Overview
Botox is a medication produced from a toxin generated by Clostridium botulinum, the bacterium responsible for the often fatal poisoning illness, botulism. Known clinically as botulinum toxin A, Botox is one of the more dangerous naturally-occurring neurotoxins. Manufactured by Allergan, the medication was originally approved by the Food & Drug Administration in 1990 for the treatment of uncontrollable eye spasms. It has since been administered for a range of both medical and cosmetic uses.
Action
Botox works by blocking the nerve terminals that produce acytlcholine, the chemical required to transmit nerve impulses. As a result, signals sent to muscles that cause them to contract fail to reach the muscles. Botox is often a temporary treatment as, over time, nerves will regrow around the affected areas, forming new connections that will carry nerve impulses. In many cases, treatments with Botox may need to be repeated every three to six months.
Administration
Botox is delivered in a sealed vial as a sterile powder that is reconstituted when administered. The prepared Botox is drawn into a syringe in an appropriate dosage, then injected around the nerves that are responsible for muscular control of the affected area. Multiple injections may be required. Careful selection of the injection sites is critical to ensuring that areas surrounding the treatment location will remain unaffected.
Medical Applications
Botox has several medical uses. Among these, Allergan lists the treatment of spasms of the arms in adults; cervical dystonia to relieve neck pain and abnormal head position; severe underarm sweating, called hyperhydrosis, that is not resolved by other treatments; spasms of the eyelids; and strabismus, or crossed eyes. Botox is also used for treatment of medical disorders without specific FDA approval including multiple sclerosis, Tourette syndrome, lower back pain, migraines, and hereditary spastic paraplegia, to name a few.
Cosmetic Applications
When Botox was administered for its original use of controlling eye muscle spasms, a beneficial side effect was noticed. Because muscular contractions around the eye were significantly lessened, a smoothing of wrinkles around the eyes, caused by years of contractions, was noticed. This eventually led to Botox being used to control the muscles in the face that caused crow’s feet, brow furrows and lip wrinkles. Cosmetic procedures using Botox usually take less than a half hour to administer and cost in the range of $300 to $1,000 per treatment as of 2010 depending on the type of procedure being performed.
Safety
Proper administration of Botox is essential to reducing the risks associated with the drug. Reactions from the cosmetic use of Botox can include bruising, numbness, swelling, muscle twitching and inappropriate muscle paralysis, such as a drooping eyelid. According to subscribing information from Allergan, medical adverse reactions can include pain in the treated area; muscle weakness or spasms; visual problems; difficulty swallowing, speaking, hearing or breathing; incorrect head movement or position; headache; flu-like symptoms; back or neck pain; and incontinence. Pregnant women and children should not be given Botox, except in cases of children 16 years of age or older for cervical dystonia, or 12 years of age or older for treating blepherospasm and strabismus.
