Botox

A New Use for an Old Poison

Botulism is caused by a bacteria called Clostridium botulinum. C. botulinum lives in soil and marine sediment and can appear on fruit, vegetables, and seafood. It can also be found in unprocessed honey. In the days when people did home canning of fruits and vegetables, botulism was a risk if the food wasn't prepared correctly.

C. botulinum releases a poison called Botulinum Toxin Type A. If a person eats food containing the poison, he or she can become seriously ill. The poison paralyzes muscles, including the muscles needed for breathing. Without medical support, botulism can be fatal.

In very small doses, however, botulinum toxin can be a useful medicine. Doctors have figured out how to refine the poison so it can be targeted to individual muscles without causing disease in the rest of the body.

Medical Uses

The Discovery

Botox was first approved for use in treating two different eye problems. Both involve problems with the eye muscles. Strabismus is a misalignment of the eyes, in which the two eyes don't move together. Blepharospam is uncontrollable blinking or eye closing. When injected into specific, tiny muscles near the eyes, botox can help relieve the blinking or allow the eyes to realign.

For Wrinkles

The drug's cosmetic use began as a sort of side effect. Doctors using it for strabismus and blepharospasm noticed that their patients had fewer wrinkles around the eyes after treatment. Since 2002, botox has been approved by the FDA as a wrinkle treatment.

Other Problems Botox Treats

The drug can also help with dystonia, a severe contraction of muscles in the shoulder and neck. In people with cerebral palsy, it can relieve muscle contractions that interfere with movement. Used on the underarms, it can help people who sweat excessively.

Why Botox Works For Wrinkles

Wrinkles form for a variety of reasons, including genetics. However, muscles do have an important effect. Muscle contractions can exaggerate certain wrinkles, including "frown lines" between the eyes and "worry lines" on the forehead. It's also possible that habitual facial expressions contribute to wrinkles.

Botox helps smooth out wrinkles by weakening or paralyzing tiny facial muscles. When it's used correctly, the only muscles affected are the ones which deepen wrinkles. Facial expression may be affected, but it should not be very noticeable.

How It's Done

It only takes a small amount of this medicine to have an effect. In fact, a 100 unit vial contains just a tiny trace of powder, but that can be enough for an entire treatment.

The medicine should always be administered by a doctor who has experience using this drug. During the process:

• The doctor will dilute the powder using sterile saline.
• S/he will then draw up the correct dose into a small needle.
• Which muscles s/he will inject depends on the location of wrinkles being treated.
• In each treatment area, the doctor will use only a small dose of the diluted drug.
• Treatment takes just a few minutes, and no recovery time is needed.
• Your doctor may take "before" and "after" photographs to help guide future treatments.

Botox is officially approved in the U.S. for frown lines between the eyebrows. Doctors also use it "off-label" for other wrinkles, including lines on the forehead and around the mouth.

How Long It Lasts

It takes a few days for the effects to appear and about a month to reach the peak effect. The treatments usually last for four to six months, with the wrinkles returning gradually.

Over time, treatments may begin to last longer. One reason is that the treated muscles become weaker with disuse.

Side Effects

Like any medicine, Botox injections can have adverse effects ranging from mild to serious. Some of the most common are:

• Bruising at the injection site.
• Inability to close the eyes fully or to move affected facial muscles, which lasts until the drug wears off.

It's possible to be allergic to Botox, especially if you've ever had botulism. Be sure to discuss your medical history, including any allergies or adverse reactions, with your doctor.

Safety

Botox is very expensive. Sometimes, cheaper versions are offered by online pharmacies or other "underground" sources. However, botulinum toxin can be very dangerous if not properly prepared. In high doses it can even cause botulism. In addition, imitations may not have been prepared under sterile conditions. And in some cases, the discount vial may not even contain the correct drug at all.

It's always best to obtain this medicine from a licensed pharmacy and to have this skin treatment done by a trained medical professional.

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