Is Botulinum Toxin Right for you

What is Botulinum Toxin?

Botulinum Toxin is a brand name for botulinum toxin, a highly purified protein which is injected in very small doses to reduce or eliminate wrinkles. The other brand available in Singapore known as “Dysport” works in exactly the same way. For the purposes of this article, we will call it as “Botulinum Toxin” but the treatment and effects are the same with “Dysport”.

The US FDA, which is the organization in the US that approves the use of medications in the US based on scientific evidence and safety profile, has approved Botulinum Toxin for use in certain medical conditions since the 1980s. Its effectiveness for reducing wrinkles was discovered more recently, where patients receiving Botulinum Toxin for lazy eye were also found to have fewer wrinkles. Since then, doctors have been using Botulinum toxin for cosmetic purposes.

How does it work?

It temporarily blocks the signal from a nerve to a muscle. The treated muscles are weaker, so that the wrinkle formed by muscle contraction relaxes and softens. Because of its mechanism of action, Botulinum Toxin works best for lines that are formed because of muscle contraction such as frown lines and horizontal forehead lines, as well as crow’s feet.

Botulinum Toxin treatment lasts three to six months. Lines and wrinkles gradually reappear as Botulinum Toxin wears off. With repeated treatments, doctors have observed that Botulinum Toxin may last longer as the muscles become less prominent from non-use.

Wrinkles resulting from gravity or sun damage, as well as pigments or laxity are not treated by Botulinum Toxin. Other laser or light treatments may be used alone or in combination with Botulinum Toxin to address these other related concerns.

What are the clinical uses of Botulinum Toxin?

Botulinum Toxin is used to treat wrinkles that form because of repeated muscle contraction. These include muscles used for frowning, smiling, concentrating or thinking. These usually present as horizontal lines on the forehead, or grooves between the eyebrows, as well as smile lines (crow’s feet) around the eyes. Botulinum Toxin is also used to lift the eyebrows (“brow lift”), make the eyes appear rounder, and to correct lines around the lips and necks. In Singapore and the rest of Asia, a common use for Botulinum Toxin is to “slim” the lower face when it is injected on the muscles we use for chewing (“masseter muscle”) along the angles of the jaw.

There are other non-cosmetic uses of Botulinum Toxin including reduction of excessive underarm or palm sweating (hyperhydrosis”), the treatment of headaches, and the management of spastic conditions.

How is the procedure performed?

A Botulinum Toxin treatment takes only a few minutes. You can come in to talk to the doctor, have the treatment, then go straight back to work without downtime. The treatment will weaken only the muscles that produce wrinkles so your natural facial expressions will not be affected.

Tiny amounts of Botulinum Toxin are injected into specific muscles and because a very fine needle is involved, it is almost “pain-free”. Some patients may ask for a little numbing cream but most people describe the treatment as like a little “ant bite”.

If you’re considering a Botulinum Toxin treatment, tell the doctor what medications you are on since some medications (for example aspirin) may increase the risk of bruising. The injection usually takes three to 7 days to take effect and the doctor may ask you to pop in after a week to assess the results. The doctor may also ask you to use the muscles that are injected so that the Botulinum Toxin takes effect in the right areas. You will also be asked to avoid lying down for a few hours.

What are the side effects of this treatment?

The most common side effect of this treatment is temporary bruising. You may also feel a temporary headache. If Botulinum Toxin spreads outside of the muscles being treated, there may be temporary eyelid drooping in a small percentage of patients. This is why the doctor will ask you not to rub the treated area for several hours and not to lay down for a few hours.

Who should not receive Botulinum Toxin?

Botulinum Toxin should not be administered in patients who are pregnant, are breastfeeding, or have a neurologic condition. Also, because wrinkles formed because of other factors may not be treated by Botulinum Toxin, it is important to have a detailed consultation with a doctor.

What other treatments should I consider?

Since aging may present with wrinkles, pigments, pores, and skin laxity, Botulinum Toxin is often combined with other effective and proven skin treatments to regain a more youthful looking skin. Examples include non-ablative and minimally ablative lasers (such as the Pearl laser resurfacing device) which may be beneficial in treating wrinkles that cannot be reduced by Botulinum Toxin. Skin tightening treatments such as the Titan can stimulate collagen growth thus improving skin laxity.

When it comes to skin rejuvenation, every person has unique concerns and individual needs. If you are looking for a treatment for wrinkles or other skin concerns, talk to a doctor about which procedure is right for you. Nothing can replace a doctor’s professional advice.