Botulinum toxin (BTX) is a protein produced by the bacterium Clostridium botulinum that acts on nerve endings to prevent their action on muscles or sweat glands. Botulinum toxin types A and B are commonly marketed under the brand names Botox, Dysport and Xeomin in North America.
Botulinum toxin was first used to treat spasmodic torticollis of the neck in the 1980`s. Since then it has been used to treat disorders characterized by overactive muscle movement and to relax clenching of muscles all over the body (neck, jaw, scalp, arms, legs, bladder). It is also often used to treat disorders of hyperactive nerves including hyperhidrosis (excessive sweating), neuropathic pain, and types of chronic pain.
Injection of botulinum toxin into the facial muscles causes relaxation of those muscles, resulting in the smoothing of the overlying skin.
Richard Clark, a plastic surgeon from Sacramento (CA), was the first to document a cosmetic use for botulinum toxin. He corrected facial asymmetry caused by one-sided facial paralysis by injecting toxin into the non-paralyzed muscles. Doctors Jean and Alistair Carruthers from Vancouver observedthat blepharospasm patients who received injections in the muscles around the eyes and upper face also enjoyed diminished facial wrinkles, thereby initiating the highly-popular cosmetic use of the toxin. In 2002, following rigorous clinical trials, the FDA approved Botox Cosmetic, botulinum A toxin as safe and effective for temporary improvement of the appearance of moderate-to-severe facial wrinkles.
While botulinum toxin is generally considered safe in a clinical setting, there can be side effects from its use. Most commonly, botulinum toxin can be injected into the wrong muscle group or spread from the injection site, causing paralysis of unintended muscles. Bruising at the site of injection is not a side effect of the toxin but rather of the mode of administration. Both toxin spread and bruising are minimized or prevented when BTX is administered by a skilled and properly trained physician. There are other rare side effects reported, such as headache, allergic reaction or low grade fever.
Choosing a provider:
Where you get your botulinum toxin and who does the injecting matters a lot. Safety should be the primary concern of your physician. Injections should be provided by an experienced board certified phsyician who has been well-trained in facial anatomy and operates in sterile facilities. Typically a plastic surgeon or dermatologist has the requisite experience for the best outcomes. BTX should be administered in a medical setting, not at a party or at the mall. Proper storage, correct dilution, sterile hygiene, legal use, and honest practices are all factors that influence the quality of a BTX treatment. Results will be dependent on physician experience and detailed knowledge of facial anatomy. A skilled and experienced physician will typically inject lesser amounts with better results and a decreased risk of side effects. Furthermore, a reputable and experienced injector who has access to other skin treatments will know what BTX can do for your skin and what it can’t. For example, you may optimize your results by combining BTX with dermal fillers or other skin treatments, such as a medical skin care regime, topical treatments or lasers. Each person is unique; therefore, at your initial consultation, your physician should address your concerns in a comprehensive, integrative manner.