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Botox is a drug that temporarily paralyzes muscle. In small doses, it can reduce skin wrinkles and help treat a range of medical conditions, including eyelid spasms, Raynaud's disease, and some types of migraine.
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.
What is Botox?
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.
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:
People casually use the term Botox to describe all of these products, though Botox is a registered trademark that one company owns.
How does it work?
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.
Cosmetic uses
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.
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:
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.
Medical uses
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
Other conditions
According to a 2017 reviewTrusted Source of existing evidence, other issues and medical conditions that may benefit from off-label Botox use include:
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.
Procedure
Clinicians use Botulinum toxin by diluting the powder in saline and injecting it directly into neuromuscular tissue.
It takes 24-72 hoursTrusted Source 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.
Cost, time, and effectiveness
The cost of Botox depends on various factors, including:
When considering Botox for any reason, it is crucial to make sure that the provider is a qualified professional with the appropriate training.
Risks and side effects
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:
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 antibodiesTrusted Source to the toxin that make subsequent treatments ineffective.