Botulinum Toxin

What Is Botulinum Toxin?

According to the National Institutes of Health, the primary component of Botox, botulinum toxin, is one of the deadliest poisons known to man. The toxin is found in nature — including in some soil samples, on certain plants, sometimes in the water, and often in animal digestive tracts. It can form spores, meaning it can lie dormant for extended periods. It’s anaerobic, meaning it doesn’t require air to live.

Botulinum toxin is composed of bacteria that can cause botulism in humans and animals. Botulism is rare, but it can be fatal if not diagnosed and treated quickly with the antitoxin. In its most poisonous form, it grows in spoiled food, infecting anyone who eats it. Botulism, the resulting disease, kills by paralyzing your muscles and lungs, leading to suffocation and, eventually, death.

The “Miracle Toxin”

But while too much botulinum toxin can kill you, a little bit of it can help you. You can likely apply the same principle to most modern medications — and some ancients ones as well. For example, even too much aspirin can hurt you, especially if you’re very young, very old, or especially weak. Botulinum toxin, despite its poisonous properties, has become an important medicine in the medical toolbox.

When prepared appropriately and thinned as injectable medicine, the toxin is very safe. Dr. Alan Scott, a dermatologist, was the first to dilute botulinum toxin as a medical treatment. Botox, the first brand name for the toxin-as-medicine, has been used worldwide since the mid-1980s. It gained popularity in the 1990s, and in 2002, the U.S. Food and Drug Administration approved Botox for cosmetic uses.

Botox is not the only product on the market that makes use of botulinum toxin. Others include:

• Dysport
• Myobloc
• Neurobloc
• Xeomin

How It Works

When injected properly into muscle by a professional specifically trained in giving Botox injections, the botulinum toxin blocks the nerve impulses to and from that muscle. In other words, the toxin creates localized paralysis. It’s not dangerous in the dosages and locations it’s used, and in fact, Botox has a long history of effective use with few side effects and no deaths.

For its use in cosmetic dermatology, Botox disables or freezes your facial muscles. Administered appropriately, the toxin can reduce or even eliminate your crow’s feet, forehead furrows, and the vertical lines between your eyes that appear when you scrunch your eyebrows together. After a Botox treatment, the toxin acts as a neuromuscular block.

Botulinum toxin has a temporary effect when injected into your muscles. It usually wears off in three to six months. You must schedule follow-up appointments to get a new series of injections to keep the toxin working. There has been no evidence to suggest that such continued use is harmful.

Known Side Effects

Side effects from Botox injections occur only about two percent of the time, and they’re both mild and temporary. Regardless of where or why you have Botox injections, you must not rub the injection sites. They shouldn’t itch, and rubbing them can force the toxin into other areas, causing minor and major side effects. You and your dermatologist want to keep the toxin where it was injected for best results.

The known and most common side effects include:

• Minor bruising or swelling at the injection sites, which is temporary
• Loss of movement in some facial muscles, which is expected in cosmetic uses, but is a side effect if this appears in unintended facial muscles
• Flu-like symptoms, which may last overnight
• An increase in your blood pressure
• A droopy eyelid, especially if the toxin was administered near your eye
• A headache, which should abate within a few hours
• Some stiffness, weakness, or pain in adjacent muscles

It’s sporadic, but if the botulinum toxin moves to unintended areas of your body, you may feel more significant side effects. Call your dermatologist in NYC if you:

• Have trouble breathing properly
• Can’t swallow
• Find that you can’t enunciate your words
• Lose control of your bladder
• Develop muscle weakness in other parts of your body
• I can’t see clearly

Approved Uses for Botulinum Toxin

From 2002 to 2012, Botox was used solely for cosmetic dermatology. It was so successful that even though there are now many cosmetic injectables to fight facial wrinkles, Botox remains the most widely known. Then in 2012, the U.S. Food and Drug Administration (FDA) approved Botox for another use: preventing and treating the chronic pain of migraine headaches.

Besides treating migraines, other uses for Botox include calming the following conditions:

• Certain eye muscle disorders, such as cross-eyes or lazy eye
• Blinking that’s uncontrollable
• Writer’s cramp
• Back pain
• Spastic muscles or other movement disorders
• Sweating excessively
• A dysfunctional bladder
• Cervical dystonia, a condition that painfully contracts your neck muscles

The Best Candidates for Treatment

Botox is a safe product, but not everyone responds to it. If it doesn’t work for you, it may not be your dermatologist’s fault; botulinum toxin isn’t effective for a small percentage of people. Other groups of people who don’t make ideal candidates for treatment include those who:

• Are allergic to Botox, the toxin, or other ingredients of the formula
• Have a skin infection at the target injection site
• Aren’t healthy, functioning adults
• Have a bleeding disorder
• Have had surgery recently
• Are you planning surgery in the next two weeks
• Have unrealistic expectations of the results

There has been no evidence suggesting that injections of botulinum toxin harm pregnant women or nursing. But administering Botox to children under 18 years of age can interfere with normal development. It’s also uncommon for Botox injections to be given to anyone more than 65 years old.

Your dermatologist in Manhattan can determine if you’re a good candidate for Botox treatments. Make an appointment to schedule an initial consultation.

Important Reminder: This information is only intended to provide guidance, not definitive medical advice. Please consult dermatologist NYC about your specific condition. Only a trained, experienced board-certified dermatology doctor or pediatric dermatologist can determine an accurate diagnosis and proper treatment.