What Is Botox? How Does Botox Work?

Botox is one of the many trade names for the neurotoxic protein called botulinum toxin that is produced by the bacterium Clostridium botulinum. In large doses, the protein causes botulism, a rare paralytic illness often linked to food poisoning.

However, the protein is used in cosmetic medicine to treat moderate to severe brow furrow (glabellar lines), uncontrolled blinking, lazy eye, wrinkles, and facial creases. These procedures use a small amount of diluted botulinum toxin that enables controlled weakening of muscles.

Botulinum toxin is sold commercially under the brand names Botox, BTXA, Dysport, Myobloc, Neurobloc, Xeomin, Botox Cosmetic, and Vistabel.

Botox widely used for non-cosmetic medical procedures

In addition to cosmetic use, Botox is used to treat cervical dystonia, writer's cramp, excessive sweating, achalasia (an esophagus problem), chronic pain, neuropathy, and migraine headaches.

For people with overactive bladders, Botox can improve their quality of life, say researchers from King's College London School of Medicine, London, England.

Men with enlarged prostates benefit from Botox injections directly into the prostate, a study at University Medical College, Taiwan found.

A possible treatment for some cases of depression

Some studies have indicated that Botox used for aesthetic purposes can help people with mental illness. A study published in Dermatologic Surgery found that treating clinically depressed patients with Botox on the frown lines of their faces actually got rid of their depression.

How does Botox work?

Botox works to relax the contraction of muscles by blocking nerve impulses. The result is muscles that can no longer contract, and so the wrinkles relax and soften. It usually takes two to four days to see cosmetic improvement and the effects tend to last from four to six months. Most patients require retreatment to remove wrinkles and lines as they begin to reappear, but after each injection the wrinkles return as less severe as the muscles are trained to relax

How is Botox administered?

Botox procedures do not require anesthesia and usually take just a few minutes to perform. The protein is injected into the muscle using a fine needle in order to minimize discomfort and maximize accuracy. It is recommended that patients avoid alcohol for about a week before the procedure. In order to minimize bruising, patients should stop using aspirin and anti-inflammatory medications about two weeks before treatment. For cosmetic procedures, a study published in Dermatologic Therapy found that men need a higher dose of Botox than women.

Is Botox better than a face-lift?

According to the American Society of Plastic Surgeons, whether Botox gives better results than a facelift (surgery) depends on the age of the patient. People in their 30s who have had limited exposure to sunlight usually show signs of aging in their eyes and temple area first, with crow's feet and some bulging of the eyelid. As they have not lost much volume at this point, fillers or Botox usually smooth out the lines that people want to get rid of.

When people enter their 40s the middle of the face starts to shift as the cheeks lose some of their fat and laugh lines set in. The cheeks become deflated towards the end of the 4th decade, and the jowls start to sag. A combination of Botox as well as minimal lifting procedures will provide the best results.

What are the side effects of Botox?

The most common side effect of Botox injections is temporary bruising. Other possible side effects include:

• Headache
• Respiratory infection
• Flu syndrome
• Blepharoptosis (drooping of the upper eyelid)
• Nausea
• Indigestion (heartburn)

Doctors in the USA and the UK have reported that some patients "binge" on Botox to the point where their faces look frozen. They refer to the term "Wrinklerexia" - when some Botox-devotees become so obsessed with their wrinkle-free image that they start seeing lines where there are none and binge on Botox to obtain a freeze-frame face.