Revealing the secrets behind botulinum toxin (Botox)

Crow’s feet, frown lines, midlife crises. We associate Botox with ageing, most typically, but what is it really?

Botox is the word people typically use to talk about Botulinum Toxin, but in reality, Botox is one of the brands of the product, like Cadbury is to chocolate. Botulinum is a muscle relaxant which can be injected to treat various medical conditions and to smooth wrinkles in the face. It’s a hot topic that elicits opinions from everyone. Opinions aside, let’s look at some facts.

The lesser-known talents of botulinum toxin

Because botulinum toxin is a muscle relaxant, it was first used to treat various uncontrollable muscle spasms for those who suffer from:

• Blepharospasm (spasms of the eyelids)
• Strabismus (squint)
• Cervical dystonia (torticollis of the neck)
• The spasms caused by muscular diseases like cerebral palsy

Botulinum is also very effective at smoothing wrinkles by relaxing the muscles responsible for creating fine lines. It’s also a useful tool in helping to shape eyebrows into an arch, to correct facial symmetry, and to reduce crow’s feet and laugh lines.

Besides cosmetics, botulinum also treats localised hyperhidrosis very well, a condition in which a person sweats excessively. Hyperhidrosis can be very uncomfortable to live with.

Hyperhidrosis can worsen other uncomfortable conditions, like pompholyx (a kind of eczema on the hand) and benign familial pemphigus (a blistering-skin disease).

How does it work?

Research is being done to create a form of botulinum that can be applied topically, rather than being injected. At the moment, however, the procedure is still only available via the needle.

Botulinum is a muscle relaxant. If you’re having the treatment to smooth facial lines, it will take effect by relaxing the muscles that are responsible for frowning and squinting. It relaxes the muscles by preventing acetylcholine, (the “messenger” that moves between the muscle and the motor nerve terminals) from being released. 3 – 5 injections between the eyebrows is enough to relax it properly.

Over the course of the next week, the muscle will slowly weaken, most people won’t even notice it. Contrary to popular belief, you can still raise your eyebrows and blink as normal.

The treatment can be used multiple times, and its efficacy speaks for itself. Often, patients become aware of the habit of frowning or squinting for the first time after receiving the treatment. This is powerful because the treatment not only relaxes the muscle, but helps the patient to incorporate good habits going forward.

Botulinum used for hyperhidrosis is also delivered via the needle, at 1 CM intervals across the skin of the affected area. A local anaesthetic is used to numb the area making it fairly painless.

Is there a downside?

As with any medical procedure, there is always the possibility of side-effects. Botulinum’s possible side-effects are mild. Some patients experience a headache for a few hours following treatment. Paracetamol addresses this effectively.

For patients having treatment for lines and wrinkles, there is the possibility of developing ptosis, although it’s quite rare. This is when the botulinum gathers in the eyelid muscle, causing the eyelid to droop. It’s temporary, but nonetheless it can be bothersome. It is easily treated with iopidine or aproclonidine eye drops.

It is also possible to experience some minor bruising as a result of the injection, which will clear up quickly.

The general outcome is positive. Fine lines and wrinkles are smoothed, hyperhidrosis will be reduced or stopped completely, and muscular spasms are able to cease. Depending on your reason for seeking the treatment, the effects can last for as long as 3 – 6 months.

Some final good advice

Botulinum toxin plays an important role both in the cosmetics and the medical fields. The horror stories we see on TV only occur, because like any medication, botulinum needs to be handled with respect. Only qualified doctors should treat patients with it. The after-care considerations are also important. While you may generally continue with your day as usual, it is important not to touch your face, and definitely avoid facials. The correct care instructions will ensure the treatment is effective.

Dr Nokubonga Khoza has been successfully treating patients with botulinum toxin for the past seven years. She is passionate about addressing each patient as a whole person, starting with the skin. Book a consultation with Dr Nokubonga Khoza because you deserve the best care.