In present-day medicine, botulinum toxin injections (known under brands Botox (Allergan), Dysport (Galderma), and Xeomin (Merz), are widely used for various cosmetic procedures. Many people have developed an association of Botulinum toxin injections only with the reduction of wrinkles and achievement of a youthful look. However, medical cosmetology is just a small niche of what botulinum toxin is able to do. It is very versatile and can be essential in different conditions like migraines, spasticity, blepharospasm (eye twitch), and hyperhidrosis (extensive sweating underarms).
In microbiology, botulinum toxin is known as “Miracle poison” and is considered one of the most poisonous biological substances to a human body. It is a neurotoxin that is produced by the anaerobic gram-positive bacterium Clostridium botulinum. Even though the C. botulinum has eight different 8 strains, ranging from A to G, only A and B are used in medicine. The general mechanism consists of neurotoxin blocking the release of acetylcholine at the neuromuscular junction. As a result, muscles are unable to contract and muscle paralysis occurs. Besides blockage of acetylcholine release, botulinum toxin is also able to block the release of pain, glutamine, and substance P (inflammatory mediators). For this reason, botulinum toxin injections are used for patients who suffer from migraines.
30-gauge 1-inch needle is used for injecting botulinum toxin into affected areas. The amount of dosage depends on its purpose and is unique to each patient. Moreover, the mass of muscle where neurotoxin will be injected also determines the given dosage. Generally, the greater the muscle mass, the greater amount of dosage is. The exception applies when a patient has pre-existing medical conditions – under those circumstances, the dosage must be reduced.
After receiving neurotoxin, it is suggested to go home and rest. Strenuous activities are not recommended for the first few days. Some of the adverse effects after neurotoxin injection may include swelling, bruising, minor discomfort, and muscle weakness of the surrounding muscles.
In the 1970s, scientists began using botulinum toxin as a treatment method for strabismus (“crossed eyes”) which is a condition of one looking directly at the viewing object while another eye is misaligned either inward, outward, or downward. The clinical trials showed positive results of botulinum toxin being able to reduce wrinkles in the glabella (the skin between eyebrows and above the nose area).
Nowadays, the usage of botulinum toxin plays a significant role in current clinical applications. This biological substance helps to manage hemifacial spasms, strabismus and focal dystonias, and other spasmic disorders. Moreover, it also helps to reduce migraines and hyperhidrosis. Lastly, in the cosmetological niche, the neurotoxin is used in correcting lines, wrinkles, and creases on the face, chin, and neck.
