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Botox injections
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
Botulinum toxin type A is produced by a specific bacteria that causes the food poisoning botulism. Botox — the brand name for medicinal botulinum toxin type A — is the purified low-concentration form of the toxin. When injected in small doses into specific muscles, Botox blocks the chemical signals that cause muscles to contract. When the muscles can't tighten, the skin flattens and appears smoother and less wrinkled.
Why it's done
Botox injections temporarily relax the facial muscles that underlie and cause wrinkles, making them appear less noticeable. The Food and Drug Administration (FDA) has approved Botox for adults ages 18 to 65 as a temporary treatment for moderate to severe frown lines between the eyebrows. However, Botox can be used to treat other facial wrinkles as well, such as the lines that fan out from the corners of the eyes (crow's-feet) and the forehead furrow.
When Botox injections may be a good option
Botox treatment areas may include:
- Frown lines between the eyebrows and on the bridge of the nose
- Crow's-feet at the corners of the eyes
- Forehead creases
- Skin bands on the neck
When Botox injections may not be a good option
Not all facial wrinkles benefit from Botox injections, however. Botox won't reverse wrinkling caused by sun damage. Also, it's less desirable to treat the lines around your mouth because muscles in this area are needed for eating and talking. Your skin type, skin thickness and degree of wrinkling all play a role in determining whether these injections are effective for you.
Botox and other health conditions
Besides a wrinkle treatment, Botox is also used to treat several health conditions, including headaches, backaches, eye muscle problems, muscle spasms and excessive sweating (hyperhidrosis). Also, researchers at Mayo Clinic have found that treating facial scars early on with Botox may improve the appearance of scars long term. This use for Botox is experimental, however, and hasn't been approved by the FDA.
Risks
Botox injections are relatively safe when performed by an experienced doctor. But side effects and complications can occur. These include:
- Pain and bruising at the injection site
- Redness
- Headache
- Flu-like symptoms
- Nausea
- Temporary facial weakness or drooping
- Spread of the toxin beyond the treatment area, which can cause botulism-like signs and symptoms (trouble swallowing, muscle weakness, slurred speech and breathing problems)
Select your doctor carefully
Botox must only be used under a doctor's care. It can be dangerous if it's administered incorrectly. Look for a doctor who is board certified in dermatology; ears, nose and throat (otolaryngology); or plastic surgery. Make sure the doctor has experience with Botox treatments. A skilled and properly certified doctor can advise you on the procedure and can help determine if it best suits your needs and health.
How you prepare
Before scheduling Botox injections for wrinkles, you need to meet with your doctor to discuss the factors that determine whether Botox is likely to work well for you. This meeting generally includes:
- Your medical history and physical exam. Your doctor asks questions about conditions you have or have had and conducts a physical exam.
- Medication use. Your doctor asks about medication use. You may need to stop using certain medications before your Botox procedure. These include blood-thinning medications, such as aspirin, aspirin-containing medications, warfarin (Coumadin) or heparin. Talk to your doctor before stopping these medications, as it may be best to continue these medications in people who have had blood clots, stroke, heart attack, angina or transient ischemic attacks.
- A discussion of your expectations. You and your doctor talk about your motivations and expectations. He or she explains what Botox can and can't do for you and what your results might be.
What you can expect
During the procedure
A doctor uses a thin needle to inject tiny amounts of Botox into specific muscles. By carefully choosing the muscles to treat, the doctor weakens only the wrinkle-producing muscles to try and preserve your natural facial expressions.
The number of injections needed depends on many factors, including your facial features, the extent of the wrinkling and the specific area being treated. For example, crow's-feet usually require two to three injections. Furrows in your forehead could take five or more injections.
Botox injections take about 10 to 15 minutes and are usually done in a doctor's office. You may experience mild pain with the injections, but most people find the discomfort tolerable. The procedure requires no anesthesia.
After the procedure
Botox injections require no downtime. Expect to resume your normal daily activities immediately. You may have headaches for a few hours after the treatment. Take care, though, not to rub or massage the treated areas. This can cause the toxin to migrate to a different area of your face. If this occurs, temporary facial weakness or drooping is possible.
Results
You'll notice results within a few days, but the full effect takes about two weeks. Results aren't permanent, however. Once the Botox has taken effect, it takes three to six months for the affected muscles to begin functioning again. So to maintain your look, you need follow-up injections every few months.
