Botulinum toxin
Botulinum toxin (trade names, Botox and Dysport)
is a toxin produced by the bacterium Clostridium botulinum. It causes muscle
paralysis and prevents sweating.
What can botulinum toxin be used for?
Botulinum toxin was originally introduced for the safe and effective treatment
of muscle spasms. In patients treated for hemifacial spasm it was noted that
facial wrinkling decreased over the treated muscle. This experience lead to the
development of Botox for the treatment of facial wrinkles. People often dislike
their central frown line, which is caused by concentrating, squinting, or
frowning. Botox injections can successfully reduce its prominence.
Images below
Botulinum toxin can also be used to lessen crow's feet and other expression
lines. The treatment can be combined with implantations such as collagen or
hyaluronic acid injections to further improve the appearance.
Botulinum toxin can also be used to prevent excessive sweating (hyperhidrosis),
for example in the armpits or on the palms.
How is botulinum toxin administered?
Tiny quantities of the toxin are injected directly into the affected muscles. It
takes three small injections between the eyebrows to treat the frown line.The
treated muscles weaken over the following week or so. Most people do not notice
anything. They simply become aware that they are no longer able to contract the
frown muscles. They can still lift their eyebrows normally and blink without
problems. The injection is almost painless.
It is important to remain upright for four hours after the injection. You can
frown as often as you like in the first day or so, but the treated areas should
not be touched. Don´t have a facial massage!
To reduce sweating, tiny injections are placed in the affected area at about
1-cm intervals; this can be quite painful, so local anaesthetic may be required.
The effect starts wearing off within a few weeks but re-treatment is not usually
needed for three to six months. Treatment can be repeated as required. Many
people find after three or four treatments that they donšt need another one
the muscle has permanently weakened or they have broken the bad habit that led
to the frowning or squinting originally.
Side effects and risks
Some people have a slight headache after treatment for several hours; it is safe
to take paracetamol to relieve this. A bruise at the site of injection is
possible. The most common significant complication, which is rare, is "ptosis".
This is a drooping of the eyelid caused by the botulinum toxin tracking into the
eyelid muscle. It generally lasts just a few days, but more prolonged weakness
is possible. Let us know if this bothers you; iopidine eye drops can be
prescribed to lessen this effect.
Botulinum toxin injections cannot be used in pregnancy or when breast feeding.
Occasionally the injection fails to result in the desired muscle weakness. The
treatment can be repeated safely.
 Subject relaxed prior to botulinum toxin injections |
 Subject frowning prior to botulinum toxin injectons |
 Subject relaxed after botulinum toxin injections |
 Subject attempting to frown after botulinum toxin injections |
