Botulinum toxin A (trade names are Botox, Dysport and Xeomin) is considered as the most popular drug that has so far emerged in the field of cosmetic surgery. Botox , which is the dominant market leader in the group and the other drugs, have been quite effective in treating wrinkles, muscular disorder in head and neck, squints, excessive blinking, excessive sweating and some other afflictions.

Botox and other drugs in the group should be injected by qualified and experienced practitioners at target locations to give the patients best results

Allegan Inc, of Irvine, California, the maker of Botox, has recently received FDA approval for treating migraine pain and urinary incontinence, and is working to get approval to treat other bladder related issues. They are also reportedly looking into use of Botox for treating arthritis pain in the knee.

Botulinum Toxin is a protein and neurotoxin produced by the bacterium Clostridium botulinum. The history of the drug briefly is as under:

It was Justinus Kerner (1786 -1862), a German doctor who first identified botulinum toxin as a deadly poison and talked of its possible therapeutic values. Later in 1897, Emile van Ermengem, a Belgian bacteriologist found a bacterium as the producer of botulinum toxin and named it as Clostridium botulinum.

In 1949, a researcher (Dr) Arnold Burgen and colleagues in London experimentally found that botulinum toxin blocked communication between nerves and muscles. In 1978, Dr Alan Scott after many years of research in 1960-70s, got FDA approval for extensive multi-site tests of botulinum toxin for treating human cross eyes.

In 1992 the first study on Botolinum Toxin A (BTX-A) for treating frown lines was published by the husband wife team of Dr. J D Carruthers, a dermatologist and of Dr. J A Carruthers, an ophthalmologist.

The rise of Botulinum toxin started in April 2002 after Allergan received FDA approval for its use in temporarily improving the appearance of frown lines between the eye brows.

There are seven types of botulinum toxins, A through G which block release of the neurotransmitters which trigger muscle contractions by attacking a series of proteins (VAMP, Syntaxin and SNAP-25). Botulinum toxin type A (Botox) affects SNAP-25.

Botolinum Toxin A (Botox) or any other type of botulinum toxin is related to botulism, a form of food poisoning that takes place by ingestion of food with the neurotoxin produced by a bacteria Clostridium botulinum.

Botulism may cause paralysis by blocking signals for contraction of muscles and when it occurs in chest muscles, it may seriously affect breathing, causing death.

This property of hindering muscle contraction allows Botox to eliminate wrinkles since wrinkle cannot form when there is no muscle contraction.

Botox is used in treating facial wrinkles, furrows and frown lines as well as blepharospasm (excessive blinking or twitching of eyes), strabismus (cross eyes) and cervical dystonia (involuntary movement of neck) which some ways are involved with spasms due to involuntary muscle contraction.

Spasmodic dysphonia (neurological disorder of larynx muscle) and dystonias like writer’s cramps, facial spasms and hyperhydrosis (excessive sweating) have been treated successfully with Botox.

But all the treatments by Botox are temporary in nature and have to be repeated.

Botox injections:

There are no specific preparatory steps prior to receiving Botox injections, except choosing an experienced doctor who has performed hundreds of such injections.

The most common usage of Botox is for treating crow’s feet, forehead lines and the lines in between the brows (glabella).The procedure typically takes less than half hour to complete and the results become fully visible after about a week.

The results usually last for about three to four months and the procedure may be repeated to extend the results further

Botox is sold to the doctor practitioners in vials containing 50 or 100 Units of Botox and is then mixed with saline solution by the practitioners before injections.

The doctors price Botox on the basis of area treated or on the basis of units injected. The pricing vary with the doctors in the urban areas charging the most. The price of a unit of Botox injected may be charged by a doctor in the range $ 12 to $20.

A patient should always find out from the doctor the number of units of Botox that were injected or are going to be injected for his/her treatment. This helps the patient in verifying the total cost of the procedure and also in having some idea about the improvement achieved vis-a-vis units injected

Recovery– Being non-invasive in nature, there is practically no down time and this is considered as the main advantage of Botox treatment along with it’s lower cost compared to other procedures treating the same symptoms.

Risks- Though risks are considered low, there have been cases where effects of Botox migrated to body areas not targeted, causing significant problems. Also there have been reported cases of too much or too less of the drug being injected.

Signs of bad use of Botox include visible ripples, shiny foreheads, completely frozen looks.

To avoid risks, following steps are recommended by the experts for removing facial wrinkles:

i) The shots should be delivered by doctors or experienced nurses who have performed hundreds of such procedures.

ii) The doctors who have knowledge of facial anatomy and facial aesthetics should be chosen. Different people require different amounts of drugs with men usually needing more than women.

iii) The doctors or nurses should be asked to mix up the solution immediately before the injection to ensure freshness. Botox is delivered in powdered form and once water is added it must remain refrigerated and it stays fresh for only about a week.