BOTOX® is the brand name of a toxin produced by the bacterium Clostridium botulinum. In large amounts, this toxin can cause a form of muscle paralysis known as botulism, which is usually associated with food poisoning. Even though one of the most serious complications of botulism is paralysis, scientists have discovered a way to use it to human advantage. Small, diluted (weakened) amounts can be directly injected into specific muscles, causing controlled relaxation of the muscles.
The FDA approved such usage in the late 1980s when it was discovered that BOTOX® could stop ailments such as blepharospasm (uncontrolled blinking) and strabismus (lazy eye). Cosmetic physicians have been using BOTOX® for years to successfully treat wrinkles and facial creases. BOTOX® is approved for treatment of frown lines on the forehead, crow’s feet (lines around the eye), and axillary hyperhidrosis (increased sweating of the armpits). Within the past few years, new products that have similar preparations have been introduced into the U.S. market and have been well-received by patients.
We will refer to the toxin as BOTOX® from here on out, but please know that this includes all of the formulations:
BOTOX® blocks the signal from the nerve to the muscles. The injected muscle can no longer contract (tighten) as forcefully, which causes the wrinkles to relax and soften.
BOTOX® can be used on the forehead lines, frown lines, crow’s feet, bunny lines (lines in the nose), chin (for dimpling), skin bands on the neck, and around the mouth (for smoker’s lines and down-turned corners of the mouth). Wrinkles caused by sun damage and gravity often will not respond to BOTOX®. It is important to re-emphasize that BOTOX® is NOT a facial filler (that is, it does not fill existing wrinkles) – it merely relaxes the muscles that are creating those wrinkles.
BOTOX® is injected with a fine needle into specific muscles, with only minor discomfort. The procedure takes only a few minutes and no anesthesia is required. It generally takes 3 to 7 days, but sometimes even as long as 2 weeks, to take full effect. It is best to avoid alcohol at least one week before treatment. Aspirin and anti-inflammatory medications should be stopped 2 weeks before treatment (if given permission by a physician) in order to reduce the risk of bruising.
A very small percentage of patients may develop eyebrow or eyelid drooping, drooping of the corner of the mouth, or inability to use a straw, depending on where the BOTOX® is injected. For this reason, one should not rub the treated area for 12 hours after injection, or lie down for three to four hours after injection. No serious side effects have been noted when using BOTOX® at the dermatologic (prescribed) doses.
Patients who should not use BOTOX® are those who:
As BOTOX® does not work for all wrinkles, a consultation with a doctor is recommended.
The effects of BOTOX® will last four to 6 months. As muscle action gradually returns, the lines and wrinkles begin to reappear and will need to be re-treated to maintain the effect. After repeated injections, the lines and wrinkles will often appear less severe because the muscles are being trained to relax.
BOTOX® is not generally covered by insurance when used for cosmetic purposes. Check with your insurance carrier for coverage details.
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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 healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 03/23/2016