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Commonly asked questions about Botox®
What
is Botulinum toxin A?
Botulinum toxin A (also
known by the manufacturers’ brand
names Botox® and Dysport®) is a
purified form of one of several protein
toxins produced by the bacterial species
Clostridium botulinum.
When released generally in the body during
an infection caused by this bacterial species,
the toxin is a potent nerve poison.
However, it has medicinal uses and when
used appropriately, in tiny doses and injected
carefully into specific areas, it has many
uses spanning various branches of adult
and paediatric medicine and surgery - all
without harmful side effects.
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How
do Botox® or Dysport® work?
By blocking the release
of a substance called acetyl choline from
certain types of nerve ending. One
example of the type of nerve transmission
blocked is that between a nerve and a muscle,
and another is that between a nerve and
certain sweat glands. In this way,
for as long as the toxin has an effect,
muscle or sweat gland function is inhibited.
The duration of action for Botulinum toxin
A varies from person to person, and according
to how many times an individual area has
been treated, but it will usually last between
four and six months.
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What
are the cosmetic uses of Botox® or Dysport®?
There are several cosmetic
uses: most commonly in the treatment of
certain types of skin wrinkles, but also
to equalise facial and brow asymmetry and
to deal with embarrassing under arm perspiration.
- Wrinkles that appear
when the muscles responsible for facial
expression contract and pull on the skin
can be treated very effectively using
Botox® or Dysport®. Wrinkles which
are commonly treated to good effect with
Botox® or Dysport® injections
include transversely-orientated forehead
wrinkles; vertical, mid forehead “frown
lines" and "crows’ feet"
around the eyes.
- Every face is slightly
asymmetrical when left and right sides
are compared. In some people this is readily
noticeable, but can be treated using injections
of Botox® or Dysport®, rather
than resorting to surgery.
- Also the nerves
which stimulate the release of the underarm
sweat associated with body odour can be
blocked using injections of Botox®
or Dysport®
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Who
should not have treatment with Botulinum
toxin A?
Patients who are pregnant,
trying to become pregnant or breast-feeding
should not be treated.
Anyone suffering from a neuromuscular disorder,
such as Myasthenia Gravis or Eaton-Lambert
Syndrome, should not be treated.
Certain medications (for instance quinidine
and amino glycoside antibiotics) interact
with Botulinum toxin A so you must tell
me if you are taking any medication. We
must discuss it if you are taking aspirin,
non-steroidal anti-inflammatory pain killers
and drugs like warfarin, which affect blood
clotting, because they will make you prone
to bruising after injections.
Otherwise, there are few restrictions on
treatment with Botulinum toxin A. In general,
healthy individuals, without underlying
health problems, aged 18-65, with cosmetic
problems amenable to this treatment are
very happy with their results.
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What
is involved in treatment?
I numb the skin and
then inject a very small volume, very precisely,
into several areas in the region being treated.
I use a tiny needle similar to that which
diabetic patients use to inject themselves
with insulin on a daily basis.
Because the skin is numbed, the needle is
so fine and only a small amount is injected
each time, there is minimal pain associated
with these injections. You will feel a stinging
sensation for a few seconds. No sedation
or local anaesthetic is required and you
can resume normal activities immediately.
You should avoid alcohol for at least two
hours after your treatment since drinking
increases the circulation in the skin your
face and so might theoretically wash the
Botox® or Dysport® into unwanted
areas causing side-effects.
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What
should I expect from this treatment?
It takes two days for
Botox® or Dysport® to have an effect.
The effect lasts between four and six months
' possibly longer after several treatments.
Effects last different periods in different
areas, with patients noticing longer durations
of action on vertical forehead wrinkles
and less on wrinkles around the mouth.
Results will vary according to your skin
type, biology and environmental factors
(cumulative sun damage and years of smoking).
Elderly patients with wrinkles which have
been etched into their skin during a life
spent smoking and sun-bathing will still
have permanent lines in their skin at the
site of the wrinkles, even after the action
of Botox® or Dysport® has removed
the dynamic wrinkle however, these may be
amenable to improvement with fillers
or after skin
re-surfacing. Generally speaking, the
younger you are when you start having treatment
with Botox® or Dysport®, the better
your chances of preventing wrinkles from
forming.
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How safe
is treatment with Botox® or Dysport®?
This is a very safe
treatment with any unwanted side effect
limited only to the duration of action of
the Botox® or Dysport®.
When used in the forehead, there is a potential
risk of an upper eyelid becoming droopy
after injections. This has been recorded
in less than 0.5% of treatments and generally
to those who are predisposed to this happening
because they suffer from neuromuscular disease,
which is something I will seek to exclude
during your assessment.
Occasionally, a patient develops a bruise
after injections, but to a degree that can
be concealed easily with make-up.
Some patients have described mild headaches
after injections.
Botox® is a registered trademark of
Allergan
Dysport® is a registered trademark of
Ipsen-Biotech Laboratory
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