Written by Aleksandra Agranovich
The Dangers of Botox Injections
Botulinum toxin (Botox) has been used for decades to treat varying cosmetic conditions and headaches. Botox is a neurotoxin that is produced by a bacterium called Clostridium botulinum and prevents the release of the neurotransmitter acetylcholine (Ach), thereby inducing muscle stiffness and causing paralysis. Many dermatologists inject their patients with Botox to temporarily relax facial muscles that cause wrinkles. This procedure involves the use of a refrigerated Botox vile, a syringe, and takes approximately a couple of minutes to complete. The effects of Botox injections usually last three to four months before waring off. Although a simple Botox procedure is very quick, it may cost up to fifteen dollars per unit of Botox, which may easily add up…
Most people usually rave about how amazing and flawless Botox looks, but what are the hidden dangers of this product and is it truly safe? There are typically no contraindications for Botox except hypersensitivity or severe allergic reaction. According to the article that has been referenced below, Botox should not be injected into infected skin, wounds, areas with psoriasis or eczema. It is also very important to avoid Botox injections if a woman is pregnant or breastfeeding. The botulinum toxin may potentially cause fetal harm if injected in large amounts.
Another factor that may interact with Botox may include certain drugs like cyclosporin, acetylcholinesterase inhibitors, and specific antibiotics. Cyclosporin, for example, can potentiate the effects of Botox and cause a paralyzing effect (Althawadi,2022). Some of the rare but serious side effects of Botox may include keloid scaring at the injection site, drooping of the skin, respiratory problems, facial weakness, headache, and pain
Botox for Headaches and Migraines
Throughout the years, botulinum toxin has been studied for the treatment of headaches and migraines. Evidence suggests that Botox can be used as a pain management technique in patients who suffer from constant tension-type headaches and neuropathic pain disorders. According to a study conducted by Carruthers MD, patients who were injected with Botox showed a "decrease in the incidence and severity of headaches for a period of three to four months, along with a reduction in the use of short-term analgesics" (Carruthers, 2004). Within this study, Botox was proven to be a safe and effective measure for the treatment of such conditions.
Refrences
Althawadi N, Ujam A, Visavadia B. Botox hidden dangers. Br Dent J. 2022;232(4):192-193. doi:10.1038/s41415-022-4006-3
Carruthers J, Carruthers A. Botox: beyond wrinkles. Clin Dermatol. 2004;22(1):89-93. doi:10.1016/j.clindermatol.2003.11.013
Khawaja HA, Hernandez-Perez E. Botox in dermatology. Int J Dermatol. 2001;40(5):311-317. doi:10.1046/j.1365-4362.2001.01176.x
Botox Injections and Side Effects
Botulinum toxin, commonly known as botox, is commonly used for the treatment of facial wrinkles. Frown lines, crows feet, and horizontal forehead lines are commonly treated with botox in the United States. Botulinum toxin is derived from the Clostridium botulinum bacterium. Injection into muscles inhibits the release of acetylcholine at the neuromuscular junction which blocks contraction of muscle. This process is called chemical denervation. Repetitive contraction of facial muscles leads to wrinkle formation. Botulinum toxin relaxes the facial muscles and smooths the skin. Most muscles in the body have bony attachments to the skin, so the skin does not move upon contraction. The skin on the face is attached to muscle through soft tissue allowing for movement upon contraction. Patients with wrinkles upon movement are the best candidates for botox treatment. Results are less dramatic for patients with wrinkles upon rest as it may take a few consecutive botulinum toxin treatments to see improvement.
Botulinum toxin type A is used for cosmetic procedures while Botulinum toxin type B is used for conditions like dystonia. FDA approved botulinum toxin serotype A products include: onabotulinumtoxinA (Botox), abobotulinumtoxinA (Dysport), and incobotulinumtoxinA (Xeomin). IncobotulinumtoxinA does not contain complexing proteins which may reduce its antigenicity and formation of antibodies in the body. Further research must be done to confirm this.
Doses are usually 1 mL or less with one injection in the procerus muscle and two injections in each of the corrugator supercilii muscles (Small R.). Results should be seen within 3 days and maximum results should be visible at 2 weeks after treatment. Results should last for about 3 to 4 months and treatment should be given again when there is visible muscle movement. Injection reactions include anxiety, erythema, headache, infection, or pain. Bruising and redness are common. NSAIDs can be used for treatment of headaches. Botulinum toxin side effects include allergic reaction, spreading from the injection site, eyebrow ptosis, or facial asymmetry.
The amount of procedures using botulinum toxin A is expanding. Studies have shown that botulinum toxin A can have an effect on hypertrophic scars. It can inhibit fibroblast proliferation and downregulate expression of actin and myosin II proteins. It may also inhibit TGF-B1 and connective tissue growth factor. The effect of botulinum toxin on vascular endothelial growth factor (VEGF) to promote new vessels for wound healing is not known, but it may be possible. There has not been as much promise for the treatment of keloids as there is for facial hypertrophic scars. The use of botulinum toxin A and dermal fillers together may enhance the effect. Fillers have a longer duration of action than botulinum toxin which may help to extend the duration of the effect. They may assist each other in improving the smoothness of the skin. Furthermore, using a skincare regimen that consists of a retinoid helps to protect the patient from photodamage. The use of botulinum toxin intradermally is another area of focus for research. There are current studies researching its effect for bruxism, psoriasis, pain, and rosacea. Botulinum toxin may help with rosacea by inhibiting acetylcholine which is responsible for redness and flushing. It may help acne by blocking acetylcholine in sebocytes. Many other skin diseases are caused by hyperhidrosis which can be treated with botulinum toxin A. Botulinum toxin is a powerful substance requiring further research for all of its possible uses.
Schlessinger, J., Gilbert, E., Cohen, J. L., & Kaufman, J. (2017). New Uses of AbobotulinumtoxinA in Aesthetics. Aesthetic surgery journal, 37(suppl_1), S45–S58. https://doi.org/10.1093/asj/sjx005
Small R. (2014). Botulinum toxin injection for facial wrinkles. American family physician, 90(3), 168–175.