Can Botox Cosmetic Affect the Brain?

Question

I just read in the  about how new studies are saying that Botox Cosmetic can affect the brain in mice.  I am freaking out! Is this for real?  I've had a lot of Botox over the past 5+ years...should I stop getting Botox injections?  How do I know if the Botox Cosmetic has affected my brain?  If it has, can I fix it?  Need more info please!

David Shafer, MD, FACS · Answer

The article in the Journal of Neuroscience earlier this year drew great attention to Botox.  The most attention was paid by news media outlets sensationalizing the topic and generating fear to help sell their news.  The studies were conducted in rodents, not humans.
Additionally, the formulation of Botox used in the studies is not the same as manufactured by Allergan.  Millions and millions of people have had Botox without any problems.  The handful of cases reported with adverse effects of Botox were not cosmetic patients.
Botox is also used in other areas of medicine such as treatment of spasticity in cerebral palsy patients.
When we treat these patient we are sometimes using more than 10 times the cosmetic dose.  This is because instead of paralyzing small facial muscles, we need to paralyze contracted extremity muscles.  And, the overwhelming majority of these patients do just fine with Botox as well.
It is up to you about whether you want to stop getting Botox.  You need to make an informed decision.  Prior to Botox, there were operations that were performed (and are still performed today) to achieve a similar effect surgically.  However, you then have do undergo anesthesia and a surgical procedure.

Harold J. Kaplan, MD · Answer

The myriad of clinical trials and millions of actual injections have shown us that Botox has a better safety profile for humans than Aspirin. While the study you read about was published, it did not involve humans and did not use Botox Cosmetic.
While we would like to think that those publicizing this study were doing so for the common good, we think it is more likely that they wanted an increase in readership or viewership and chose to sensationalize the study.
Don't worry, Botox is safe for you.

Benjamin Barankin, MD, FRCPC · Answer

I agree that BOTOX should not be injected in high doses into the brains of mice and rats ;) Presuming that you are not a rodent, there has been no scientific data or clinical experience to suggest any danger to the human brain.

Steven Wallach, MD · Answer

It is extremely unlikely that Botox could impact brain function from use on the forehead. The studies that you mention were done in a rodent model.

Kamran Jafri, MD · Answer

Hello Devora,
Please be at ease about Botox and your brain!
The study you are referring to was Published in the Journal of Neuroscience earlier this year.  The study was conducted in Italy and involved scientists injecting Botox into mice and rats by their whiskers and portions of the brain itself (hippocampus).
The study found that certain proteins that result from the actions of Botox were detected in the brain tissue of the mice and rats.  The theory is that the Botox travels from the whisker muscles into the nerves and back into the brain tissue.  On the surface this is very scary sounding and cause for concern!
However, it is important to note that the physiology of mice and rats is not the same as humans and therefore needs to be taken into account.  In studies with primates who have a much more similar physiology to humans these same concerns about Botox have not been seen.  It is also very important to note that the Botox used in the study was formulated in the lab - making it different than the botox that is used cosmetically (Botox for human use is made by Allergan Corp. under strict clinical guidelines).  
Another very important point is that there are no muscles in the brain itself - and while Botox can have some impact on nerve to nerve transmission, it's main effect is to weaken muscles by preventing a chemical that triggers the muscle to move from working properly.  So being that there are no muscles in the brain any concerns about muscle weakness there is not valid.
Clearly more studies need to be done to validate and clarify the findings of this one paper.  Hundreds of other papers, millions of patients and years of clinical use clearly and strongly indicate that Botox is safe to use in humans.
Bottom line: Botox used in appropriate doses has been shown to be very safe and effective in humans. Always go to a board certified physician for your Botox and try to space the treatments apart as far as possible.
Very interesting topic and I am sure that this study will lead to further studies which is always a good thing for both Patients and Physicians.

Can Botox Cosmetic Affect the Brain?

Answers (5)

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