Botulinum Toxin (Botox) : Medical and Cosmetic Uses

Botulinum toxin is a protein and neurotoxin produced by the bacterium Clostridium botulinum. Botulinum toxin can cause botulism, a serious and life-threatening illness in humans and animals.

Popularly known by one of its trade names, Botox, it is used for various cosmetic and medical procedures. Botulinum can be absorbed from eyes, mucous membranes, respiratory tract or non-intact skin.

Cosmetic Uses
Although botulinum toxin is a lethal, naturally occurring substance, it can be used as an effective and powerful medication.

In cosmetic applications, a Botox injection, consisting of a small dose of botulinum toxin, can be used to prevent development of wrinkles by paralyzing facial muscles. Botox cosmetic providers include dermatologists, plastic surgeons, aesthetic spa physicians, dentists, nurse practitioners, nurses and physician assistants. The wrinkle preventing effect of Botox normally lasts for approximately three to four months, or in some cases up to six months.

Medical Uses
In addition to its cosmetic applications, Botox is currently used in the treatment of spasms and dystonias, by weakening involved muscles, for the 60–70 day effective period of the drug. The main conditions treated with botulinum toxin are:

  1. Cervical dystonia (spasmodic torticollis) (a neuromuscular disorder involving the head and neck)
  2. Blepharospasm (excessive blinking)
  3. Severe primary axillary hyperhidrosis (excessive sweating)
  4. Strabismus (Squints)
  5. Achalasia (failure of the lower oesophageal sphincter to relax)
  6. Local intradermal injection of BTX-A is helpful in chronic focal neuropathies. The analgesic effects are not dependent on changes in muscle tone.
  7. Migraine and other headache disorders, although the evidence is conflicting in this indication
  8. Excessive sweating is a condition for the treatment of which FDA has approved the use of Botox.

Other uses of botulinum toxin type A include treatment of:

  • Idiopathic and neurogenic detrusor overactivity,
  • Pediatric incontinence, incontinence due to overactive bladder, and incontinence due to neurogenic bladder.
  • Anal fissure
  • vaginismus To reduce the spasm of the vaginal muscles.
  • Movement disorders associated with injury or disease of the central nervous system including trauma, stroke, multiple sclerosis, Parkinson’s disease, or cerebral palsy
  • Focal dystonias affecting the limbs, face, jaw, or vocal cords
  • TMJ pain disorders
  • Diabetic neuropathy
  • Wound healing
  • Excessive salivation
  • Vocal cord dysfunction (VCD) including spasmodic dysphonia and tremor
  • Reduction of the Masseter muscle for decreasing the apparent size of the lower jaw
  • Painful bladder syndrome,
  • Detrusor sphincter dyssynergia and benign prostatic hyperplasia,
  • Treatment and prevention of chronic headache and chronic musculoskeletal pain are emerging uses for botulinum toxin type A.

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