Botox: Cosmetic and medical uses, procedures, and side effects (2022)

Botox is a drug that weakens or paralyzes muscle. In small doses, it can reduce skin wrinkles and help treat some medical conditions.

Botox is a protein made from Botulinum toxin, which the bacterium Clostridium botulinum produces. This is the same toxin that causes botulism.

Botox is a toxin, but when doctors use it correctly and in small doses, it can have benefits. It has both cosmetic and medical uses.

As a cosmetic treatment, Botox injections can reduce the appearance of skin wrinkles.

Also, the Food and Drug Administration (FDA) have approved it as a treatment for various health issues, including eyelid spasms, excessive sweating, some bladder disorders, and migraine.

In this article, we explain how Botox works and explore its uses, side effects, and other risks.

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Botox derives from C. botulinum bacteria, which are present in many natural settings, including soil, lakes, forests, and the intestinal tracts of mammals and fish.

Naturally occurring C. botulinum bacteria and spores are generally harmless. Problems only arise when the spores transform and the cell population increases. At a certain point, the bacteria begin producing Botulinum toxin, the deadly neurotoxin responsible for botulism.

Botulinum toxin is extremely dangerous. Some scientists have estimated that 1 gram of a crystalline form of the toxin could kill 1 million people and that a couple of kilograms could kill every human on the planet.

However, when Botox is appropriately used in a therapeutic context, it is safe and has few side effects, the American Osteopathic College of Dermatology report.

(Video) Botox: Cosmetic and medical uses, procedures, and side effects

Manufacturers make Botox injections with very small doses of Botulinum toxin. The drug can temporarily paralyze muscles, which can benefit people with various muscle or nerve disorders.

Commercial preparations of Botulinum toxin include:

  • onabotulinumtoxin A (Botox)
  • abobotulinumtoxin A (Dysport)
  • incobotulinumtoxin A (Xeomin)
  • rimabotulinumtoxin B (Myobloc)
  • prabotulinumtoxin A (Jeuveau)

People casually use the term “Botox” to describe all of these products, though Botox is a registered trademark that one company owns.

Botox is a neurotoxin. These substances target the nervous system, disrupting the nerve signaling processes that stimulate muscle contraction. This is how the drug causes temporary muscle paralysis.

In order for any muscle to contract, the nerves release a chemical messenger called acetylcholine at the junction where nerve endings meet muscle cells. Acetylcholine attaches to receptors on the muscle cells and causes the cells to contract, or shorten.

Botox injections prevent the release of acetylcholine, which stops the muscle cells from contracting. In this way, the toxin helps the muscles to become less stiff.

The primary use of Botox is reducing the appearance of facial wrinkles.

According to the American Board of Cosmetic Surgery, Botox injections are the most popular cosmetic procedure nationwide. In 2016, over 7 million people had Botox treatments.

(Video) BOTOX INJECTIONS: Side Effects, Risks, Cost, & Experience | Doctor ER

The effects are temporary, lasting 3–12 months, depending on the type of treatment.

People often request the injections in the following areas of the face:

  • wrinkles between the eyebrows, called frown lines, glabellar lines, or elevens
  • wrinkles around the eyes, known as crow’s feet
  • horizontal creases in the forehead
  • lines at the corners of the mouth
  • “cobblestone” skin on the chin

However, the FDA have only approved the injections for use around the eyes and on the forehead.

Research has not shown whether Botox could improve dark circles under the eyes. Learn more here.

Some people also try Botox to improve the appearance of their hair. There is little evidence that this works, however. Find out more here.

Healthcare professionals also use Botox to treat a variety of medical conditions, most of which affect the neuromuscular system.

The FDA have approved Botox for the following uses. Unless otherwise specified, the approval is for use in people 18 or older:

  • upper limb spasticity, in anyone older than 2 years
  • crossed eyes, or strabismus, in those older than 12 years
  • severe underarm sweating, or hyperhidrosis
  • preventing migraine in people whose migraine headaches last at least 4 hours on 15 or more days per month
  • reducing symptoms of an overactive bladder due to a neurological condition if anticholinergic medications do not help
  • eyelid spasms, or blepharospasm, due to dystonia
  • a neurological movement disorder called cervical dystonia that affects the head and causes neck pain

Some people also have Botox injections for off-label, or unapproved, uses, including as treatments for:

  • alopecia
  • sialorrhea, which involves producing too much saliva
  • psoriasis
  • dyshidrotic eczema, which affects the palms of the hands and soles of the feet
  • anismus, a dysfunction of the anal muscle
  • post-herpetic neuralgia
  • vulvodynia, pain and discomfort in the vagina without a clear cause
  • Raynaud’s disease, which affects circulation
  • achalasia, an issue with the throat that makes swallowing difficult

Other conditions

According to a 2017 review of existing evidence, other issues and medical conditions that may benefit from off-label Botox use include:

  • facial redness and flushing, including during menopause
  • keloids and scars from wound healing
  • hidradenitis suppurativa, an inflammatory skin disease
  • blistering lesions due to Hailey-Hailey disease, a rare genetic disorder

However, confirming that Botox is safe and effective for off-label uses will require more research. Scientists must also establish the appropriate ways to deliver treatment in each case.

