“Doctor, I have heard of Botox injections, are they safe? How do they work? How long does the effect last? Are the injections painful? What is the cost? Are the results worth its cost? Yup! These are the question we address during pre-Botox counselling in our dermatology clinic. Botox is the brand name for botulinum toxin, though a toxin, its popularity in cosmetic dermatology speaks aloud about the safety of this product, along with its efficacy. All you need to do is choose an experienced doctor to do the procedure for you. This article will take you through the basic of Botox injections, how it works, cost factor, side effects and the non-cosmetic uses. So, read on!

See the list of skincare products that can help in reducing Aging/Wrinkles

What is Botox?

Botox is actually a trade name for botulinum toxin. This toxin is produced by a bacteria named Clostridium Botulinum.  There are various other brands and companies which distribute this toxin, e.g. Dysport, Myobloc, Xeomin. We continue to use the word “Botox” in this article because the name has become synonymous with botulinum toxin and for the ease of reading.

How do Botox works?

Botulinum toxin blocks the transmission of nerve impulses to the muscle by preventing the release of the neurotransmitter acetylcholine (ACh) at the neuromuscular junction, temporarily preventing muscle contraction (source: Botox website). What does this mean to you? In simple words, Botox paralyses the muscle into which it is injected, that too temporarily.

You must be wondering how it helps in erasing my wrinkles. Botox is used for relaxing the dynamic wrinkles and not the static ones. Dynamic wrinkles appear on making certain facial expression, for example:

• Crow’s feet: These are the lines that appear on the sides of your eyes on smiling.
• Forehead lines: These are horizontal lines that appear on your forehead on raising your eyebrows.
• Frown lines: These are vertical lines that appear on frowning in the centre of your forehead.
• Bunny lines: These are dynamic lines that appear on the sides of the nose on smiling.

Beside dynamic wrinkles, other common uses of Botox include:

• Gummy Smile: These are showing up of gums upon smiling, this can be addressed by Botox as well.
• Masseter hypertrophy: If you have a bulky jaw that gives a square shape to your face, this can be addressed by Botox provided that overactive Masseter muscle is the cause.
• Eyebrow shaping: Few shots of Botox can help you get the eyebrow shape you desire, however, from experienced hands only.

Can I take Botox injections?

Yes! You can but after detail discussion with your doctor, also take a note of the below-listed contradictions for using botulinum toxin:

• Age below 18 years and above 65 years.
• Pregnancy and lactation.
• Muscle or nerve related problem like Myasthenia Gravis.
• Hypersensitivity reaction to botulinum toxin.
• Infection at the injection site: Botox should be postponed till the area is completely normal.
• Bleeding disorders.
• Patients on blood thinners like aspirin or high dose Vitamin E, pain killers, etc.  Should stop the medication for seven days before the procedure.

How long does the effect of Botox injections last?

The Botox injections result in smoothening of skin at the injection site and non-appearance of dynamic wrinkles on making that facial expression, but this becomes evident only after 5-7 days of injection and maximum effect is seen by the 15th day. The results last for 4-6 months. If you wish to stay wrinkle free, you have to undergo Botox injections every 6-8 months. The good news is that if you take injections every six months, the amount of toxin required decreases with every session and also the effect might last longer. A good tip is to take the Botox injection, at least, a month before the important function such as marriage so that you can flaunt in the wrinkle free face on your day.

How are Botox Injections given?

After a detailed counselling, your doctor will follow these steps:

• Anaesthesia: Don’t worry! This involves the application of aesthetic cream on the area to be injected for an hour or so, to minimise the pain and discomfort. Since the injection feels like biting of ant, you can choose to take injections without anaesthesia as well.
• Assessment of wrinkles: Your dermatologist would ask you to make various expressions so as to identify the muscle which needs to be treated. Any pre-existing asymmetry or ptosis is noted, and photographs are also taken for the record.
• Injections: The injections are usually administered with the help of thin insulin syringe into several points, the discomfort can be further minimised by use of ice packs if needed.
• Post-injection care:
  • You should avoid exertion for few hours like lifting heavy weight or exercise after the procedure.
  • You should not sleep or lie down for 3-4 hours after injection. So the good idea is to take injections before evening so that your sleeping schedule is not disturbed.
  • Avoid any facial massage for few days post injections.
• Revisit: Ideally, a re-visit is needed on the 15th day of injection to assess the effect of injection, and give few extra shots if needed.

What are the side effects of Botox injections?

The side effects of Botox can be categorised into the following categories:

• Common side effects: There can be mild swelling and redness at injection area that fades eventually, rarely a bruise might occur which can take a week to fade. A headache and flu-like symptoms can occur though not as common.
• Rare side effects: These include lid or brow ptosis, eyebrow asymmetry or spocky eyebrows in the case of upper face injection and difficulty in breathing, eating, smiling, crooked smile, facial asymmetry, etc. in lower face or neck injections.

Is Botox used for sweating or a migraine?

Yes! Besides cosmetic uses, botulinum toxin is used for:

• Excessive sweating from axilla and hands. The effect of these injections lasts through one summer season (4-6months). So getting the injections at the beginning of summer is a good idea.
• Migraine
• Cervical Dystonia
• Strabismus
• Eye twitching
• Limb spasticity