WHAT IS BOTOX?
Botox is the brand name of a protein medication made from botulinum toxin. It has been nicknamed the “miracle poison” because it’s the same toxin that causes a life-threatening type of food poisoning called botulism. In the medical setting it is a prescription medication, approved by the FDA, that is used in small doses to treat many different conditions including:
- Temporary smoothing of facial wrinkles and improving your appearance
- Severe underarm sweating
- Cervical dystonia – a neurological disorder that causes severe neck and shoulder muscle contractions
- Blepharospasm – uncontrollable blinking
- Strabismus – misaligned eyes
- Chronic migraine
- Overactive bladder
Botox was the first botulinum toxin used as a medication in the 1970’s. Other companies were soon to follow and currently there are now 2 other USA FDA-approved botulinum toxins, abobotulinumtoxinA (Dysport) and incobotulinumtoxinA (Xeomin). Each is a little different, particularly when it comes to dosage units, so they aren’t interchangeable, but all have been extensively researched and consistently proven in clinical trials and are used worldwide.
HOW DOES IT WORK?
Toxin injections work by blocking specific chemical signals from nerves, that cause muscles to contract. When very strategically dosed and placed, the medication effects the muscle by causing a temporary relaxation so the overlying skin attached to the muscle does not produce a wrinkle when the muscle is contracted. Just like when you clinch your fist and the muscles in your palm contract, the overlying skin forms wrinkles. This is the same as what happens in the face -wrinkles are formed from repeated contraction of expression muscles such as smiling, squinting because of the sun, frowning, teeth clinching, etc. Some of these muscle contractions we are not even aware of because they have become a habit, and therefore wrinkles develop over time.
HOW LONG DOES IT LAST?
In comparison, Botox and Dysport are considered ‘heavier’ because they contain added proteins. These proteins are for protection and are clustered around the toxin to enable them to last a little longer. However, the clinical argument is that these protective proteins may also shield the active part of the toxin thereby minimizing product effectiveness.
Both Botox and Xeomin require up to two weeks for full treatment and in most cases Dysport has a much quicker onset for those patients wanting faster results. All 3 products can last anywhere from 3-6 months depending on the person.
ARE THERE SIDE EFFECTS?
The most common possible side effects include:
- headache
- temporary injection site pain
- temporary injection site skin reaction
- eyelid drooping (incorrect injection placement)
- nausea
ARE THERE CONTRAINDICATIONS?
- pre-existing medical conditions that cause muscle weakness, including motor neurone disease (amyotrophic lateral sclerosis) and myasthenia gravis
- infection overlying the injection site
- previous allergic reaction to botulinum
WHAT TO EXPECT DURING TREATMENT
After the initial consultation to determine your desired outcomes, health history and previous treatments, areas are marked on the skin where injections are to be made. The injector decides the correct dosage, placement and product choice after assessing muscle strength, movement patterns and anatomy. Topical numbing cream may or may not be used, depending on patient preference. Needle size for medication administration is as small as an insulin needle, and most places of injection are very superficial. Patients describe the sensation like a sting with minimal to no bleeding or bruising.
AFTERCARE INSTRUCTIONS
Toxin injections don’t require any recovery time. Therefore, you won’t have to take off work or school. You can resume your usual activities right after. Immediately after injection:
- avoid touching, rubbing, or physical pressure on the affected area
- leave the treated area alone
- wait 24 hours to exercise
- sit up for the first 4 hours after getting injections
- don’t sleep on the treated area
Toxin needs some time to settle into the muscle. Therefore, for the first 24 hours, avoid other skin treatments like:
- facials
- facial massage
- exfoliating scrubs
- dermal fillers
It’s also best to avoid forms of heat exposure, such as:
- tanning
- hot tubs
- sauna
