What is Botox?
Botox is the common name for botulinum toxin. It occurs naturally as a neurotoxin, but is also used in (aesthetic) medicine.
The name Botox is now used as a synonym for various products containing botulinum toxin. However, it is actually a trademarked brand name of a manufacturer.
Naturally occurring botulinum toxin
This is a neurotoxin secreted by the bacterium Clostridium botulinum that causes what is known as botulism:
These symptoms of poisoning are usually caused by eating poorly preserved foods (such as canned foods) in which the bacteria’s toxin has accumulated. It causes paralysis, including of the heart and respiratory muscles, which can lead to death. In the past, many deaths were due to botulism. Nowadays, patients can be treated with antidotes (antisera).
Botulinum toxin in medicine
What does Botox do in the body?
To excite a muscle, the associated nerve releases the transmitter substance acetylcholine. This causes the muscle to contract (contraction).
The effect of Botox is based on an irreversible inhibition of the release of acetylcholine. As a result, the muscle cannot contract – it is paralyzed for some time.
When is Botox used?
Botulinum toxin A – one of seven serotypes of botulinum toxin and the one with the strongest and longest effect – is very often used. The toxin is used in aesthetic medicine to smooth wrinkles.
On the other hand, botulinum toxin finds its medical application primarily in neurology: Common areas of application are movement disorders (dystonia) in which involuntary and abnormal muscle movements occur, such as torticollis. Botox treatment has also proven effective for eyelid spasm (blepharospasm).
In addition, Botox is effective against sweating: It prevents increased sweating (hyperhidrosis). Botox is also used to treat migraines, but may only be injected in chronic cases.
What is done during a Botox treatment?
Botox treatment consists of injecting the nerve agent (after disinfection of the affected skin area). This does not require anesthesia, and the patient usually does not need to be fasting for the procedure.
Before injecting the toxin, the doctor asks about the medical history and informs the patient about the possible complications and risks of the treatment.
Botox against movement disorders
When treating movement disorders, spasms or tremors, the doctor injects the botulinum toxin into the muscle that is to be paralyzed. Depending on the extent of the disease, sometimes several muscles have to be treated. In this case, the doctor must make sure that a certain total dose of Botox is not exceeded.
Botox against wrinkles
Botox is used to prevent the muscles from contracting, which should smooth out expression lines, for example. Especially to smooth the frown lines in the forehead area, many people choose Botox.
Botox against sweating
Botulinum toxin A therapy is considered one of the most effective treatments for excessive sweating. As the toxin inhibits the release of acetylcholine from the nerve cells, the sweat glands are no longer stimulated to activity – the patient sweats less. Incidentally, the same principle can help with increased salivation.
Botox against migraine
For people with chronic migraines, the doctor injects botulinum toxin into at least 31 sites in the muscles of the head, neck and shoulders. Muscular relaxation and other anti-inflammatory processes can relieve symptoms and prevent further migraine attacks.
How long does the Botox effect last?
An exact prediction of how long the Botox effect will last cannot generally be made, as the toxin is broken down at different rates. In addition, in rare cases the body forms antibodies against it, whereupon it is broken down more quickly.
What are the risks of Botox?
Too high a dose of botulinum toxin can lead to dysphagia, dry mouth, headaches, nausea or even a severe restriction of facial expressions.
If the toxin enters the bloodstream, an antiserum must be given immediately. Until the antiserum takes effect, the patient must be ventilated because the toxin paralyzes the respiratory muscles.
What must be considered during Botox treatment?
In most cases, therapy using Botox injections can be performed without any problems. However, the procedure must not be used in neuromuscular diseases such as myasthenia gravis, Lambert-Eaton syndrome or amyotrophic lateral sclerosis (ALS).
There are also other contraindications to Botox: pregnancy, breastfeeding, and an allergy to the bacterial toxin or one of the other components of the injection solution.
If discomfort or a feeling of weakness occurs after treatment with Botox, a doctor should be consulted immediately.
