What is Botox®?
Botox® is the trade name for Botulinum Toxin A, a substance mainly used to reduce the appearance of wrinkles and fine lines. Although the effects are temporary, Botox® treatment is quick and straightforward and requires no down time, allowing patients to resume their daily activities straightaway.
The history of Botox®
Botox® dates back to the 1800s. Let’s take a quick look at its history:
- Botulinum Toxin owes its name to Justinus Kerner, a German poet and district medical officer, who published information of food borne botulism between 1817 and 1822. He described the bacterium as “sausage poison” or “fatty poison” having recognised it produced the toxin which grew in improperly handled or prepared meat products. On identifying the potential therapeutic uses for Botulinum Toxin he coined the name botulism from the Latin botulus meaning “sausage”.
- In 1895, a botulism outbreak after a funeral dinner with smoked ham, led Emile Pierre van Ermengem, a Professor of bacteriology at the University of Ghent, to discover the pathogen Bacillus botulinum (later renamed Clostridium botulinum).
- In 1928 P. Tessmer Snipe and Hermann Sommer isolated the Clostridum Botulinum Toxin for the first time.
- In 1949, Arnold Burgen's group discovered, through an elegant experiment, that Botulinum Toxin blocked neuromuscular transmission through decreased acetylcholine (a neurotransmitter in the autonomic nervous system) release.
- In the 1950s scientists conducted experiments and discovered that Botulinum Toxin could reduce muscle spasms.
- In the late 1960s Alan Scott, MD, an ophthalmologist, and Edward Schantz pioneered work on a standardised Botulinum Toxin preparation for therapeutic purposes. By 1973 Scott was actively testing Botulinum Toxin as a treatment for Strabismus (crossed eyes).
- In 1981 Scott filed a trademark for the neurotoxin Oculinum (number 1212107).
- By 1985, a scientific protocol of injection sites and dosage had been empirically determined for treatment of Blepharospasm and Strabismus.
- In 1988 Allergan further researched other medical uses of Botulinum Toxin.
- In 1989 Allergan introduced Botox®, the first Botulinum Toxin approved by the FDA to treat Blepharospasm (eyelid spasms), Strabismus and Hemi-Facial Spasm in patients over 12 years old.
- In 1993 while treating patients with Hemi-Facial Spasm at Southend Hospital in England in 1993, Khalaf Bushara and David Park were the first to show that Botulinum Toxin injections inhibited sweating.
- In 2000 the FDA approved Botox® therapy for Cervical Dystonia to reduce the severity of abnormal head position and neck pain – though it can become ineffective over time.
- In 2002 the FDA approved Botox® Cosmetic (onabotulinumtoxinA), the same formulation as Botox®, with dosing specific to moderate to severe frown lines between the brows.
- In 2004 the FDA approved Botox® for severe underarm sweating in cases where topical medicines don't work well enough.
- In 2010 the FDA approved Botox® therapy for increased muscle stiffness in elbow, wrist, and finger muscles with upper limb spasticity. Also in this year Allergan received FDA approval for treatment of chronic migraines.
- In 2012 European Urology journal published a study which found that Botox® injections into the bladder can effectively treat urinary incontinence.
- In 2014 a study was undertaken into whether Botox® could be used to treat patients with asthma with scientists concluding that further research and tests would need to be carried out.
Why is Botox® used?
How does it work?
Wrinkles such as frown lines, crow’s feet and forehead lines are generally the result of your muscles contracting. During treatment, a small amount of Botox® is injected into the muscle, causing the nerve signals which tell your muscles to contract to become blocked. This paralysing of your facial muscles helps to eliminate wrinkles.
How long before I see the effects of treatment?
It can take up to about four days before you notice the effects of Botox®, although you are safe to resume your usual activities around two to three hours following treatment. The full effect can be seen from one week after treatment with results lasting an average of three to four months. Top ups are not usually administered within this initial three month period, however, once the results start to wear off you may wish to return to have another treatment.
Are there any limitations?
As mentioned above, Botox® is used to treat lines and wrinkles caused by muscle contraction. For those who have fine lines caused by sun damage or facial skin sagging, Botox® will not be recommended as it has no effect. Those with heavier lines may need a few treatments to enjoy a maximum effect, although it should be advised that undertaking Botox® too often or in too high a dosage may cause your body to form antibodies, leading it to reject the treatment. You will be advised on the correct amount and frequency of treatment during your consultation.
Is Botox® suitable for everyone?
Although approved by the FDA (US Food and Drug Administration) for treating lines and wrinkles in those younger than 65, there are other contraindications for treatment. If you have a neuromuscular disorder, are taking certain antibodies and muscle relaxants, or are pregnant or breastfeeding then you will not be considered a suitable candidate for treatment. This is something which will be advised during your consultation.
From what age should I start using Botox®?
There are no tried and tested rules about when you should start having Botox® - there is no need to have the treatment before you notice the appearance of any wrinkles though. It is recommended that you book a consultation with a trained specialist prior to having any treatment. That way you can come to a mutually agreed decision about the best type of treatment for your needs.
Are there any side effects?
There are a few minor side effects of Botox® although they are only temporary. Patients may experience slight bruising, while one to five per cent of Botox® users may notice mild droopiness of the eyelid or brow, which returns to normal within two weeks. In order to ensure that the results of Botox® treatment are as you would expect, it is essential that you book treatment with an accredited specialist registered by the Care Quality Commission.
Will Botox® give me a frozen look?
When administered correctly, Botox® can smoothen out wrinkles and leave a patient looking younger and refreshed. The frozen look occurs when too much Botox® is injected into the treatment area – often the case when patients are treated by someone inexperienced or unqualified.
Does Botox® have other uses?
There are other uses for Botox® in addition to treating lines and wrinkles. At The Harley Medical Group, we also use it to treat patients with Hyperhidrosis (Excessive Sweating). This condition can cause the sufferer to become embarrassed easily and feel self-conscious – it may even affect their quality of life. Botox® works for this condition in a similar way to lines and wrinkles. The treatment blocks the signals your brain sends to sweat glands, preventing your armpits, hands and feet from sweating. The effects of Botox® for this purpose can last around eight months.