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Botox 101: Your guide to this wrinkle-erasing injectable

By Methodist Health System

By Sanders McEachern - Speakeasy Content Studio

Botox is best known as an injectable cosmetic enhancement that erases age-related wrinkles and crevices. However, you might be surprised to learn that many patients turn to Botox not only to smooth their skin but also to relieve pain or address a chronic health condition.

Whether you’re curious about the age-erasing powers of Botox or just interested in some of its other health applications, read on to get the facts about Botox along with questions to ask your doctor if you're considering this treatment.


What is Botox?​​

The Botox drug commonly used for cosmetic and therapeutic purposes in the United States is derived from a bacteria called Botulism toxin type A. This microorganism also causes the foodborne illness known as botulism. Due to the potency of the toxin from which it is derived, Botox does carry a few risks, so make sure you understand the possible complications that can arise from its use before choosing this form of therapy.

Uses and side effects of Botox

Two distinct versions of Botox have been approved by the United States Food and Drug Administration (FDA): Botox Medical and Botox Cosmetic. According to the National Institutes of Health, both forms of Botox work by isolating and paralyzing specific nerve and muscle groups in the body. Consequently, the drug should only ever be used in small, targeted doses.

Botox Cosmetic is an approved treatment to enhance the look of aging skin, smoothing and tightening areas where the march of time has been unkind to your appearance. It is most commonly used on frown lines between the eyes and along the forehead, crow’s feet, wrinkles and folds that develop around the mouth, drooping eyelids and other areas of the face and neck. This form of Botox is also approved for use in reconstructive surgery and cosmetic dentistry procedures — for example, to reduce the painful wear and tear on teeth associated with TMJ.

Botox Medical is FDA-approved to treat the following conditions:

  • Urinary incontinence and overactive bladder

  • Chronic migraine headaches lasting over four hours per episode or occurring on more than 15 days per month

  • Head and neck pain caused by muscle spasms related to cervical dystonia

  • Muscle spasticity and stiffness

  • Excessive sweating

  • Crossed eyes, excessive involuntary blinking and other eye muscle conditions

The results of Botox applications can last from three months a year, depending on the purpose and type of treatment.

Aside from pain, swelling or bruising at the injection site, known Botox side effectsinclude difficulties with swallowing or speaking and respiratory issues. Spread of the botulism toxin to other areas of the body is also a risk, and ignoring signs of an infection can have serious consequences. Symptoms of botulism poisoning can include muscle weakness, double or blurred vision and loss of bladder control. Botox treatment is not recommended for women who are pregnant or breastfeeding.

Questions for your doctor

Before undergoing any medical procedure or course of therapy, it's best to have accurate information about what to expect. In order to make an informed choice about whether a Botox treatment is right for you, ask your doctor the following questions:

  • What kind of improvement can I expect to see and feel from a single Botox treatment, and how long will the effect last?

  • How many treatments will be required in order to make further progress or maintain results?

  • Will follow-up visits be required during treatment, and if so, how often?

  • What are the potential short and long-term risks of Botox treatment?

  • Is there anything in my medical history that raises my chances of a negative reaction or result?

  • What are the possible side effects I can expect? Will they be temporary, or could they become permanent?

  • How will I know if my body is having a negative reaction to Botox? What are specific warning signs or changes I should look for?

  • How long is it possible to use Botox in this course of treatment or therapy? Are there any additional risks associated with a sustained treatment regimen?

The American Academy of Facial Plastic and Reconstructive Surgery also recommends that patients check the credentials of any physician or other health provider from whom they seek Botox treatment. It’s critically important to ensure that you’re dealing with a certified professional who is properly licensed and trained to administer this powerful drug, and who can recognize signs of a negative or life-threatening reaction.

Doctors and researchers continue to experiment with new uses for Botox, including its potential for treating acne, depression, anxiety, abnormal heartbeat and other conditions. Though none of those treatment scenarios are currently approved by the FDA, and most are being tested through clinical trials rather than with active patients, new possibilities for the drug remain intriguing.

Patients who would never think of visiting the doctor for lip wrinkles or crow’s feet may well become the majority of Botox users in the future. For now, knowing the risks and rewards of current treatment options can help you decide whether they’re a good fit for your health and beauty goals.

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