Botox: The Bad, The Good, And The Really Bad!

March 01, 2021

Women receiving botox in the forehead

When most people hear the word “botox,” they are likely to think of Hollywood stars, Beverly Hills dermatologists, and expensive facial injections that promise to banish wrinkles and keep those famous faces looking forever young.

Maybe you’ve even thought of looking into having a botox injection done on your own face, as there is nothing wrong in wanting to look your best! And you would not be alone as, in the United State, the treatment of facial wrinkles with botox is the most popular cosmetic procedure performed, with over 7 million people undergoing the procedure in 2016.

But exactly what is botox? What is it made from, is it safe, and does it have any downsides? Let’s get a closer look.

The Bad

Botox is short for botulism toxin, as it’s derived from the bacterium Clostridium botulinum,and yes, your suspicions are correct. This is the very same toxin that causes the deadly illness botulism!

Most cases of botulism come from improperly canned food but can also be contracted through a contaminated wound. The C. botulinum bacterium is common in soil and in untreated water and can survive for long periods of time as a spore. The type of toxin the bacteria produces damages nerves and leaves them unable to communicate normally.

People who have botulism will experience paralysis, starting in the face and spreading to their arms and legs. If the toxin reaches the respiratory muscles, the person will become unable to breathe and if not promptly treated, will die.

The Good

Like many medicines that are dangerous if used incorrectly, botulism toxin has its place in modern medicine, not only to reduce facial wrinkles but also as a treatment for eyelid spasms caused by dystonia (a movement disorder), an overactive bladder caused by a neurological condition that does not respond to medications, as well as several other indications. But as specified earlier, the treatment of facial wrinkles remains its primary indication.

When the word “botox” is used, it should really be capitalized, because although theterm "botulinum toxin” is not under trademark the term “Botox” definitely is, as it’s a registered trademark of Allergan Labs. Actually, there are several companies that produce botulinum toxin and under various tradenames, but Botox is the one most people recognize.

Although many people request Botox injections for lines at the corners of the mouth and for reducing the “cobblestone” appearance of the skin on the chin, the FDA has only approved its use for two areas: for use around the eyes and on the forehead. The procedure is fairly straightforward and involves the clinician diluting the powdered botulinum toxin in sterile saline, then injecting it with a small needle into the neuromuscular tissue of the area to be treated.

The treatment effect is not instantaneous and usually takes 24 to 72 hours for the full effect to be seen. Occasionally in some patients, it can take up to five days for the full effect to be seen.

The results are not permanent and can be expected to last from 3 to 12 months when a repeat treatment will be needed, which of course adds to the expense of the procedure over time. In 2016, the cost of a single Botox treatment for frown lines or crows’ feet on the face was $376, according to The American Society for Aesthetic Plastic Surgery.

The Really Bad

Although side effects are relatively uncommon they are possible and include GI distress, numbness, headache, temporary drooping of the eyelid, dry eye, and even possible cardiovascular events, such as an irregular heartbeat and heart attack. Some people develop antibodies to Botox rendering any follow-up treatments ineffective.

Obviously, if you are considering Botox, you should find a licensed qualified professional with appropriate training in its use.

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