-dermis of the axilla that is approximately 2 mm deep, thus combating excessive sweating. For an effective treatment, it typically takes 50 units on each underarm and the effect lasts for about 6 months.

How long does a Botulinum injection last?

The effect of Botox could last for four to six months. The lines and wrinkles begin to reappear as the muscle action gradually returns. This needs to be re-treated to maintain the effect. Due to the repetitive Botox treatment on the muscles, they are trained to relax and the lines and wrinkles become less severe with time and the treatment tends to last longer than six months.

Is it possible to become immune to Botox?

To stop the effect of Botox on your body, antibodies in the body are formed.In order to minimize the risk of forming antibodies to the toxin, Dr. Pandya recommends using the lowest dose needed for the desired effect and avoiding re-injections at shorter than 4 month duration.
There are also a few patients (who have not had prior treatments) in whom the toxin simply does not work. This might be due to individual variations in docking proteins or having antibodies from a subclinical exposure to the toxin.

Can I do Botox at the same time as my Laser / Massage / Facials?

It is advisable to get your laser treatments, facial massages, and facials well before the Botox treatment. This is to avoid any potential dislodging or spreading of toxin that has not bound yet. Dr. Pandya also recommends not laying down for 3-4 hours after Botox treatment and not doing strenuous activity or working out for at-least 24 hours after treatment. Also, massaging the treated muscles is not recommended.

What are the risks?

• A temporary headache.
• Droopy eyelid.
• Crooked smile
• Eye dryness
• Bruising

Dr. Pandya recommends avoiding blood thinners like aspirin, ibuprofen, vitamin E, fish oil, flax seed, for at least 10-14 days prior to injection to minimize the risk of bruising. The bruising can also be minimized by icing the area prior to injection and holding brief pressure at the needlestick sites during injection.

Who cannot get Botox injections?

• Anyone with pre-existing neuromuscular diseases such as myasthenia gravis.
• Pregnant women.
• Women who are breastfeeding.
• Anyone who is on certain medicines that can alter the effect of the toxin