Botulinum Toxin: Effects, Uses & Risks

Botulinum toxin is a neurotoxin that has been successfully used as a drug in neurology for many years. However, botulinum toxin has become generally known as Botox, the active agent against expression lines. What exactly is botulinum toxin? And how is botulinum toxin applied?

What is botulinum toxin?

Botulinum toxin is a neurotoxin that has been successfully used as a drug in neurology for many years. However, botulinum toxin has become commonly known as Botox. Botulinum toxin is a neurotoxin – that is, a toxin that acts specifically on nerve cells. Botulinum toxin occurs in nature and develops under low-oxygen conditions, especially in the soil. However, meat products such as sausage or canned sausage were also frequently affected by botulinum toxin in the past. This is where the name of the toxin comes from, which is derived from the Latin word “botulus” for sausage. The consumption of food contaminated with botulinum toxin, especially in the 19th century, not infrequently led to a serious nervous disorder, botulism. This is because botulinum toxin inhibits the signal transmission of nerve cells and thus leads to muscle weakness and even to the suspension of lung function. Thus, botulinum toxin is considered one of the strongest poisons. As early as 1822, the possibility was recognized that botulinum toxin in small quantities could be used as a drug against nervous disorders. However, it was not until the 1970s that botulinum toxin was first used as a drug to treat “strabismus”. Since then, botulinum toxin has been used to treat various nervous disorders. For some years now, botulinum toxin has been increasingly used in aesthetic-cosmetic medicine. Here, botulinum toxin serves as an effective agent against facial wrinkles under the better known term “Botox”.

Pharmacological effect

If botulinum toxin enters the body, the transmission of excitation from nerve cell to muscle is restricted. The muscle can only be moved to a limited extent or not at all, depending on the dosage of the nerve toxin, and relaxes in this way. In a medical treatment, botulinum toxin is injected specifically into the corresponding part of the body. Tiny amounts of the highly toxic botulinum toxin are used. In the muscle, botulinum toxin causes the messenger substance acetylcholine, which is responsible for the transmission of nerve impulses, to be blocked. Due to the low dose and the targeted application, only the desired muscle is affected. It can no longer tense as usual, while sensory perceptions such as feeling and touch are not affected. Depending on the medical purpose for which botulinum toxin is used and in what quantities, the effect, which builds up slowly, reaches its peak after about ten days. After that, the nerves begin to recover and the effect of the botulinum toxin wears off before it can no longer be felt or seen at all after six months at the latest. Depending on the desire, need or necessity, a new treatment with botulinum toxin is now carried out.

Medical application and use

Botulinum toxin finds its medical application primarily in neurology. Here, it is primarily used to treat certain movement disorders. For example, patients suffering from spasms such as eyelid spasm, oral spasm, tongue spasm, pharyngeal spasm, writer’s cramp, or vocal cord spasm can be treated with botulinum toxin. Spastic syndromes such as the pointed foot or spasms that occur after a stroke can also be treated with botulinum toxin. This can result in a significant improvement of the disorders. In many cases, such as eyelid spasm, even a temporary complete disappearance of the unpleasant nerve disorder is possible. However, botulinum toxin only acts against the symptoms and must therefore be injected again as soon as the effect has worn off. Botulinum toxin is also used to treat complaints such as migraine, increased salivation and heavy perspiration under the armpits. The most widespread treatment, however, is the so-called “Botox treatment” with botulinum toxin. After the wrinkle-reducing effect following an injection with botulinum toxin was proven in the early 1990s, botulinum toxin has enjoyed great popularity since its approval for the cosmetic sector in 2001.When a suitable, small dose of botulinum toxin is injected into the muscle under an expression line, the muscle relaxes, causing the skin overlying it to smooth out.

Risks and side effects

Side effects of botulinum toxin mainly concern overdose, which must be avoided at all costs. Because botulinum toxin is a very powerful neurotoxin, an incorrectly administered injection can cause serious nerve damage. In addition, botulinum toxin must not be allowed to enter the bloodstream under any circumstances. Patients who have undergone “Botox treatment” have sometimes complained of eyelid spasms, eye disorders and dry mouth as side effects. Furthermore, botulinum toxin as an agent against facial expression wrinkles can lead to restrictions of the facial expression if the injections are not placed in a targeted manner, resulting in a mask-like effect. In principle, the medical treatment with botulinum toxin should emphasize the experience of the doctor, and it is also important to place oneself in knowledgeable hands when undergoing a cosmetic procedure with botulinum toxin.