What You Need To Know About Botox

What Is Botox?

Botox (onabotulinum A toxin) is a drug that is produced from a protein, also a neurotoxin, from the bacterium Clostridium botulinum. This toxin and its role in the nervous system was identified due to the illness botulism. In cosmetics and medical practice, the protein is purified and used in Botox ® used in medicine since the 1970s. During the last 20 years, Botox has been increasingly exploited and is widely used in dermatology, in addition to the treatment of medical conditions such as migraines and excessive sweating. There are other brands of Botox-like treatment containing the same neurotoxin protein, such as Bocouture.

How Does Botox Work?

Botox works by blocking the activity in the local muscles by preventing the release of neurotransmitter, acetylcholine, at the nerve synapse. Loss of acetylcholine in the neuromuscular junction results in flaccid paralysis due to the prevention of muscle contraction. The result is a more relaxed expression, and it is the weakening of the selected muscle that induces a smoother and flatter appearance in the overlying skin. For this reason, Botox is frequently used to relax facial muscles and reduce facial wrinkles, inducing a more youthful appearance. An experienced clinician will use a tiny needle to inject the Botox into the striated facial muscles. Subsequently, the clinical effect of Botox is usually observed a number of days, post-injection.

Why Would You Have Botox?

The skin is the largest organ of the body and is exposed to both internal and external ageing factors. Skin ageing is characterised by wrinkles, loss of elasticity and lessening of smoothness in appearance. Internal ageing results from decreases, for example, in collagen and elastin, proteins that support the skin structure, whilst, external factors can include smoking, in particular, this can produce lines around the mouth.

In dermatology, the site of the Botox injection is generally the muscles responsible for facial expression, that over time can lead to a tired, disapproving or aged appearance. This results in the formation of lines, creases and/or wrinkles. Aesthetically, treatment with Botox has plentiful applications, including reducing the appearance of lines, wrinkles, folds and/or creases positioned: between the eyebrows (glabellar frown lines), horizontally on the forehead, side of the eyes (crow’s feet or laughter lines), neck and chest/cleavage (turkey neck), nasolabial folds around the mouth and nose; in addition, Botox can be used to raise the eyebrows.

How Long Does Botox Last?

The optimal results from Botox can be seen within approximately 2 weeks, although, the effect of the Botox can be observed for 3 to 6 months [1]. The efficacy is dose-dependent and will vary between individuals due to muscle arrangement and the frequency of Botox treatment. Periodic re-treatment of Botox is necessary to maintain the effects of wrinkle reduction. In some cases, the effects of Botox will gradually lessen, resulting in reduced efficacy in muscle paralysis over time. Your practitioner at Omniya Clinic London will provide expert treatment guidance in this regard.

There is strong scientific evidence in support of the successful use, efficacy and tolerability of Botox ® in glabellar frown lines. Trials also confirmed that many subjects that have had Botox respond better after a second or a third treatment session. It is important to have realistic expectations in relation to the results to be expected. However, it is generally accepted worldwide that Botox treatment does produce a noticeable improvement in the appearance of the skin, with rejuvenation and anti-ageing effects seen by individuals that have sought Botox treatment by expert clinicians.

How Does Botox Compare To Dermal Fillers?

Both Botox and dermal fillers involve injections; however, this is where the similarity ends. In contrast to the relaxing effect that Botox has on muscles, dermal fillers involve the filling of small lines, wrinkles, creases and folds. The dermal filler treatment involves injections that are given just beneath the skin surface and contain products that aim to add fullness to areas that may have become thinner. Dermal fillers treatment may also be sought for personal aesthetic preference. The products used will frequently contain molecules that are known to have anti-ageing or skin-plumping effects, and the products contained in the treatment will determine the outcome of the results.

Areas for dermal filler treatment commonly include around the cheeks, the mouth or lips, and the increase in volume in the selected area can produce a more youthful appearance due to the restructuring and volumising effect of dermal fillers.

The choice between Botox and the dermal fillers will be dependent on the desired result, cost and suitability. The cost of dermal fillers can be more than Botox; however, the effects may last longer. Your practitioner at Omniya Clinic London will provide professional advice and expertise to aid in the decision-making process.

Does Botox Hurt?

Botox is administered via injection, and therefore, some pain can be expected. Fortunately, the needles are particularly small, and this minimises any discomfort that may be felt. There is also the option of topical anaesthetic cream application to numb the area of treatment should this be required. The discomfort is not enough to prevent people from coming back for future treatments.

Is Botox Safe?

The Botox frequently used in cosmetics, is relatively safe and does not produce any permanent nerve or muscle damage [2]. Like any medical procedure, it does not come without risks; however, it is rare, and a full assessment will always be performed by the aesthetic practitioner prior to treatment. A clinical assessment will help to identify any contraindications or potential allergies to treatment ingredients. Contraindications may include those on certain medications, such as anticholinesterases and so full disclosure is recommended.

Whilst considered safe, at the site of the injection, there may be bleeding, swelling and/or pain, although this should not be persistent. Some experience headaches, should this be the case they can be treated with standard analgesics. It is prudent to be aware that treatment with Botox will affect muscle action in the target area, this is necessary due to the underlying principle behind the effectiveness of the treatment, and so it may affect sensation in the target area and/or alter particular expressions. This is not an undesirable effect but may feel unusual to start with.

Who Can Have Botox?

If you are over 18, you can have Botox. It is not advisable to have treatment if you are suffering from any illness, a skin infection, are breastfeeding or pregnant, or suffer from a neuromuscular condition.

Limitations To Botox

Due to the specific mechanisms of action, Botox it is not an effective treatment for wrinkles and creases that have not been caused by muscle contraction; therefore, damage to skin that results from sun damage will not be addressed .

There are alternative options for sun and other environmental-induced skin damage and these include Dermatologist prescribed treatments, Microneedling, IPL, Platelet Rich Plasma PRP and Skin Peels to name a few. To decide on the most suitable treatment, we have expert practitioners in the clinic that can discuss all available options.

In summary, Botox is a well-tolerated and safe procedure that is used to smooth and rejuvenate the skin, leading to a more youthful appearance for months. Principally, the treatment should be provided by an expert clinician in the field following an initial consultation.

References

1. Frampton, J.E. and S.E. Easthope, Botulinum Toxin A (Botox® Cosmetic). American Journal of Clinical Dermatology, 2003. 4(10): p. 709-725.
2. Satriyasa, B.K., Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol, 2019. 12: p. 223-228.