Botox (botulinum toxin) is a medication that induces muscle paralysis, and can be injected into the muscles to treat conditions like migraines, overactive bladder and TMJ.

Botox is often also injected for cosmetic purposes and facial rejuvenation, as it reduces the appearance of wrinkles and fine lines.

Botox is a neurotoxin that is produced by Clostridium botulinum bacteria and, therefore, its use should only be done if approved by a doctor, as inappropriate Botox injections are also associated with health risks.

How it works

Botox blocks nerve transmission by inhibiting the release of acetylcholine, a neuromuscular neurotransmitter.

Muscle injected with Botox essentially become paralyzed, leading to reduced muscle tension, twitching and spasms. This can help with symptom relief of specific neurological conditions, as well as improving the appearance of wrinkles and fine lines.

Botulinum toxin should be inbjected by a trained health care professional.

What it's used for

Botox can be indicated for medical or cosmetic purposes. it is most commonly used for:

1. Reducing muscle tension

Botox injections can help to manage, reduce or even eliminate muscle tension associated with conditions like

Chronic migraines
Overactive or neurogenic bladder
Involuntary contractions in the neck muscles;
Nervous tics;
Ocular strabismus;
Bruxism (teeth grinding)

In addition, Botox can be indicated for the treatment of excessive salivation, neuropathic pain, TMJ disorder or tremors from Parkinson's disease.

It can also be injected to help control spasticity from neurological diseases, like a stroke, cerebral palsy, or blepharospasm.

2. Facial Botox

Botox injected into the face can help to achieve cosmetic goals, like

Obtaining a more symmetrical smile
Reducing the appearance of the gums
Smoothing wrinkles and fine lines.

It can be injected in areas like the forehead, Crow's lines or around the mouth. Many may also use Botox preventatively, to reduce the development of premature aging in the skin.

However, Botox for cosmetic purposes should be injected a trained health care professional to reduce your risk for complications

3. Anal Botox

Botox can be injected in the anus by a gastroenterologist to help speed-up the healing of anal fissures. By promoting muscle relaxation in the sphincter, the fissure does not continue to tear and the skin can heal.

4. Botox for eyelid ptosis

Botox for eyelid ptosis can be recommended for treating mildly drooping eyelids, especially when the person does not wish to undergo blepharoplasty plastic surgery.

5. Excessive sweating

Botox can be injected into areas of the skin, like the palms, armpits, soles of the feet and face, to reduce excessive sweating, or hyperhidrosis. It works by blocking the nerve signals that trigger sweat glands to produce sweat.

How to prepare
To prepare for the Botox application, the doctor must make a complete assessment of the health status and determine the ideal amount to be used in the treatment so as to avoid adverse effects.

In addition, you should inform the doctor of the medications you use frequently, as it may be recommended to stop using anticoagulants a few days before to avoid excessive bleeding and bruising.

It is also important to keep the body hydrated by drinking plenty of water before and after the treatment.

How Botox is injected

Botox is injected by a dermatologist, plastic surgeon or trained health care professional in a clinical setting, with or without the use of topical anesthetics.

To inject Botox, the provider will typically follow these steps

The skin is cleansed with antiseptics in the area to be injected;
A topical anesthetic is applied, as necessary;
The areas to be injeccted are marked with a surgical pen;
Botox is injected intramuscularly into the intended areas.

Botox is injected in small concentrations, and effects are usually temporary. Further applications after a few months can be repeated to maintain the results.

What is the recovery like?

Recovery from Botox injection is quick and requires minimal care. The doctor will typically advise patients to avoid physical activity for at least 24 hours after the procedure and to avoid massaging the treated area.

With facial Botox, doctors may recommend patients to keep their head elevated and to avoid lying down in the first hours following the procedure,

How long does Botox last for?

The effects of Botox are temporary and duration may vary depending on the area treated. Its effects may last for up to 6 months.

After it has worn off, Botox can be re-injected, as approved by your doctor.

Possible risks

The main risks of Botox are bruising, swelling or pain at the injection site.

Facial Botox can lead to unintended effects, especially if inappropriately injected, such as drooping of the upper eyelid or eyebrow, arching of the eyebrows or decreased closing strength of the eyes.

Another complication that may occur is an allergic reaction to Botox or anaphylaxis, which requires immediate medical attention.

Botulinum toxin poisoning

Botulinum toxin poisoning, or botulism, can occur when large amounts of the Botox are injected.

This condition presents with symptoms like difficulty swallowing, hoarseness, slurred or slow speech, double vision, and paralysis appear.

Symptoms of botulism can appear 12 hours to 3 days after its application.

Contraindications

Botox is contraindicated in the following situations:

Allergies to botulinum toxin;
Allergic reactions after previous use;
Pregnancy or breastfeeding;
Infection at the site where it is to be applied;
Body dysmorphic disorder;
Amyotrophic lateral sclerosis myopathies.

Botox should not be administered to people with autoimmune diseases, as it is not known how the body will react to the substance.

Botox 101 (How It Works, What It's Used For & How Long It Lasts)