For decades, cosmetic surgeons have been using botulinum toxin, or Botox for short, as a treatment for a range of conditions. However, perhaps Botox is best known as an anti-ageing treatment which can help to smooth out any lines and wrinkles. So far, it is estimated that over seven million people have had Botox injections. Furthermore, its popularity continues to rise as more and more people are looking for preventative techniques to keep a youthful appearance.
So, with Botox becoming more and more popular, what is its story and why is it such a sought-after treatment?
Is Botox new?
Botulinum toxin is nothing new in the medical world. It is a product made from Clostridium botulinum. This is where many of the scare stories for Botox arise as an infection of Clostridium botulinum causes botulism which can disable and paralyse. Botulism illness outbreaks can occur and can be fatal as the infection spreads around the body causing paralysis.
There is truth that Botox is derived from one of the most dangerous toxins in the world. However, the form of Botox takes, and the protein used can make Botox entirely safe for medical and cosmetic use. Clostridium botulinum has several different strains; however, the strains that are used to make Botox are just A and B serotypes.
Providing it is used in the right doses, form and by trained and experienced professionals, Botox is not a toxin to be feared, but a leading treatment method that can make a difference to the lives of patients.
What does Botox do?
Botox is perhaps best known now as a wrinkle treatment. When it is injected into muscles, it can help to relax the muscles and, therefore, smooth out any wrinkles. However, Botox can treat a range of conditions. It is extremely effective as a treatment for severe sweating (hyperhidrosis), and it can also help with migraines and overactive bladder conditions.
Botox is also used for many eye conditions such as eye-twitching as well as other conditions such as cervical dystonia and spasticity too.
The treatment works through injections where the Botox attaches to the nerve terminals and then binds together which prevents the release of a neurotransmitter called acetylcholine, which facilitates muscle activity. After an injection of Botox, the spasms from the acetylcholine stop and the Botox essentially paralyses the muscle activity which in turn helps to stop spasms and smooths wrinkles.
The treatment of Botox also interferes with the pain and inflammatory receptors in the body too, which is why it can be so beneficial as a treatment for persistent headaches and migraines.
It is important to remember that Botox isn’t a permanent treatment. While Botox works to suffuse nerve endings, these nerve endings regenerate and have their functionality restored after a time (around 120 days), so the paralysis of Botox eventually wears off. However, when this happens, Botox treatment can be repeated.
Botox in the 1920s
After an outbreak of botulism in Belgium, the scientist Emile Pierre van Ermengem researched the illness and discovered Clostridium botulinum. However, it wasn’t until the 1920s when scientists in San Francisco began to isolate the botulinum toxin. However, this was a lengthy project, taking over twenty years to isolate the toxin and store it in a crystalline form.
Botox in the 1970s
By the 1970s, Botox was researched as a treatment for a range of eye conditions. It was used for strabismus which is a condition on crossed eyes and was tested on monkeys. During the research, the researchers noted that the treatment had reduced wrinkles between the eyebrows and the nose.
In Vancouver, an ophthalmologist was using Botox on a patient to treat tight eyelids. During which the patient complained that she wanted injections on her inner brow as it reduced the appearance of her wrinkles. The ophthalmologist, Carruthers, then spoke to her husband, a dermatologist about how Botox could be used for those with frown lines.
The FDA did not approve Botox as a treatment for strabismus and blepharospasm (eye twitching) until 1989, however.
Botox in the 1990s
The Carruthers continued to research Botox for cosmetic use well into the 1990s and was growing increasingly popular, so much so that the US actually ran out of its Botox supply. By 2002 the FDA approved the use of botulinum toxin for glabellar lines (lines between eyebrows and the nose), and then in 2013, it received approval for treating crow’s feet.
Despite not all uses of Botox having FDA approval, more and more research continues to come in, which finds more and more uses, formulations and applications of what is now such as popular treatment.
During the early use of Botox treatment, there was little guidance on where to inject and how much to inject to ensure the best results. Many clinicians were administering Botox as a trial and error, rather than correctly understanding the anatomy of the face and which muscles to inactivate.
As Botox is a technique-driven treatment, proper placement is essential and to meet the demand, Botox providers and medical professions set up botox training courses and certification. There are several different routes and certification course available, and many tend to be country-specific, depending on the medical regulations and research that the country follows.
While many beauty salons offer Botox, it is crucial to know that Botox is a prescription drug. As a result, it should only be administered by medical professionals such as doctors, dentists, nurses and pharmacists. Furthermore, as it is a prescription drug, training for its proper use is essential too.
Fortunately, as Botox has grown in popularity, accredited botox training programmes have also developed to ensure patients are safe and receive the appropriate treatment.
For over 20 years, Dr Hennessy has been practising, researching and training others in medical aesthetics. As an international trainer for Galderma and a trainer to other professionals such as Allergan, who are the makers of Botox, Dr Hennessy has driven his commitment for high-quality training.
To ensure Botox remains as safe, effective and popular as possible, Botox training needs to continue its progress in providing highly qualified, accredited practitioners.