Botox Injection
Botox is a drug made from a neurotoxin produced by the bacterium Clostridium botulinum called botulinum toxin. It is used medically to treat certain muscular conditions and cosmetically remove wrinkles by temporarily paralyzing muscles.
How does botox work?
Botulinum toxin is one of the most poisonous substances known to man. Scientists have estimated that a single gram could kill as many as one million people and a couple of kilos could kill every human on earth. In high concentrations, botulinum toxin can result in botulism, a severe, life-threatening illness. Botulism, left untreated, may result in respiratory failure and death. Despite botulinum toxin being so toxic and so costly, Botox is in huge demand.
Botulinum toxin has proven to be a successful and valuable therapeutic protein when dosage, frequency of treatment and variety of treated clinical conditions are considered.
“Only the dose makes a remedy poisonous”
Botulinum toxin can be injected into humans in extremely small concentrations and works by preventing signals from the nerve cells reaching muscles, effectively leaving the muscles without instructions to contract, therefore paralyzing them.
In order for muscles to contract, nerves release a chemical messenger, acetylcholine (a neurotransmitter), at the junction where the nerve endings meet muscle cells. The acetylcholine attaches to receptors on the muscle cells and causes the muscle cells to contract or shorten. Injected botulinum toxin prevents the release of acetylcholine, preventing contraction of the muscle cells. The effect of botulinum toxin causes a reduction in abnormal muscle contraction allowing the muscles to become less stiff.
Medical and cosmetic uses of botox
Botulinum toxin is predominantly used as a treatment to reduce the appearance of facial wrinkles and fine lines in older adults. Beyond aesthetic applications, Botox has been found useful in treating a variety of medical conditions including eye squints, migraines, excess sweating and leaky bladders. Botulinum toxin is currently used to treat over 20 different medical conditions, with more applications under investigation.
Botulinum toxin is currently approved for the following therapeutic applications:
- Blepharospasm (spasm of the eyelids)
- Idiopathic rotational cervical dystonia (severe neck and shoulder muscle spasms)
- Chronic migraine
- Severe primary axillary hyperhidrosis (excessive sweating)
- Strabismus (crossed eyes)
- Post-stroke upper limb spasticity
- Detrusor overactivity urinary incontinence
- Overactive bladder
- Hemifacial spasm
- Glabellar lines (frown lines between the eyebrows)
- Canthal lines (crow’s feet).
Botulinum toxin is also often used off-label for:
- Achalasia (an esophageal issue causing symptoms such as difficulty swallowing)
- Anal fissure and Anismus (dysfunction of the anal sphincter)
- Sialorrhea (hypersalivation)
- Allergic Rhinitis
- Sphincter of oddi (hepatopancreatic) dysfunction
- Cerebral Palsy
- Oromandibular dystonia (forceful contraction of the jaw, face and/or tongue)
- Laryngeal Dystonia (forceful contraction of the vocal cords).
How is the botox procedure performed?
Botulinum toxin is administered by diluting the powder in saline (sodium chloride) and injecting it directly into neuromuscular tissue. It takes 24-72 hours for botulinum toxin to take effect, which reflects the time needed for the toxin to disrupt the synaptosomal process. In very rare circumstances, it may take as long as 5 days for the full effect of botulinum toxin to be observed.
Botulinum toxin should not be used in pregnant or lactating women, or by people who have had a previous allergic reaction to the drug or any of its ingredients.