Everyone has an opinion on Botox these days (we love it!). But this also means that there's a lot of misinformation around 'tox treatments.

Part of our mission is to address those common misconceptions so our patients feel informed and confident in their skin care treatments. So, what is Botox? How does it work? And is it really made out of botulism?

If you're looking to separate fact from fiction, we got you! Consider this your comprehensive Botox primer. Let's get real about all things Botox — its many uses, safety and potential side effects. 

First things first — what is Botox?

The basic concept behind Botox is also part of what makes it so controversial, so let’s just get that out of the way.

Yes, Botox is a derivative of the same bacteria that can cause the disease botulism. 

Known as Clostridium botulinum, the bacteria is most commonly found in contaminated foods or the soil. In large enough quantities or if allowed to enter into an open wound, Clostridium botulinum can develop a severe nervous system disorder known as botulism.

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However, it’s how Clostridium botulinum impacts the nervous system that really interests the cosmetic dermatology industry. We've taken that neurotoxic ability and filtered out a specific type of the bacteria (known as type A) and developed it into the medical injections we know as Botox (as well as Dysport). 

That means that Botox is also characterized as being a botulinum toxin injectable. But don’t the name scare you…it's proven safe and typically has minimal to no side effects. 

How does Botox work?

When injected into the muscles under the skin on the face, Botox treatments get to work using neurotoxic potential. Even the small amounts of Botox that are used in cosmetic procedures can cause paralysis of those muscles, which is the goal of treatment.

The same method of action that allows botulism to paralyze the muscles of the respiratory system (which is part of what makes it such a scary disease) is also what helps it block the nerve signals that are sent to the muscles where we inject it.

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It’s a common misconception that Botox injections erase or completely get rid of wrinkles, like crow's feet or 11s. Instead, injections like Botox simply relax those wrinkle-forming muscles.

The wrinkles that occur on the face result from the repetitive movement of the muscles under the skin. There's nothing that you can do to “get rid” of wrinkles. But you can use Botox to stop those muscles from continuing to contract, which allows the skin over them to relax and reduces the appearance of those lines.  

Out of the estimated few million people who get Botox injections each year, the majority state that they're very satisfied with their treatment and results. 

Is Botox safe?

Generally speaking, there's always a risk associated with any cosmetic procedure. But the risks that come along with Botox (including that of botulism) are incredibly low.

Instead of coming into contact with Clostridium botulinum in the wild, the cosmetic version has been created in a lab. Even though it's made with the same type of bacteria, it's sterilized and diluted down so much that there's minimal risk of catching botulism from a controlled environment.

However, there are a few side effects of Botox that may occur. In most cases, such symptoms resolve within a day or two and are very mild in nature:

• Flu-like symptoms
• Neck discomfort
• Tiredness
• Dizziness
• Headache
• Dry mouth and eyes
• Eye redness or irritation
• Temporarily drooping eyelids (known as ptosis)
• Upset stomach

In very rare cases, botulinum toxin overdose may occur. The symptoms of overdose include trouble swallowing, trouble breathing, muscle weakness, hoarseness, blurred vision, loss of bladder control, double vision and loss of voice. 

Side effects like itchiness, wheezing, rash or asthma symptoms may be signs of an allergic reaction to Botox. If you experience any of these severe side effects, seek medical help immediately.

What is Botox used to treat?

Of all of the botulinum toxins out there, Botox is by far the most studied and diverse in its treatment abilities. 

It’s most widely known for its use for cosmetic issues. Specifically, Botox is used to reduce the appearance of fine lines, wrinkles and creases on the face, including:

• Crow’s feet lines: the wrinkles around the outside corners of the eye 
• Glabellar lines: frown lines/forehead lines, or the “11s” between your eyebrows
• Bunny lines: the crinkles around the nose

However, it's also been approved for a variety of other medical issues, such as:

• Overactive bladder
• Urinary incontinence
• Chronic migraine
• Cervical dystonia (an involuntary contraction of the neck muscles)
• Strabismus (abnormal eye alignment)
• Blepharospasm (eye twitching)
• Spasticity
• Excessive sweating (hyperhidrosis) + severe underarm sweating

It’s important to note that Botox can help with all sorts of wrinkles resulting from repetitive facial muscle movement. However, it isn’t effective against wrinkles that result from gravity or sun damage. 

Essentially, this comes down to the concept of static versus dynamic wrinkles. Static wrinkles are the type of wrinkles that remain in place even with an unmoving face. Dynamic lines, on the other hand, are more noticeable when the face is in motion.

How does the Botox procedure work?

While different clinics have their own protocol, here's a little insight into how the Botox process works at Skin Pharm. 

When you first come in for a consultation, we’ll talk to you about your skin goals and recommend ways to help you reach them. If that includes Botox, we’ll decide how many units of Botox you'll need. 

Our goal here is to create natural, never overdone results — you'll simply look like the best version of yourself! 

You’ll also want to come prepared with a list of all of the medications that you’re currently on, as well as any underlying health conditions. This will help ensure the treatment is safe and goes as smoothly as possible. 

The treatment continues until all of the areas have been treated, which usually takes under an hour. After the procedure is over, you may temporarily see swelling or redness at the injection sites. 

However, those symptoms should go away within an hour or so after your appointment. We recommend that you avoid touching the treated areas for at least 4 hours afterward, as well as hold off on working out or lying flat. 

When will I start to notice results?

The results that you can achieve from Botox injections won’t start immediately. Because of the way that Botox works and how long it takes for the neurotoxin to really settle into the muscle and take effect, most people state that they first start to notice results around three to five days after their injections are complete. 

After about two weeks, however, you’ll be able to see the full benefit of the injections. Those results last up to three to four months. 

Planning on getting your injections every three to four months will help prevent wrinkle rebound and keep your skin looking as smooth as possible for as long as possible.

As the Botox begins to wear off, you’ll notice the muscle movement slowly start to return as well. However, with each set of injections, the wrinkles will start to get smaller and smaller. That’s why people choose to keep coming back for more!

Who shouldn’t get Botox?

While Botox is relatively safe for most people, there are a few who should avoid it.

For instance, Botox is not considered safe for anyone who is pregnant. While no research has proven this to be bad, there haven't been extensive studies around it. 

The same goes for people who are breastfeeding. It’s unknown if Botox will pass into breast milk when you nurse. Until further studies are performed, though, it’s best to avoid it for the safety of your baby.

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Studies have shown that Botox may be safe for treating certain medical conditions, like dystonia, which is the involuntary muscle contractions of the neck.

It is important to avoid Botox within two weeks of taking NSAIDs, blood thinners, sleep medicine or OTC medications. This will help avoid bruising and speed up the healing process.

To sum it up...

Skin Pharm offers both Botox and Dysport injections to help you achieve a natural look — you’ll still look like yourself, just the most refreshed version! We want you to feel confident and comfortable in your skin, and it's an honor to be part of that process. 

Sources:

Botox (onabotulinumtoxinA) FDA Approval History | Drugs.com

The Botox Lowdown: Science, Safety, and Success | USC Viterbi School of Engineering

Botulinum toxin type A therapy during pregnancy | PubMed