BOTULINUM TOXIN MECHANISM OF ACTION - Botulinum toxin

Doctors have been using botulinum toxin ("Botox") for years to treat various medical conditions, but also to treat facial wrinkles.

Botulinum toxin is a toxin produced by the bacterium Clostridium botulinum.

How does botulinum toxin work?
Botulinum toxin blocks signals from the nerves to the muscles. Therefore the muscle cannot contract. This mechanism of action smoothes out wrinkles and reduces them.
Botulinum toxin is often used on areas of the face, like:

the forehead
eye contour area
frown lines

Wrinkles caused by sun damage and gravity will not respond to the administration of botulinum toxin. Botulinum toxin injections can be made in one or more areas at a time, depending on what is to be treated.

What is the procedure used for botulinum toxin?
The treatment only takes a few minutes and does not require anaesthetic.
Botulinum toxin is injected with a thin needle into specific muscles and only a slight discomfort is felt. Botulinum toxin can be of various types, the one used for wrinkles is the bacteria that causes botulism. Botulinum toxin blocks nerve activity in the muscles, causing a temporary reduction in muscle activity. It usually takes 7 to 14 days to see the results.

The uses of botulinum toxin

Botulinum toxin is used for:

the treatment of cervical dystonia (severe spasms in the neck muscles)
the treatment of muscle spasms (stiffness) in the upper limbs (elbows, wrists, fingers) or lower limbs (ankles, toes)
the treatment of severe armpit sweating (hyperhidrosis)
the treatment of muscular dysfunctions of the eye caused by nervous disorders (uncontrolled blinking or spasm of the eyelids)
strabismus (eyes not pointing in the same direction)
the treatment of overactive bladder and incontinence (loss of urine) caused by nervous disorders such as spinal cord injury or multiple sclerosis
the treatment of chronic migraine in adults who have migraine headaches for more than 15 days a month, lasting at least 4 hours
the aesthetic treatment of wrinkles, to temporarily reduce the appearance of facial wrinkles

How long do the effects of a botulinum toxin injection last?
The effects of botulinum toxin will last from 3 to 6 months. The muscle action gradually returns, the lines and wrinkles return and must be treated again. The lines and wrinkles often appear less severe due to the action that the botulinum toxin produces on the muscles.

What are the side effects of botulinum toxin?
The most common side effects include:

temporary bruising
headache, which usually goes away in 24 to 48 hours
drooping eyelids this effect generally subsides within 3 weeks, it occurs when the injected substance moves from the injection site. This can happen when:

you haven't massaged the treated area for 12 hours after injection
you haven't lain down for 3 or 4 hours

The effects of an injection are temporary.
You may notice an improvement on your face 6 weeks after the injection. After repeated injections, the duration of treatment is reduced because antibodies to botulinum toxin are developed. The possibility of antibody production can occur when high doses are used close together.
You should call your doctor in case of the following:

hoarse voice
drooping eyelids
impaired eyesight
severe muscle weakness
loss of bladder control
trouble breathing, talking or swallowing

Some of these effects can occur even several hours or several weeks after an injection.

Who should not use botulinum toxin? People who:

are pregnant
are breastfeeding
have a neurological disease

Since botulinum toxin does not work on all wrinkles, it is advisable to consult a doctor first.
Regarding the contraindications of botulinum toxin use, among the most common are:

patients allergic to botulinum toxin
myasthenia gravis muscle function disorders
taking blood thinners
Inflammation or infection at the injection site
administration of high doses of aminoglycosides
pregnancy
unrealistic expectations for treatment results
uncertainty about the possibility of reliable therapeutic monitoring

There are also precautions to be taken:

great caution should be exercised in patients with respiratory disorders
caution during breastfeeding

Botulinum toxin and choosing your doctor

You must choose your doctor carefully. Botulinum toxin injections should only be administered by a qualified physician, even if for cosmetic purposes. It is important that the injections are precise so as to avoid any side effects. Aesthetic treatment with botulinum toxin can be dangerous if it is administered incorrectly. A qualified and experienced doctor will be able:

to advise on the procedure
to help determine whether it suits your personal needs and health

What to avoid after receiving botulinum toxin?
Botulinum toxin may have reactions that you should be aware of.
These include:

Impaired vision or depth perception. Care should be taken if

o you drive

o you do anything that requires a clear view

For the treatment of excessive sweating

o you must shave your armpits about 24 hours before injection

o no underarm antiperspirants or deodorants should be applied for 24 hours before receiving the injection

Avoid resuming normal physical activities too quickly (as this may result in serious life-threatening side effects in some people receiving botulinum toxin injections, including for cosmetic purposes). When receiving botulinum toxin treatments around your eyes, you may need to use:

o eye drops

o ointments

o special contact lenses

o other devices to protect the surface of the eye

Avoid exercise and hot food or drinks at least 30 minutes before injection
Avoid alcohol intake as early as one week before treatment.
You should also stop taking aspirin and anti-inflammatory drugs 2 weeks before treatment to reduce bruising.
Do not request botulinum toxin injections from more than one medical professional at a time.
Be sure to report how long it has been since your last botulinum toxin injection.
Using this medication more often than prescribed will not make it more effective and may cause serious side effects.
Always follow your doctor's instructions.