Clinicians use Botulinum toxin by diluting the powder in saline and injecting it directly into neuromuscular tissue.

It takes 24–72 hours for the toxin to take effect. Rarely, it can take as long as 5 days for the full effects to show. They may last 3–12 months, depending on the treatment.

People should avoid using Botox during pregnancy or breastfeeding, or if they have ever had an allergic reaction to the drug or any of its ingredients.

What are the safety concerns about Botox during breastfeeding? Find out here.

(Video) What Are The Side Effects Of Botox? | This Morning

The cost of Botox depends on various factors, including:

  • whether it is for medical or cosmetic purposes
  • who provides the treatment
  • where the treatment takes place
  • the number of Botox units involved

For cosmetic use, The American Society for Aesthetic Plastic Surgery noted in 2016 that, on average:

  • the cost of a Botox treatment for frown lines or crows’ feet was $376
  • the procedure lasted 30 minutes
  • the improvement appeared in 1–5 days
  • repeat treatments were necessary every 4–6 months
  • the person could return to work at once

Medicare covers the cost of Botox for medical purposes that doctors deem necessary. However, due to the potentially high cost, it is important to confirm that the treatment is covered before the appointment.

When considering Botox for any reason, it is crucial to make sure that the provider is a qualified professional with the appropriate training.

For people looking to have cosmetic Botox, the American Academy of Facial Esthetics have a locator function that can help.

Anyone who believes that Botox might help with a medical condition should speak with their doctor.

(Video) MUSCLE ANATOMY: How to avoid side effects & maximise Botox efficiency [Aesthetics Mastery Show]

People generally tolerate Botox injections well, and side effects are uncommon.

However, depending on the reason for the injections and the person’s response, Botulinum toxin can cause some unwanted effects, including:

  • dry eye, following cosmetic uses
  • an upset stomach
  • numbness
  • mild pain, swelling, or bruising around the injection site
  • a headache
  • temporary eyelid drooping
  • temporary unwanted weakness or paralysis in nearby muscles
  • urinary problems after treatment for urinary incontinence
  • a worsening of neuromuscular disorders
  • spatial disorientation or double vision after treatment for strabismus
  • corneal ulceration after treatment for blepharitis
  • cardiovascular events, such as arrhythmia and myocardial infarction

People should not use Botox if they have:

  • a sensitivity or allergy to it
  • an infection at the injection site

Depending on the type of treatment, there are concerns that the effects of Botox may extend beyond the injection site, possibly leading to symptoms such as difficulty breathing.

This is more likely to occur in some individuals than others, and genetic factors may play a role.

Also, some people receiving injections of Botulinum toxin type A develop antibodies to the toxin that make subsequent treatments ineffective.

Summary

(Video) Botox Procedures | Salamat Dok

Botox has cosmetic and medical uses. It can reduce the appearance of wrinkles and help treat certain disorders related to the nervous and muscular systems.

If someone wants to try Botox, it is a good idea to speak to a healthcare provider about the risks, costs, and other considerations.

FAQs

What are the medical uses of Botox? ›

Overview. Botox injections are noted primarily for the ability to reduce the appearance of facial wrinkles. They're also used to treat conditions such as neck spasms (cervical dystonia), excessive sweating (hyperhidrosis), an overactive bladder and lazy eye. Botox injections may also help prevent chronic migraines.

What are the side effects of cosmetic Botox? ›

Redness, bruising, infection, and pain at the injection site may occur. Dizziness, mild difficulty swallowing, respiratory infections such as cold or flu, pain, nausea, headache, and muscle weakness may occur when this medication is used to relax muscles.

What is Botox and why is it used in cosmetic applications? ›

Botox blocks signals from the nerves to the muscles. The injected muscle can't contract. That makes the wrinkles relax and soften. Botox is most often used on forehead lines, crow's feet (lines around the eye), and frown lines.

What is Botox cosmetic? ›

BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to temporarily improve the look of moderate to severe forehead lines, crow's feet lines, and frown lines between the eyebrows in adults. For more information refer to the Medication Guide or talk with your doctor.

How safe is Botox? ›

Is Botox safe? Although botulinum toxin is life threatening, small doses — like those used in the application of Botox — are considered safe. In fact, only 36 cases of adverse effects associated with cosmetic use were reported to the Food and Drug Administration (FDA) between 1989 and 2003.

