Dr. Samuel Lam explains the function of Botox injections...

Dr. Samuel Lam explains the function of Botox injections and how your wrinkles are smoothed out over time by the injections.

Botulinum Toxin Type A (Botox Cosmetic) is a protein complex produced by the bacterium Clostridium botulinum, which contains the same toxin that causes food poisoning.

When used in a medical setting as an injectable form of sterile, purified botulinum toxin, small doses block the release of a chemical called acetylcholine by nerve cells that signal muscle contraction. By selectively interfering with the underlying muscles' ability to contract, existing frown lines are smoothed out and, in most cases, are nearly invisible in a week.

The medication takes 48 to 72 hours to take effect and can be expected to last about 3 months, though individual results vary and additional injections may be necessary to get desired results.

Botox was first approved in 1989 to treat two eye muscle disorders - uncontrollable blinking (blepharospasm) and misaligned eyes (strabismus). In 2000, the toxin was approved to treat a neurological movement disorder that causes severe neck and shoulder contractions, known as cervical dystonia. As an unusual side effect of the eye disorder treatment, doctors observed that Botox softened the vertical frown (glabellar) lines between the eyebrows that tend to make people look tired, angry or displeased.

In early 2002, Allergan performed studies to show a decrease in these frown lines for up to 120 days which satisifed the FDA. The agency granted an indication for temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients < 65 years of age for Botox Cosmetic.

In 2004, Botox received an additional indication for the treatment of severe primary axillary hyperhidrosis (armpit sweating) that is inadequately managed with topical agents.

While these are the only FDA indicated uses of Botox, Botox has been used to treat "crow's feet" and other areas of wrinkling in the face. Though no controlled studies have shown the safety and efficacy of Botox when used in these applications, hundreds of applications have proven out the efficacy.

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