Botox is a drug that weakens or paralyzes muscle. In small doses, it can reduce skin wrinkles and help treat some medical conditions.
Botox is a protein made from Botulinum toxin, which the bacterium Clostridium botulinum produces. This is the same toxin that causes botulism.
Botox is a toxin, but when doctors use it correctly and in small doses, it can have benefits. It has both cosmetic and medical uses.
As a cosmetic treatment, Botox injections can reduce the appearance of skin wrinkles.
Also, the Food and Drug Administration (FDA) have approved it as a treatment for various health issues, including eyelid spasms, excessive sweating, some bladder disorders, and migraine.
In this article, we explain how Botox works and explore its uses, side effects, and other risks.
What is Botox?
Botox derives from C. botulinum bacteria, which are present in many natural settings, including soil, lakes, forests, and the intestinal tracts of mammals and fish.
Naturally occurring C. botulinum bacteria and spores are generally harmless. Problems only arise when the spores transform and the cell population increases. At a certain point, the bacteria begin producing Botulinum toxin, the deadly neurotoxin responsible for botulism.
Botulinum toxin is extremely dangerous. Some scientists have estimated that 1 gram of a crystalline form of the toxin could kill 1 million people and that a couple of kilograms could kill every human on the planet.
However, when Botox is appropriately used in a therapeutic context, it is safe and has few side effects, the American Osteopathic College of Dermatology report.
Manufacturers make Botox injections with very small doses of Botulinum toxin. The drug can temporarily paralyze muscles, which can benefit people with various muscle or nerve disorders.
People casually use the term “Botox” to describe all of these products, though Botox is a registered trademark that one company owns.
How does it work?
Botox is a neurotoxin. These substances target the nervous system, disrupting the nerve signaling processes that stimulate muscle contraction. This is how the drug causes temporary muscle paralysis.
In order for any muscle to contract, the nerves release a chemical messenger called acetylcholine at the junction where nerve endings meet muscle cells. Acetylcholine attaches to receptors on the muscle cells and causes the cells to contract, or shorten.
Botox injections prevent the release of acetylcholine, which stops the muscle cells from contracting. In this way, the toxin helps the muscles to become less stiff.
The primary use of Botox is reducing the appearance of facial wrinkles.
According to the American Board of Cosmetic Surgery, Botox injections are the most popular cosmetic procedure nationwide. In 2016, over 7 million people had Botox treatments.
The effects are temporary, lasting 3–12 months, depending on the type of treatment.
People often request the injections in the following areas of the face:
wrinkles between the eyebrows, called frown lines, glabellar lines, or elevens
wrinkles around the eyes, known as crow’s feet
horizontal creases in the forehead
lines at the corners of the mouth
“cobblestone” skin on the chin
However, the FDA have only approved the injections for use around the eyes and on the forehead.
Research has not shown whether Botox could improve dark circles under the eyes.
Some people also try Botox to improve the appearance of their hair. There is little evidence that this works, however.
Healthcare professionals also use Botox to treat a variety of medical conditions, most of which affect the neuromuscular system.
The FDA have approved Botox for the following uses. Unless otherwise specified, the approval is for use in people 18 or older:
upper limb spasticity, in anyone older than 2 years
crossed eyes, or strabismus, in those older than 12 years
severe underarm sweating, or hyperhidrosis
preventing migraine in people whose migraine headaches last at least 4 hours on 15 or more days per month
reducing symptoms of an overactive bladder due to a neurological condition if anticholinergic medications do not help
eyelid spasms, or blepharospasm, due to dystonia
a neurological movement disorder called cervical dystonia that affects the head and causes neck pain
Some people also have Botox injections for off-label, or unapproved, uses, including as treatments for:
sialorrheaTrusted Source, which involves producing too much saliva
dyshidrotic eczema, which affects the palms of the hands and soles of the feet
anismus, a dysfunction of the anal muscle
vulvodynia, pain and discomfort in the vagina without a clear cause
Raynaud’s disease, which affects circulation
achalasia, an issue with the throat that makes swallowing difficult