How long do side effects of Botox last? ›

An upset stomach, nausea, or constipation can occur in 1 to 10% of patients. Symptoms are reported as mild or moderate and typically last a few days up to two weeks.

What are long term effects of Botox? ›

There are no long-term or life-threatening adverse effects related to botulinum toxin treatment for any cosmetic indications. Moreover, the risk of possible complications can be reduced by means of a thorough analysis of the patient's medical history and the use of the appropriate dose and technique for the injection.

Is Botox permanent? ›

Unfortunately, Botox is not permanent. Typically a BOTOX treatment lasts for about three months. But, it can last up to six months for some people. During those three to six months, it will help you look youthful and vibrant.

Does Botox cause hair loss? ›

Botulinum toxin A can increase blood flow to the follicle, thus stimulating hair growth. However, in patients repeatedly treated for forehead wrinkles, it can induce hair loss.

Is Botox good for skin? ›

Botox uses various forms of botulinum toxin to temporarily paralyze or relax muscle activity and is a good option for dynamic wrinkles. It can smooth out wrinkles and restore a more youthful appearance.

Is Botox Safe for face? ›

Botox is safe to use long term, and you can stop using it at any time without your skin looking worse than it did before you started Botox. When used for cosmetic purposes, medical insurance does not cover Botox treatments. Botox injections use forms of botulinum toxin to paralyze muscle activity temporarily.

Is Botox treatment good for face? ›

They work by blocking the nerves that contract muscles, softening the appearance of wrinkles. A Botox treatment is minimally invasive and is considered a safe, effective treatment for fine lines and wrinkles around the eyes. It can also be used on the forehead between the eyes. It has both cosmetic and medical uses.

How fast does Botox work? ›

How long does it take for BOTOX to work? The results of BOTOX typically begin to appear within a few days after the injection. However, the full results may not be visible for about 1 – 2 weeks, so it is important to wait an adequate amount of time before seeking a touch-up treatment.

How long does Botox take to work? ›

It takes about 2 or 3 days to start working, and 2 to 3 weeks to see the full effect. Do not massage or rub your face for 3 days. Also, avoid vigorous exercise, sunbathing (including using sunbeds), and the sauna for 2 days.

How does Botox work? ›

Botox blocks signals from the nerves to the muscles. The injected muscle can't contract. That makes wrinkles relax and soften. Botox is most often used on forehead lines, crow's feet (lines around the eye), and frown lines.

Who should not use Botox? ›

If you are in poor general health, your skin is very thick or you have existing muscle weakness in the proposed injection site, you may not be a good candidate for Botox. Patients with sensitive skin may experience an allergic reaction at the injection site.

Can Botox cause heart problems? ›

The research shows that having facial Botox injections for cosmetic reasons can also produce side-effects including muscle stiffness, pain, dizziness and even a heart attack.

What age should you start Botox? ›

If you want to prevent the earliest fine lines from becoming full-blown wrinkles, preventative Botox can be the solution. Botox is approved for patients who are 18 years and older and most experts agree that patients in their mid to late 20s and early 30s are at a good age for preventative Botox treatment.

What happens when you stop using Botox? ›

If you stop BOTOX treatments after many years of regular injections, the only effect will be that your wrinkles will return, albeit a bit more slowly than if you had not been using BOTOX. It's true: Even after you stop, you will still look younger than you would have if you had never been injected.

Can Botox affect your vision? ›

Spread of Botox can cause changes in vision. This can include double vision, blurred vision, dry eyes, excessive tearing and drooping of the eyelid. If experiencing these symptoms, consult your doctor.

Does Botox work after 50? ›

There is no upper age limit for people who want to have Botox. In fact, many women enjoy the refreshed look they can get from Botox and complementary treatments when they are in their 60s or older.

How many uses are there for Botox? ›

Crossed eyes and eyelid spasms are just two of the seven uses of Botox approved by the U.S. Food and Drug Administration, and that doesn't take into account the off-label uses that have become commonplace.

Is Botox used to treat Parkinson's disease? ›

Botulinum toxin (BoNT) therapy is frequently employed in the treatment of Parkinson's disease (PD) symptoms. It can effectively ameliorate the symptoms of cervical dystonia, blepharospasm, sialorrhea, and hyperactive bladder.

Where should you not inject Botox? ›

Botox Injection Mistakes: Where Not to Inject Botox

Injecting the frontalis muscles (the two main forehead muscles above the eyebrows) instead of the corrugator supercilii muscle (smaller muscles around the eyebrows) can cause a “Mephisto Effect” or “Spock brows” — comically arched eyebrows.

Can Botox help an overactive bladder? ›

Botox injection into the bladder is a well-established treatment for overactive bladder and urgency incontinence, including urgency incontinence associated with neurological disease. It is usually used when behavioral and exercise therapies and medications have not been effective in treating symptoms.

Videos

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