Botox , The Patient Education Institute, Inc. rxf60101 Last reviewed: 01/11/2018 1

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1 Botox Introduction Botox is a well known brand name for a medicinal form of a toxin, or poison. When injected in small doses into specific muscles, Botox doesn't poison you. Instead, it acts as a muscle relaxant. Botox is used to treat certain medical problems. It is also used to improve facial wrinkles. The effects of Botox can last for several months. This reference summary will explain the benefits and risks of Botox. It includes information about Botox, why it s done, how it is done and its risks. Why It s Done and How It Works Botox is a medicinal form of a toxin, or poison. The toxin is known as botulinum toxin type A, or onabotulinumtoxina. It is produced by bacteria that cause botulism, which can cause a type of food poisoning. There are two forms of the botulinum toxin medicine, Botox and Botox Cosmetic. Botox is used to treat medical problems. Botox Cosmetic is used to improve facial wrinkles. You may hear both referred to as Botox. Botox injections weaken or paralyze certain muscles. Paralysis is the loss of ability to move all or part of the body. Botox blocks chemical signals from nerves that tell the muscles to contract. This causes the muscles to stay flaccid or weak. It can have therapeutic or cosmetic effects, especially where muscles are chronically tight or spastic. Botox is used to treat several medical problems, including: Cervical dystonia. Spasmodic dysphonia. Chronic migraine. Excessive sweating. 1

2 Lazy eye. Muscle stiffness in the elbow, wrist and finger muscles. Twitching of the eyelids and uncontrollable blinking. Cervical dystonia causes neck pain and abnormal head position. It also causes severe muscle spasms of the neck. Spasmodic dysphonia is a condition that affects the vocal cords, causing them to tighten at times for no reason. It can make it difficult to speak. Chronic migraines cause headaches for more than 14 days a month, including a migraine on at least eight of those days. When Botox is used to treat excessive sweating, it weakens the sweat glands rather than muscles. Botox is injected into the area where excessive sweating takes place. It can be injected into the palms of the hands, underarms or soles of the feet. Botox Cosmetic can temporarily relax the facial muscles that cause wrinkles. Botox can make them less noticeable. Botox is used as a temporary treatment for moderate to deep frown lines between the eyebrows. But, Botox can be used to treat other facial wrinkles as well. Your skin type, skin thickness and degree of wrinkling all play a role in deciding if Botox injections are right for you. Botox can treat the lines that fan out from the corners of the eyes, also known as crow's feet. It can also be used to treat the forehead furrow. Botox won't reverse wrinkling caused by sun damage. Also, it is less effective to treat the lines around your mouth. Muscles in this area are needed for eating and talking. How to Prepare Before Botox injections, you need to meet with your health care provider to see if they are right for you. Your health care provider will ask about your medical history and give you a physical exam. He or she will also ask about medications you use. You may need to stop using certain medications before your Botox procedure. Talk to your health care provider before stopping any medications. It may be best to continue certain medications if you have a history of: Blood clots. Stroke. 2

3 Heart attack. Angina. Transient ischemic attacks. Let your health care provider know if: You have received any other Botox product before, especially in the last four months. You have recently been given antibiotics by injection. You take muscle relaxants. You take allergy, cold or sleep medicine. You and your health care provider should talk about your reasons for getting Botox. You should also discuss your expectations. Your health care provider will explain what Botox can and can't do for you. Botox injections can be expensive. They are not always covered by insurance. Make sure you know in advance: How much the injections will cost. If your insurance provider will cover them. If you're being treated for excessive sweating, there are several steps to take before you receive injections. Your health care provider may ask you to: Shave your underarms. Do not use deodorant for 24 hours before treatment. Avoid foods or activities that may make you sweat more for 30 minutes before the procedure. During the Procedure You will be placed in an upright position on an exam table. A cleanser is used on the area where the injection will be given. A medicine may be used to numb the area. Your health care provider will use a thin needle. He or she will inject tiny amounts of Botox into your skin or muscles. When treating excessive underarm sweating, your health care provider will inject Botox into the skin under your arms. 3

