Botox is a drug which is increasing becoming popular. It was the first drug to use botulinum toxin. Other products now include abobotulinumtoxinA (Dysport), rimabotulinumtoxinB (Myobloc) and incobotulinumtoxinA (Xeomin). Botulinum toxin also called the “miracle toxin,” is a neurotoxin produced by the bacteria Clostridium botulinum. Initially, the toxin gained popularity as a disease-causing “poison”. It was only later that it found its way to becoming a must have in modern aesthetic practice. Today, this wonder toxin has proven to be an apt and convenient option in the field of anti-aging medicine.
The popularity of selfies has been associated with an increase in the use of botox for cosmetic purposes. To keep up with filters, facial modification apps and Photoshop apps, more young people are rushing to get Botox than ever before. The 2020 report of the American Society of Plastic Surgeons state that about 4.4million Americans had Botox done, an increase of about 459% from 2000 which is 20 years ago.
How does Botox work?
Botox consists of 7 types of neurotoxins; however, only toxins A and B are used clinically. Botox A is the widely used type of Botox by cosmetic surgeons. It works by blocking the release of a chemical which helps in muscle contraction called acetylcholine, resulting in paralysis of the local muscles, which usually occurs 24 hours to two weeks following Botox injection. This effect will last three to six months. The optimal dose of cosmetic Botox in dermatology is 20 units.
How is Botox used for cosmetic purposes?
In cosmetology, Botox is commonly used to selectively weaken certain facial muscles to reduce crow’s feet wrinkles, elevate the brows, help turn up the lips and soften the chin pad. When used correctly Botox can dramatically reduce early and moderate signs of aging by minimizing the appearance of fine lines and wrinkles or reshaping the eyebrows. A skilled board-certified plastic surgeon has the intimate anatomic knowledge of these muscle groups and can accurately determine the placement and quantity needed to achieve the desired result.
A common trend emerging is the use of Botox to prevent aging rather than correcting the aging process. More and more millennials are requesting Botox to prevent wrinkle formation as opposed to correcting the wrinkles once they appear. It is thought that perhaps this preemptive use will negate the need for surgical aging correction for a long time. This claim will have to be substantiated with time.
What are the other uses or benefits of Botox?
Apart from the cosmetic use of Botox for wrinkles and aging, it has many surprising uses in Medicine where its property of muscle relaxation is put to use in the management of other ailments. It is used for:
- Treatment of crossed eyes (strabismus) and lazy eyes. This was one of the first approvals for the use of Botox. Its use has been well documented in the treatment of this condition in some selected patients, especially children.
- Treatment of a condition called Blepharospasm, or uncontrollable blinking
- Treatment is also useful for patients with Bell’s palsy who experience facial drooping.
- Treatment of neck spasms (cervical dystonia). This drug acts to relax the tense neck muscles that characterize this condition.
- Treatment of excessive sweating (hyperhidrosis), especially in the armpits ( a condition called severe primary axillary hyperhidrosis). It can also be used to treat overly sweaty hands and feet.
- Overactive bladder. Botox can help relax the muscles of the bladder to prevent the frequent contractions causing frequent urination seen in an overactive bladder.
- Chronic migraines. Studies have confirmed the efficacy of the botulinum toxin in the reduction of migraines in individuals with chronic migraine. The mechanism is proposed to be due to inhibition of the release of neurotransmitters that transmit pain in migraine.
- Depression. Though this is not FDA approved, early trials suggest Botox may alleviate symptoms in people with depression. The mechanism is based on the proposed improvement in an individual’s mood based on Botox-induced smoother facial features.
- Premature ejaculation. Injecting Botox into the penis might relax the muscle and delay ejaculation.
- Potential therapy to prevent abnormal heartbeat patterns after open-heart surgery (called postoperative atrial fibrillation).
- Severely cold hands. Even though this is an off label use, some doctors use Botox to treat people with very cold hands. When injected into the hand, it relaxes muscles that surround constricted blood vessels, causing increased blood flow to the hand and finger tips, relieving the symptom.
- Cleft lip scars in babies. Some doctors also inject the scars on infants with cleft lip after they have repaired it surgically. This will make the muscle relax so healing can occur properly.
- It is also used off label to relax the muscle spasms on the pelvic floor or contractions of the vagina which occur in some women, making sex painful. that can make sex painful.
- It can also be used to treat foot pain in some individuals like athletes and people who wear high heels; who have foot pain due to tight muscles and tendon contracture of the calves. Its use for this has been shown to be more effective than using a steroid.
- The Botox injections can also be useful in treating patients who have digestive problems due, to an increase in the tone of the pyloric sphincter which is a muscle that controls stomach emptying. Botox relaxes this muscle, making it easier for food to flow out of the stomach and digest properly in such people.
What are the side effects of Botox?
Botox is relatively safe when used properly by a medical doctor who can inject it at the right places in the right quantity. The side effects usually occur when the injection seeps into the surrounding tissues. These possible side effects and complications include:
- Pain, swelling or bruising at the injection site
- Headache or flu-like symptoms
- Droopy eyelid or cockeyed eyebrows
- Crooked smile or drooling
- Eye dryness or excessive tearing
In the very rare case of spreading of the toxin to the whole body; late complications like Muscle weakness, vision problems, trouble speaking or swallowing, breathing problems, and loss of bladder control may occur.
When can I not use Botox?
It is generally not recommended to use Botox in the following situations:
- Allergy to cow’s milk protein