Botox Injections

Botox treatments are well known for their ability to help minimize the appearance of facial wrinkles. To a lesser degree, Botox is also known to help those individuals with excessive sweating issues (hyperhidrosis), cervical neck spasms (cervical dystonia), lazy eye, and even an overactive bladder. Botox injections are even showing promise in helping to control chronic migraine issues.

Botox is a trademark name for a commercial medication comprised of a toxin called onobotulinumtoxin A. This drug is a purified version of the botulinum toxin which is a toxin normally produced by a bacteria causing botulism, a form of food poisoning. The toxin works to temporarily impair muscle contractions in the treated muscle.

The commercial drug Botox was the first drug to contain the botulinum toxin. Since the initial introduction of Botox, additional products have now become available on the market. The most commonly used are abobotulinumtoxin A (Dysport), rimabotulinumtoxin B (Myobloc) and incobotulinumtoxin A (Xeomin).

How it works

Botox injections work by blocking the neuromuscular signals that cause muscles to contract. The result is a temporary relaxation of the treated muscle group. This mechanism of action is what allows people to relax the facial muscles that cause wrinkles in and around the forehead and eyes. Hence the “cosmetic” uses for botox. Over time, by relaxing the muscles that contribute to facial wrinkles, the creases in the skin that make up the wrinkles will start to slowly disappear. This makes the skin look younger by helping to minimize the lines that come with aging.

Outside of the cosmetic arena, Botox injections has also had a significant role in the treatment of certain medical conditions. Some examples include:

  • Cervical dystonia: This is a medical condition whereby the cervical neck muscles involuntarily remain in a contracted position. This causes the head to turn or twist awkwardly resulting in the development of pain and discomfort.
  • Chronic Migraines: Botox has been shown to help decrease the frequency of migraine headaches in those experiencing migraines more that 15 days a month.
  • Muscle contractures: In those individuals suffering from paralysis or cerebral palsy, it is not uncommon to have neurologic conditions whereby limbs are contracted or locked in awkward positions. Botox has been successful in helping to relax these contracted muscles.
  • Hyperhydrosis: This is an unpleasant medical condition whereby the sufferer experiences an excessive amount of sweating even in the absence of warm temperatures. Botox has been successful in helping to temporarily minimize the sweating.
  • Bladder dysfunction: Botox has been helpful in decreasing urinary incontinence in those individuals suffering with overactive bladder issues.
  • Lazy eye: Lazy eye results from the imbalance in the ocular (eye) muscles that allow us to move our eyes. Botox can be used to alter this imbalance so that ocular positioning normalizes.
  • Eye twitching: Botox can be used to decrease the involuntary twitching that some individuals experience especially around the eye.
  • Tension Headaches: For some individuals, the grinding of the jaw muscles can result in periodic tension-like headaches. Botox can be used to help minimize these headaches.

Risks

When performed by an experienced medical provider, Botox injections are generally quite safe. On rare occasions, side effects can still occur which include:

  • Pain, swelling or bruising at the injection site
  • Drooping eyelid or pointy eyebrows
  • Dry eyes or excessive tearing
  • A tension-like headache or flu-like symptoms
  • A crooked smile or drooling

Botox is generally not recommended for use during pregnancy or in those individuals who are actively breastfeeding due to the unlikely possibility that the botulinum toxin somehow makes its way into the systemic blood stream. Should this occur, although extremely, extremely rare, the individual may experience:

  • Visual issues
  • Breathing problems
  • Trouble talking or swallowing
  • Muscle weakness
  • Bladder incontinence

Should the individual experience any such symptoms within a few hours to weeks of the botox injections, they should call their physician immediately.

What to expect

Botox injections are typically performed in a physician’s office. Topical anesthetic is sometimes applied to the treatment area especially when treating the palms of the hand or soles of the feet for hyperhidrosis. For the majority of individuals due to the nature and location of the injections, anesthetic is generally not required.

The actual procedure involves the use of a tiny needle to inject the botulinum toxin directly into the treatment muscle. The number of injections required varies greatly depending on the size and location of the treatment area. The larger the area, the greater the number of injections.

Immediately after the injections, the patient may or may not see little bumps at the injection sites depending on the location of the injection. It is also normal to sometime see a little drip of blood originating from the actual needle puncture sites. This bleeding normally stops within a few seconds to minutes.

Following completion of the treatment, the patient should not rub or massage the treatment area for at least 6-8 hours. They should also avoid laying down for at least the next 6-8 hours in order to prevent any excess toxin from working its way into surrounding muscles that the toxin was not originally intended for. Otherwise the person can return to normal activities after this period of time.

Results

Botox treatments can take from 1 day to up to 2 weeks to show their effect depending on the size and location of the treatment area. Most treatments last up to 3 months or longer but this is greatly dependent on the area being treated. Generally, the more active the muscle, the shorter the effect of the treatment. Regular treatments follow ups are required to maintain the desired results.

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