The use of botulinum toxin has increased in dermatology over the years and is currently the most common cosmetic procedure performed in the United States. In 2002, onabotulinumtoxinA was approved for the treatment of glabella lines (those lines formed when you frown in between your eyebrows). Though botulinum toxin is almost exclusively used for relaxation of the lines and wrinkles in the upper third of the face, it has been extensively utilized in many other anatomical sites off-label.
Clostridium botulinum is the bacterium from which Botox is derived-there are seven different types: A, B, C1, D, E, F, and G. They inhibit the release of acetylcholine (a chemical messenger [neurotransmitter] that assists in carrying signals across the nerve synapse) from the motor neuron, causing temporary paralysis of the treated muscles. Over time, new nerve terminals form which gradually restores motor function, and you can move the muscle again!
Botulinum toxin type A (Botox® Cosmetic, Allergan) is the most common type used in dermatology. The effects are generally noted 2-5 days after treatment, but sometimes can take 10-14 days for the full effect. Results with Botox® can last 2-5 months. Botox® is used for the treatment of dynamic wrinkles-wrinkles that occur when you use your muscles to form facial expressions. The key to a successful Botox® treatment is an understanding by the injector of the anatomy involved in facial expression. Having the patient frown, squint and raise the eyebrows before, during and after treatment helps identify the active target muscles and serve as a guide for proper placement.
Botox® is commonly used for glabella frown lines (those in between your eyebrows), horizontal forehead lines (the ones you see when you raise your eyebrows) and crow’s feet (squint lines). Botox® is also used for creases along the nasal side wall (bunny lines), mental crease (horizontal crease that rests between the lower lip and your chin) and depressor anguli oris muscle lines or as they are affectionately called the “DAO’s” (the lines formed by frowning of the lateral corners of the mouth).There are also many other uses for Botox® including hyperhidrosis (excessive sweating), migraines, blepharospasm (spasm of the eyelids), cervical dystonia (neck and shoulder muscle spasms), strabismus (crossed eyes) and bowel and bladder disorders.
Botox® has really proven to be a successful and valuable therapeutic treatment for a multitude of health issues. Although Botox® is a neurotoxin (makes it sound very scary!) it is perfectly safe, as long as it is safely administered by a licensed professional. Just think…a few days after it is injected, you will have noticeably smoother skin!
Dr. J – JODI LOGERFO, DNP, APRN, FNP-BC