What Is Botox?
Botox is an injectable medicine that's been used since the 1970s to treat some medical conditions, such as crossed eyes. But it's probably best known as a treatment for fine lines and wrinkles. Botox is the brand name of a neurotoxin made by the bacterium Clostridium botulinum.
Botox was the first botulinum neurotoxin to be approved by the FDA for cosmetic purposes, but there are other brands. These "Botox-type" injections include:
- Daxxify
- Dysport
- Jeuveau
- Xeomin
All of these brands have the same active ingredient: botulinum toxin type A. They're all used to treat wrinkles and fine lines but may differ in the formulation used, how many doses you need, and how much the product tends to move from the point of injection. Your cosmetic surgeon will help you pick the best option depending on your body and your goals.
What Does Botox Do?
Botox and Botox-like injections are used in a couple of different ways: cosmetically, to reduce the signs of aging, and medically, to treat certain conditions.
Botox is mainly used to treat dynamic wrinkles, which are those that form due to facial movements when you make expressions, such as frowning, smiling, and squinting. It won’t help with wrinkles caused by sun damage or gravity. It's used most often to reduce the appearance of fine lines and wrinkles on your face, such as:
- Glabellar lines between your eyebrows (also called elevens or frown lines)
- Forehead creases or furrows
- Wrinkles around your eyes, especially crow's feet
- Thick bands in your neck
- Wrinkles at the corners of your mouth (also called marionette lines)
- Nasal/nasalis wrinkles on both sides of your nose (also called bunny lines)
- Nasolabial folds (smile lines or laugh lines) that run from your nose to the corners of your mouth
- Wrinkles and dimples on your chin that create a "cobblestoned" appearance
Botox injections have also been used to:
- Soften thick jaw muscles (making your jaw appear more rounded)
- Correct your smile if you show a lot of your gums when you smile
- Improve your complexion by smoothing your skin texture overall
Botox can also be used medically for pain management and as part of the treatment plan for some medical conditions, such as:
- Eyes that point in different directions (strabismus)
- Excessive muscle contractions (dystonia), such as cervical dystonia, a neurological disorder that causes severe neck and shoulder muscle spasms
- Severe sweating (hyperhidrosis)
- Eyelid twitching
- Chronic migraine
- Overactive bladder
- Blinking that you can’t control (blepharospasm)
- Stiff or rigid muscles (spasticity) in adults and kids
How Does Botox Work?
Botox is an injectable form of botulinum neurotoxin, which is made by the bacteria Clostridium botulinum. The bacteria C. botulinum is found naturally in soil, but it doesn't make botulinum toxin unless it's growing in a low-oxygen environment.
Botox works by stopping your nerves from releasing some brain chemicals (neurotransmitters) that cause your muscles to contract. This paralyzes the muscle so it stays relaxed. This makes the wrinkles on your face softer and smoother so they're less visible.
There are seven different types (called serotypes) of botulinum neurotoxin. Two of these serotypes are used for cosmetic and medical purposes:
- Serotype A is mainly used cosmetically to treat wrinkles and fine lines.
- Serotype B is mainly used to treat muscle spasms.
How Is a Botox Procedure Done?
Before getting a Botox injection
Make sure your doctor knows all the medicines and supplements you're taking. Also, don't drink alcohol within 24 hours of your injections. If you take an anticoagulant (such as warfarin) or nonsteroidal anti-inflammatory drugs (NSAIDs), you may have an increased risk of bleeding and bruising where you get your injection.
Getting a Botox injection
During the procedure, your doctor will use a very fine needle to inject a small amount of Botox into the skin and muscles where you're getting treatment. You may have several injections in different areas, depending on where you're getting treatment.
If you're worried about discomfort during your injection or if you're having several areas treated at once, you may want to ask your doctor to numb your skin beforehand. They can use a numbing cream, ice, or massage.
You can usually go back to your regular activities, with minor restrictions, immediately after your treatment.
After your Botox injection
Don't lie down for 3-4 hours after your injection, and don't rub or massage the treatment area for about 24 hours. This will help keep the medicine where your doctor put it.
You may see improvements in your skin about 1-7 days after your treatment, but it can take 7-14 days to take full effect.
Where Is Botox Injected?
This depends on where you're getting treatment. Common areas where people get Botox injections for wrinkles include:
- Forehead
- Between the eyebrows
- Top of the nose
- Around the eyes
- Around the lips
- Chin
- Jawline
- Neck
If you're getting Botox for a medical condition, you may get the injection in other areas. For instance, for excessive sweating (hyperhidrosis), you may get injections in your hands, feet, or armpits. For chronic migraine, you may get injections along your hairline or in your scalp.
