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Health Talk: Botox

November 3, 2008 |

With the increasing obsession about staying young forever, Botox treatments have become very popular. By removing unwanted wrinkles, many agree that Botox possesses the cosmetic wonders to return that youthful appearance.

Botox is not only used for its cosmetic abilities, but also for treating certain health problems like cervical dystonia, blepharospasm, and strabismus. Dystonia is a neurological disorder that causes shoulder and neck muscle contractions.

Blepharospasm involves uncontrollable blinking of the eyes. Strabismus is characterized by misaligned eyes. Botox primarily helps treat these by stopping the movement of muscles in the concerned areas. Today, Botox is very popular in the United States. Women, and even men use Botox to relive their youthful years. But, along with this, Botox also has a history of being used primarily in ophthalmology for treating spastic eyelid disorder since the 1980s.

Botox was approved by the Food and Drug Administration in 1989 to be used by patients above the age of 18 and below the age of 65 to treat medical conditions and for cosmetic purposes. However, it is important to understand how the drug manages to produce its seemingly magical effects. Botox, or botulinum toxin A, is a neurotoxin produced by a bacterium called Clostridium botulinum. Consumption of this neurotoxin leads to botulism, a form of food poisoning. One of the major symptoms of botulism is paralysis.

Paralysis occurs because botulinum toxins attach themselves to nerve endings, blocking the release of a neurotransmitter, called acetylcholine, which is responsible for triggering muscle contractions. This happens because the toxin attacks a protein, SNAP-25, which is essential for the release of acetylcholine. As a result, the signal for muscle contraction is blocked. If the toxin attacks the muscles of the chest, it can impact breathing because the respiratory muscles will get paralyzed. This has, more often than not, been the cause of death due to botulism.

The question then is how does botulinum toxin A prevent wrinkle formation? The answer is simple. If taken in small doses and injected in a specific area of the face, the area is paralyzed and movement is stopped. Thus, no wrinkles can be formed as all muscle contraction reaches an end. When Botox or botulinum toxin A is injected into the affected muscles, it takes a few hours to a couple of days to reduce or eliminate all spasms and contractions in the area. The risk of spreading the effect of the toxin to other areas is minimized to a great extent by injecting it directly into the targeted muscle group. A disadvantage of the treatment is that the effect of botulinum toxin A is not permanent. It lasts for a duration of only three to eight months. Thus, a person who wants to look evergreen would have to shell out a couple of dollars every few months and undergo the treatment every now and then.

Also, Botox has been known to cause minor side effects like headaches, an upset stomach, or flu-like symptoms. Sometimes, in the case of injections in the face, Botox can lead to drooping eyelids. The drooping eyelids, however, are temporary and the effect usually fades.

Although Botox has not clinically shown any long-term side effects in those who use it, many medical personnel worry that using such a lethal neurotoxin will have its share of adverse long-term effects. A notable aftereffect of long-term Botox therapy is that people are no longer able to voluntarily move the muscles of the face which have been injected with Botox. Hence, portraying complex facial expressions would be difficult for Botox users.

According to a February FDA press release, severe cases of respiratory failure were noted in children treated with Botox for spastic limbs. Although use of Botox to treat spastic limbs has not been approved by the FDA, the finding nevertheless led to the review of the safety of Botox.


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