What Is Botox & How Does it Work?


Botox injections are commonly used to temporarily lessen wrinkles and other types of facial lines. Botox can also be used for diseases such as strabismus (lazy eye) or blepharospasm (uncontrolled blinking), as well as other muscular conditions. Botox is made of diluted botulinum toxin, which at full strength causes food poisoning, but in its diluted form safely relaxes muscles to create a more youthful appearance. Because it is created from such a dangerous substance, trained physicians should be administering the injections and managing any side effects that may occur.


Botox is the trade name of a purified preparation that is derived from the botulinum toxin A. The bacteria, Clostridium botulinum, produces 6 different types of botulinum toxin, but most research has been done with type A. In large quantities, botulinum causes botulism, a kind of food poisoning and muscle paralysis.

Botulinum toxin itself is a potent neurotoxin, but in 1981 in the Transactions of the American Ophthalmological Society Journal, Dr. Alan B. Scott published the first study that showed the efficacy of using the purified solution to selectively paralyze eye muscles in humans and improve strabismus. Small amounts of botulinum injected into these muscles were effective and safe. The FDA approved botulinum in 1989, and the preparation Botox to treat moderate to severe frown lines in adults 18 to 65 in 2002.

How It Works

As a neurotoxin, when injected in small amounts into the muscle itself, Botox interrupts the transmission of nerve signals; this causes the muscle affected to weaken temporarily. These muscles are not able to contract, and the skin overlying these muscles becomes flattened against the muscle. This smoothing effect applies to frown lines, forehead wrinkles and crow's feet—any place on the face where the lines are associated with muscle contraction. Lines that are caused by the sun will not improve with Botox.


Many of the cosmetic issues that Botox is used for at one time had to be treated by more drastic procedures such as plastic surgery. All surgeries have risks, including the risks of anesthesia. Botox injections only take a few minutes and are injected with a thin needle into specific muscles, so no anesthesia is needed. In about a week, you will see the full effect of the injection, but the results are not permanent. The improvement usually lasts for 3 to 6 months.

Another benefit is that the person can judge the results of the injection without making a permanent commitment to plastic surgery.

Side Effects

According to the Mayo Clinic, the side effects of Botox injections include mild bruising and pain around the injection sites, nausea, flu-like symptoms and redness. Rarely, headaches may develop, but these only last 24 to 48 hours.

A few patients may develop eyelid drooping or drooping of other muscles of the face. This is often caused by massaging or rubbing the injection site, causing the Botox to spread to another part of the face. It is suggested that a person should not rub the area for at least 12 hours or should lie down for 3 to 4 hours to prevent this migration.


Several issues should be considered when deciding to have Botox injections. Select the doctor who will be doing the Botox injection carefully and do research on his experience with Botox injections. Don't use alcohol for about 1 week prior to the injections, and aspirin and other anti-inflammatory medications should be avoided for 2 weeks before to prevent bruising.

Pregnant women or women who are breastfeeding should not receive Botox injections. Certain neurological diseases prevent the use of Botox as well.

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