How Long Does a Botox Shot Last?
The effects from Botox generally last about 3-6 months. As the medicine wears off, you may see your fine lines and wrinkles get deeper. At this point, you will need another treatment. As you get Botox injections over time, your muscles may stop contracting as often or as strongly. So, you may be able to get injections less often.
Do Botox Injections Hurt?
The needle that's used for Botox injections is very thin and the injections aren't done very deep, so most people say the injection doesn't hurt. You may feel a pinch or sting. It's usually over in just a few minutes. If you're worried about it, you can ask your doctor to numb your skin with a topical anesthetic before your injection.
Botox Side Effects
You may have some side effects after a Botox injection. Most are temporary and don't need treatment because they go away on their own.
The most common side effects include:
- Bruising
- Swelling and redness where the needle went in
- Pain or soreness where the needle went in
- Flu-like symptoms or a general feeling of being unwell
The more rare side effects include:
- Headaches (typically rare and end in 24 to 48 hours)
- Neck pain
- Infection where you got your injection
- Eyelid drooping (more likely if Botox is used for frown lines between your eyebrows and the medicine moves around, or if you lie down or rub the area soon after)
- Crooked smile or drooling
- Eye dryness or severe tearing
- Upset stomach or indigestion
If you have any of the following symptoms, you may be having a serious reaction to botulinum toxin:
- Generalized muscle weakness
- Double vision
- Trouble swallowing
- A hoarse voice
- Trouble forming words
- Trouble breathing
- Urinary incontinence (when pee leaks out of your bladder)
These symptoms can happen hours to weeks after your injection. If you have you have these symptoms, you need to see your doctor as soon as possible. If you're having trouble breathing and swallowing, you need to go to the ER right away.
Who Should Not Get Botox?
Botox is safe for most people, but it may not be for you if you:
- Are prone to developing keloid scars
- Have a neuromuscular disorder, such as amyotrophic lateral sclerosis (ALS), Guillain-Barré syndrome (GBS), or myasthenia gravis
- Have a known allergy to botulinum toxin
- Have body dysmorphic disorder
- Are pregnant or are nursing
Make sure your doctor knows all the medicines and supplements you take, as Botox may interact with the following:
- Antibiotics in the class of aminoglycosides (gentamycin, neomycin, and streptomycin) and fluoroquinolones (ciprofloxacin, levofloxacin, and moxifloxacin)
- Anticoagulants, such as warfarin
- Alzheimer's disease medicines, such as galantamine, rivastigmine, and tacrine
- Myasthenia gravis medicines, such as ambenonium and pyridostigmine
- Quinidine
How Much Does Botox Cost?
The cost for Botox injections can vary due to several factors, such as how deep your wrinkles and fine lines are and how aggressively you want to treat them because this determines how much of the product your doctor will use.
According to a survey by the American Society of Plastic Surgeons, the average cost for a course of Botox injections is about $435.
Is Botox Covered by Insurance?
This depends on what your insurance plan covers and what you're getting Botox injections for. Like most cosmetic procedures, Botox isn’t generally covered by insurance — unless you're getting it as part of your treatment for a medical condition. Check with your health insurance company for the coverage details of your policy.
Takeaways
Botox was the first botulinum toxin approved by the FDA to treat fine lines and wrinkles. Currently, several brands of botox-type injectables are available. Botox-type injectables work to decrease the appearance of fine lines and wrinkles by temporarily paralyzing the muscle into which it's injected.
This keeps the muscles relaxed so that your skin looks smoother. Botox injections may also be used to treat some medical conditions, such as chronic migraine, overactive bladder, and excessive sweating. Most people say the injections don't hurt because the needle used is thin and they aren't done very deep. Your insurance may not cover injections for cosmetic purposes but may cover them for medical conditions.
Botox Injections FAQs
Will Botox cause cancer?
No, Botox does not cause cancer. Botox has been used medically since the 1970s and was approved by the FDA in 2002 for cosmetic purposes. No long-term studies have shown that people who get Botox injections get cancer more than people who don't. Also, Botox doesn't affect or alter your DNA in a way that could lead to cancer.
Is Botox safe?
Yes, Botox is generally considered safe. Since Botox is not injected into your bloodstream, it usually stays where your doctor put it. It doesn't move around to affect other areas of your body. Just avoid rubbing or massaging the area after getting the injection. Also, Botox has very few drug interactions, and most complications tend to be mild and short-term.
