What is Botulinum Toxin?
Botstrium toxin is used on the market as Botox or Botox. The name Botulinum is derived from the Latin word botulus (sausage).
Botulinum toxin trademarks;
- Botox®️ (onabotolinumtoxinA),
- Dysport®️ (abobotulinumtoksinA),
- Xeomin®️ (incobotulinumtoxinA),
- BOTOX®️
Botulinum toxin is an injectable muscle relaxant.
How does Botulinum toxin (Botox, Botox) work?
Botulinum-A and Botulinum-B block nerve signals coming into the muscles. To contract, a muscle must receive signals from the peripheral nerve endings. These signals are neurotransmitter acetylcholine, which binds the receptors with muscle and initiates muscle contraction. Botulinum toxin inhibits the release of acetylcholine and thus prevents muscle contraction.
More specifically, botulinum-A and botulinum-B target a group of proteins called SNARE (specific NSF supplement protein receptor). The function of SNARE releases neurotransmitters from storage vesicles by helping fusion of vesicle membranes with the cell membrane. Since SNARE is also involved in the release of other neurotransmitters, botulinum toxins have additional effects. Usage requires botulinum toxin pain sensation by preventing glutamate and P release.
Eyebrow weakness typically work within two to four days and is approx. They renew the new effect. After about three months, a working link is reestablished between the nerve and the muscle. The reason is, together with an element of atrophy (loss of muscle) in injection. This incremental atrophy explains why the interval required for treatment for the second time may gradually extend after injections.
What are the differences between the different Botulinum-A (Botox or Botox) types?
There are three commercially available botulinum-A brands:
- Botox®️ (onabotolinumtoxinA)
- Dysport®️ (abobotulinumtoksinA)
- Xeomin®️ (incobotulinumtoxinA)
- Each form has a unique molecular structure, but it shares the same core elements of botulinum-A. Most research for cosmetic uses of Botulinum-A is based on onabotolinumtoxinA.
- It is important to note that there is no standardized international unit that can be used to compare or measure the amount of botulinum toxin administered. This means that the effect of one unit of Botox is different from one unit of Dysport. The approximate conversion factor is 1: 2.5 to 1: 5 between Botox and Dysport; and 1: 1 between Botox and Xeomin.
- Myobloc (rimabotulinumtoxinB) is a commercially available botulinum-B brand. Myobloc is mainly used in other medical specialties other than dermatology.
Can Botulinum-A (Botox or Botox) reverse the effects of aging?
The appearance of aging skin is caused by a combination of factors. Changing pigmentation of ritids (wrinkles) is caused by unnecessary loss of sagging skin and soft tissue. The rhythms arising from muscle movements are dynamic rites, and those that do not change with muscle movement are called static rites.
As an injectable muscle relaxant, botulinum-A is effective in the treatment of dynamic rites and is currently FDA approved for the treatment of rhythms occurring on the upper face.
Can Botulinum-A (Botox or Botox) reverse the effects of aging?
The appearance of aging skin is caused by a combination of factors. Changing pigmentation of ritids (wrinkles) is caused by unnecessary loss of sagging skin and soft tissue. The rhythms arising from muscle movements are dynamic rites, and those that do not change with muscle movement are called static rites.
As an injectable muscle relaxant, botulinum-A is effective in the treatment of dynamic rites and is currently FDA approved for the treatment of rhythms occurring on the upper face.
For the forehead lines
Horizontal lines along the forehead are caused by the contraction of the frontalis muscle. It is the facial muscle that occurs when you express this concern; hence it is called ‘lines of concern’.
Glabella lines
They are the lines formed vertically between the eyebrows. These lines are caused by the contraction of the procerus and corrugated cardboard supercilii muscles.
Wrinkle around the eyes
These are the horizontal lines formed in the outer corners of the eyes. These lines are caused by the contraction of the orbicularis oculi muscle.
Are there other approved uses for Botulinum-A (Botox or Botox)?
Another important use of botulinum-A in dermatology is the treatment of localized hyperhidrosis. Hyperhidrosis is a condition of excessive and uncontrollable sweating. Botulinum-A, injected into the skin of the axilla and palms, targets the eccrine sweat glands to prevent sweating. It is used to treat auriculotemporal syndrome.
Botulinum-A (Botox or Botox) is also approved for the following uses;
- Overactive bladder causing symptoms of urinary incontinence, urgency and frequency
- Prevention of Migraines
- Blepharospasm (abnormal contraction of the eyelid muscles)
- Cervical dystonia (painful spasms of the neck muscles)
- Focal spasticity (localized overactive muscle groups).
How is Botulinum-A (Botox or Botox) applied?
The facial muscle system of every person is unique; therefore, the approach to botulinum-A injection should be individualized. Before any treatment, any existing asymmetry should be considered.
Botulinum-A is mixed with sterile saline and stored in bottles that need to be regenerated. The mixture should be used within 24 hours to ensure that it does not get dirty.
It is recommended to apply with a thin needle (30 gauge). For the treatment of dynamic rites, exactly small (0.1 mL) injections are made into the muscle responsible for the facial contours. Generally, it can be expected to inject five different areas while receiving treatment for the upper face. Generally, a local anesthetic is not required. The exception is for the treatment of hyperhidrosis of the hands and feet, where injection into thick skin can cause a significant amount of discomfort.
In rare cases, the body’s immune system can respond to botulinum-A injections by producing antibodies that try to neutralize the effects of the toxin. The main risk factor for developing antibodies is injection frequency. Therefore, injections should generally not be administered more than once every eight to twelve weeks.
What are the contraindications to taking Botulinum-A (Botox or Botox) injections?
Botulinum-A is contraindicated in the following people:
- Pre-existing medical conditions that cause muscle weakness, including motor neuron disease (amyotrophic lateral sclerosis) and myasthenia gravis
- Infection covering the injection site
- Previous allergic or hypersensitive reactions to Botulinum-A.
- Botulinum-A should also be avoided during pregnancy and lactation.
- Some drugs that increase the effects of Botulinum-A should be avoided. These drugs include tetracycline antibiotics and aminoglycoside antibiotics.
- Blood thinners, including aspirin, warfarin and dabigatran, significantly increase the risk of bruising from the injection sites.
What are the negative effects of Botulinum-A injections?
The most common side effects of Botulinum-A include pain, bruising, swelling and redness at the injection site.
Treatment of keloid and hypertrophic scars;
Botulinum-A injected to paralyze the muscles under a healing wound can reduce wound tension in keloids and hypertrophic scars, which is an important determinant of the cosmetic result. Botulinum-A can also block nerve signals to help modulate pain, redness, and itching associated with keloid scars.
Treatment of facial erythema and redness;
Mixed results have been obtained in studies using botulinum-A to reduce facial redness associated with menopause and rosacea. May help treat erythema and redness.
Oily skin treatment;
Botulinum-A may reduce sebum production in the facial area due to its effects on the arrester battery muscles.
Treatment of postherpetic neuralgia;
Postherpetic neuralgia is a painful common complication of herpes zoster that persists after healing of the rash. Botulinum-A has been shown to significantly reduce pain by modulating nerve signals.
Raynaud phenomenon treatment;
Botulinum-A injections to the neurovascular bundles in the hands have been reported to reduce pain in Raynaud’s phenomenon, which is associated with excessive blood vessel narrowing when exposed to cold.
Treatment of conditions affecting skin folds;
Botulinum-A promised to heal these dermatological ailments by modifying skin folds to reduce maceration and infection caused by the moist environment. These conditions include hydradenitis suppurativa, benign familial pemphigus, and bending psoriasis.
