Botox®

BOTOX is a purified form of a substance called Botulinum Type A toxin - produced by the bacterium Clostridium botulinum.

Used carefully and in small doses, it can be used to treat a range of health problems. There are similiar botulinum toxin products available such as Dysport and Myobloc.

Botox® is best known for use in cosmetic surgery for easing facial lines, however it is also good for easing muscle spasms, including stroke patients and suffers of cerebral palsy. It helps prevent constant bladder leakage, is used for low back pain, neck and shoulder spasms, unaligned eyes, chronic migraine and as an anti-inflammatory for the nose linings of hay fever suffers.

No preparation is needed before treatment. Botox® is injected directly into the affected area or applied as a gel.

Risks

Some people report headaches or flu-like symptoms in the first few days after treatment. Facial muscles may be a bit slack as the treatment settles in. In rare cases patients may experience blurred or double vision and breathing difficulties. Botox® is a poison and must be used carefully.

Only have treatment from a reliable person and organisation and make sure the product is the correct FDA approved Botox® or Botox Cosmetic. Severe reactions and temporary paralysis requiring the victims to be ventilated have occurred when unapproved, cheaper Botox toxin (only intended for research purposes and not for human use) was purposely used to provide cheaper options for cosmetic procedures.

Botox and related products should not be used with pregnant for breastfeeding.

Botox® and Botox Cosmetic have a boxed warning that says: 

"the effects of the botulinum toxin may spread from the area of injection to other areas of the body, causing symptoms similar to those of botulism. Those symptoms include swallowing and breathing difficulties that can be life-threatening. There has not been a confirmed serious case of toxin spread when Botox or Botox Cosmetic has been used at the recommended dose for the approved indications."

How long will it last?

The effect of Botox® lasts 3–12 months depending on what is being treated. Talk with your doctor and make sure you know all the pros and cons before having Botox® treatment and how long the effects are expected to last.

Does evidence support using it?

OnabotulinumtoxinA is marketed as Botox and Botox Cosmetic. In the USA, The Federal Drug Agency (FDA) has approved Botox® for the treatment of:

  • chronic migraine,
  • severe underarm sweating,
  • blepharospasm (eyelid spasm) and
  • strabismus (misalignment of the eyes when one or both eyes turn inward or outward)
  • eye lines - also known as crow's feet lines or lateral canthal lines (approved by FDA Sept 13).

There are a range of studies looking at the use of Botox. For low back pain, one recent high quality review (Waseem, et al) could only find 3 randomised controlled clinical trials involving 123 individuals with long-term back pain, sciatica or both. Because of the way these trials were designed and carried out, and the low numbers, the review concluded that the evidence in favour of botulinum toxin injections is  of low quality and further studies are needed.

References

  1. FDA Law Enforcers Crack Down on Illegal Botox Scammers FDA Consumer Updates, 2014
  2. Botulinum toxin injections for low-back pain and sciatica. Waseem Z, Boulias C, et al. Cochrane Database of Systematic Reviews, 2011
Credits: Created by Health Navigator NZ, August 2014. Reviewed By: Health Navigator