DEAR DOCTOR K:
Can you explain how Botox reduces lines and wrinkles?
“Botox” is short for “botulinum toxin.” Botulinum toxin injections were first used for cosmetic purposes in the late 1980s. Since then, this therapy has gained quite a following. In 2012, these injections were the leading nonsurgical cosmetic procedure in the United States among men and women in nearly all age groups.
Why is this treatment for wrinkles and frown lines so popular? Botulinum toxin injections are quite effective at temporarily smoothing a wrinkled face, brow or neck. Over time, they slow the formation of deeper, more permanent facial lines. They are relatively affordable; they have very few risks; and they require no recovery time.
Wrinkles and frown lines are caused, in part, by the tug of muscles beneath the skin. The tug causes smooth skin to form wrinkles and creases. Botox relaxes the muscles that are tugging on the skin.
Botulinum toxin is a protein produced by bacteria. If you ingest these bacteria in improperly preserved foods, or if they infect a wound, they can cause botulism. Botulism is a rare but potentially deadly disease.
Down with the frown
An injection of botulinum toxin can eliminate deeper lines and wrinkles around the forehead, between the eyebrows, at the corner of the eyes, and other locations. Botulinum toxin works by blocking the release of the neurotransmitter acetylcholine, which helps trigger muscle movement, from nerve cells.
Impairing the muscle movement allows the creases in the skin to smooth out and prevents the formation of new expression lines.
But when Botox is used for a cosmetic procedure, it is in small and harmless amounts. Tiny doses of sterile, purified botulinum toxin are injected into specific muscle sites. The solution doesn’t enter the bloodstream, and the procedure causes no harm. The amount used in a cosmetic treatment is far less than the amount needed to cause illness.
Botulinum toxin works by blocking the release of acetylcholine. This chemical messenger helps trigger muscle movement. By blocking acetylcholine in a few strategic areas, the toxin inhibits selected muscles from contracting. As a result, the muscles controlling facial expressions relax and creases in the skin smooth out. Because the muscle can’t contract, new creases don’t form. Here’s an illustration showing how botulinum toxin works.
Botulinum toxin injections take just minutes and don’t cause much discomfort. You may notice mild redness, minor headaches or occasionally minor bruising. The muscle-relaxing, wrinkle-reducing results usually last for about three or four months.
Many people worry that botulinum toxin injections will leave them with an unnatural expression or with frozen features. But when done well, these injections shouldn’t drastically change your ability to form facial expressions. In rare cases, injections near the upper eyelids or eyebrows may make them droop temporarily. But side effects are typically uncommon and minimal.
Following its introduction for cosmetic purposes, Botox also is being used to treat a growing number of medical conditions. All of these conditions involve muscle tension that can be relieved by Botox. Examples include overactive bladder, symptoms of an enlarged prostate, excessive sweating, tremors and other uncontrollable muscle spasms, and even migraine headaches.
You’ve heard the phrase, “Too much of a good thing can be bad”? Well, Botox teaches us that a very small amount of a bad thing can do good.