Botox^® is the name of a substance derived from botulinum toxin. In large amounts, this toxin causes a form of muscle paralysis known as botulism. Very small amounts, however, it can be directly injected into specific muscles, causing controlled muscle weakness.

The FDA approved such usage in 1989 when it was found that Botox^® could stop blepharospasm (uncontrolled blinking) and strabismus (lazy eye). In 2002, the FDA approved Botox^® for the treatment of glabellar (frown) lines. In 2004, it approved Botox^® for the treatment of axillary hyperhidrosis (excessive sweating).

Physicians have also used this drug off label successfully to treat other facial wrinkles and creases, as well as excessive sweating of the palms.

How does Botox^® work?

Botox^® blocks signals from the nerves to the muscles. The injected muscles can no longer contract, which causes the wrinkles to relax and soften.

Botox^® is most often used on forehead lines, crow’s feet (lines around the eyes), and frown lines (glabellar). Wrinkles caused by sun damage and gravity will not respond to Botox^® and are best treated with other treatments.

How is the procedure performed?

The procedure takes only a few minutes. No anesthesia is required. Botox^® is injected with a fine needle into specific muscles, causing only minor discomfort. It takes three to 14 days for Botox^® to take full effect.

In order to minimize bruising, it is best to have no alcohol two days before the treatment as well as to stop taking aspirin and anti-inflammatory medications two weeks before the treatment.

How long does a Botox^® injection last?

The effect will last three to four months. As muscle action gradually returns, the lines and wrinkles begin to re-appear and wrinkles will need to be re-treated. Wrinkles often appear less severe with time because the muscles are being trained to be less active.

What are the side effects of Botox^®?

Temporary bruising is the most common side effect. Headaches, which resolve in 24 to 48 hours, can occur, although rarely.

A small percentage of patients may develop asymmetry or ptosis (eyelid drooping). This usually resolves in three weeks. (This is usually caused by migration of the Botox^®. For this reason, we ask that you don’t rub the area for 12 hours after injection). There have been no allergies associated with Botox^® to date.

Who is a candidate for Botox^® injection?

Patients who are pregnant, breast feeding, or have a neurological disease should not use Botox^®. Since Botox^® doesn’t work for all wrinkles, a consultation with a dermatologist is recommended