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What is Botox?

Botox® is the brand 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, 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 uncontrolled blinking and so-called “lazy eye.” In 2002, the FDA approved Botox for the treatment of frown lines. In 2004, Botox was approved for the treatment of excessive underarm 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 between the eyebrows. 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 avoid alcohol for 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 come back and will need to be re-treated to maintain the effect. 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 but are uncommon.

A small percentage of patients may develop asymmetry or eyelid drooping. This typically resolves in three weeks and is usually caused by migration of the Botox. For this reason, you must not rub the treated 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, breastfeeding, or have a neurological disease should not use Botox. Since Botox does not work for all wrinkles, consultation with a dermatologist is recommended.


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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/1/2013...#12566