Botox
Botox(botulinum toxin)
- It’s a proteases exotoxin produced by a bacteria called clostridium botulinum
- It consists of seven type of neurotoxins but only type A and B are used
- It works by blocking the release of acetylcholine from cholinergic nerve endings
- These causes inactivity of muscles or glands (both sweat and sebaceous) innervated by these nerves
- Its effects are not permanent, seen within 1-4 days, with maximum effect at 1-4 weeks
- Usually the effects lasts for 3-4 months
Uses in dermatology
- Mostly it’s used to treat facial wrinkles:
glabellar frown lines,
crow’s feet or side of the eyes,
horizontal forehead crease,
wrinkles around the mouth,
nasolabial folds,
smoothing out the neck and chest/cleavage wrinkles
- To elevate the eyebrows
- Treat hyperhidrosis
- To treat lichen simplex, dyshidrotic eczema and acne vulgaris
- Can also be used to prevent other signs of aging like:
dry skin
pigmentation disorders
vascular abnormalities
dull and rough texture
Side effects:
- Injection side reactions such as pain, swelling, erythema and bleeding
- Headaches, expected to resolve within 2-4 weeks
- Malaise, nausea and flu-like symptoms
- Ptosis, ectropion and strabismus can occur
- None of the side effects are permanent
Microbotox:
- Microbotox technique was developed by Dr Woffles Wu
- With the aim to deliver tiny blobs of Botox as superficial as possible in the skin
- These is to create an intradermal effect and superficial muscle weakness avoiding paralyzing the entire muscle
- Also used on the T-zone to decrease oiliness
- On the lower face and neck injections are given for a face lift effect by relaxing the muscles which tend to pull the face down
- Other known effects are decreasing sebum production, pore size and reduce hyperhidrosis
- Additional effects are seen in adult acne and fine crinkly skin of face and neck
- It also leads to increased collagen production leading to anti aging effect
Hyperhidrosis:
- Primary disorder of excessive sweating, mainly affects the maxilla, the palms, the sole of the feet and the face
- Botox acts by blocking acetylcholine release by overactive sudomotor nerves that innervate exocrine sweat glands leading to reduction in sweating
- Sweating is often relieved for 3 to 14 months
- The sweating area is defined by iodine starch test
- Intradermal injections are given evenly in the area that sweats a lot
Other uses:
- Facial contouring
- Facial asymmetry correction
- Even rejuvenation-facial elasticity, texture, pore size or sebum production
Contraindications:
- Neuromuscular disorders eg myasthenia gravis
- Taking certain medications that can interfere with neuromuscular transmission eg aminoglycosides penicillamine, quinine and calcium channel blockers
- Pregnancy, infection at side of injection
- Allergy to botox
After injection no lying down, exercise, massage of treated area during the first 4 hrs
References:
- Clinical,Cosmetic and investigative Dermatology 2019:12
- J Cutan Aesthet Surgey.2018 April-Jun;12(2):47-50
- J Clin Aesthet Dermatol.2019;12 (11): 32-34
- Dermatol Ther (Heidelb) (2020) 10:779-789
- J Clin Aesthet Dermatol. 2017;10(2):34-44.