4 Your health care provider may inject Botox into specific muscles to treat facial wrinkles or other conditions. The number of injections needed depends on many factors, including the size of the area being treated. Botox injections take about 10 to 15 minutes. They are usually done in a health care provider's office. You may experience mild pain with the injections, but most people find it tolerable. It is common for the health care provider to apply pressure if an area bleeds after the injection. Applying pressure will help stop the bleeding. After the Procedure You should be able to resume your normal daily activities right after the procedure. But, you may experience bruising or other minor side effects from the injection. It is important to avoid rubbing or massaging the treated areas. Doing so can cause the toxin to move to a different area. Avoid lying down for two to four hours. To prevent bruising, you should avoid taking aspirin or related products, such as ibuprofen. You should discuss this with your health care provider prior to the Botox treatment. You should see results within three to 10 days. Wrinkles should disappear for up to three or four months. As time passes, the muscle activity will gradually return to normal. Other areas may return to normal sooner or later, depending on how much Botox was used. Two or three sessions of Botox treatment may be needed for deeper wrinkles before you notice results. People who use Cosmetic Botox may have additional procedures, such as the use of filler substances. Collagen is one type of filler substance. Collagen is a protein found in human connective tissue. It can be injected into the skin to raise wrinkles, making them easier to treat. The area of the crease between the eyes is an ideal place for Botox and filler together. These wrinkles don't always respond best to Botox alone. To get the best results, go to a health care provider who is experienced in Botox treatment. He or she should have a good reputation for performing this type of procedure. 4

5 The manufacturers of Botox recommend physicians inject the medication. Ask for a referral from your primary care health care provider. Look for a physician who specializes in your condition. He or she should have experience giving Botox treatments. Risks Botox injections are often safe when performed by an experienced health care provider. But side effects and complications can happen. If a side effect causes you problems or won't go away, talk to your health care provider. Side effects include: Pain and bruising at the injection site. Headache. Increased body sweat. Itching. Nausea. Redness. Temporary drooping eyelids. Temporary muscle weakness. Upset stomach. Side effects may happen hours to weeks after you receive Botox. Rarely, it is possible that the effect of the toxin may spread to other parts of the body. This can cause: Loss of bladder control. Muscle weakness all over the body. Vision problems. Trouble breathing. Trouble speaking or swallowing. Serious side effects are rare. They include: An allergic reaction, such as itching, hives, swelling, chest tightness or trouble breathing. Blistering, peeling of your skin or severe rash. Chest pain, shortness of breath or uneven heart rate. Eye pain, bleeding or bruising around your eye. 5

6 Face or neck pain. Flu like symptoms. Seizures. Call your health care provider immediately if you have any side effects after Botox treatment. Do not use Botox when you are pregnant or breast feeding. The effects on the baby are not known. Summary Botox injections work by weakening or paralyzing certain muscles. Botox blocks chemical signals from nerves that cause muscles to contract. It can have therapeutic or cosmetic effects, especially where muscles are chronically tight or spastic. Botox Cosmetic can temporarily relax the facial muscles that cause wrinkles. Botox can make them less noticeable. Botox is used to treat several medical problems, including: Cervical dystonia. Chronic migraine. Excessive underarm sweating. Lazy eye. Muscle stiffness in the elbow, wrist and finger muscles. Twitching of the eyelids and uncontrollable blinking. Botox injections take about 10 to 15 minutes. They are usually done in a health care provider's office. You may experience mild pain with the injections, but most people find it tolerable. You should be able to resume your normal daily activities right after the procedure. But, you may experience bruising or other minor side effects from the injection. You should see results within three to 10 days. Wrinkles should disappear for up to three or four months. As time passes, the muscle activity will gradually return to normal. Other areas may return to normal sooner or later, depending on how much Botox was used. 6