Medical Author: Alan Rockoff, MD
Medical Editor: Frederick Hecht, MD
On the face of it, asking a doctor to inject a deadly poison into your skin to make you look better doesn't seem like such a good idea. Yet that's exactly what people do when they get Botox treatment. And, they usually like the results.
"Botox" is short for botulinum toxin A, the product behind a nasty form of bacterial food poisoning. (The bacterium is called Clostridium botulinum.) Swallowing too much of the toxin can make you very sick, but doctors have learned to purify Botox for injection into specific muscles. This treatment has a growing number of uses, from easing muscle spasms (for example, in spastic cerebral palsy) to flattening wrinkles.
Dermatologists and plastic surgeons use Botox to relax the frown lines in the middle of the forehead, just above the nose. These lines make you look annoyed or angry, even if you're not (or if you are and don't want everybody to know it!).
Botox treatment involves injecting very small amounts of the purified toxin into the wrinkles. Within two or three days, the muscles that produce frown lines lose their ability to contract. For the next three months or so after you're treated, you can't frown even if you try. After that, the effect gradually decreases until muscles return to normal about six months after the treatment, which can then be repeated.
The effect of Botox is not permanent. The downside of Botox treatment is that it needs repeating every six months or so. The upside is that complications, which don't happen very often, also go away over time. Sometimes, a muscle that has been repeatedly injected, eventually loses its ability to contract and doesn't need to be treated anymore. However, this is not an outcome you can count on.
Botox acts by blocking the transmission of nerve impulses to the muscles, so you should not use Botox if you have a neurologic disease or are pregnant or breastfeeding. Certain antibiotics and other drugs that interfere with the transmission of nerve impulses to the muscles should not be taken when Botox is used.
The major complication of Botox is weakening of muscles in the vicinity that you didn't want treated. Improper injection of frown lines, for instance, can result in temporary eyelid droop. This goes away in the same 3 to 6 month period.
Doctors familiar with the proper use of Botox can generally avoid even mild and temporary side effects. It is therefore a good idea to ask around and be sure the dermatologist or plastic surgeon you consult is experienced and uses Botox often.
Injection sessions generally cost several hundred dollars, depending on how much work you have done. Insurance rarely covers Botox treatments that are intended for cosmetic improvement.
Hey, stop frowning--you knew that!