THE 101 : Botox

For me, Botox is as commonplace as toothpaste, but from some, the idea of freezing your muscles is still terrifying! Here's what you need to know.

What exactly is it and how does it work? Botox is a brand from the pharmaceutical company, Allergan. Its botulinum toxin (a purified version of the bacteria that causes botulism) that prohibits nerves from delivering their signal to muscles, typically in your face. Its also referred to as a 'neurotoxin'.  It blocks the ability of the nerve ending to secrete acetylcholine, which the muscle needs in order to contract.  By blocking these nerve endings, the muscles in your face  stay in a relaxed position so you stop scrunching, and when you stop scrunching, the wrinkle disappears. It can be used preventatively if you do happen to have really strong muscle movement; Botox essentially freezes the muscle, so leaving you unable to make a scrunching wrinkle-causing expression, any wrinkles from these muscles will take longer to develop. 

How long has it been around, and how we do we know its safe? Scientists have been playing around with this stuff for over a hundred years! In 1989, it got approval to treat eyelid spasms. Throughout the nineties, it was used to treat bladder spasms, writer's cramp, excessive sweating, even cerebral palsy in kids. Finally, in 2002, Botox got approved by the FDA to treat wrinkles, and continues to get FDA approvals for other uses. 

Where in your face do you get it and does it hurt?  Though Botox can be used many places, the most common areas are crow's feet around the eyes, frown lines between the eyebrows, and furrows on the forehead. Some doctors can make lines on the neck smooth out also! If you have excessing sweating, Botox can also get injected into the glands under the arms. Getting needles in your armpits totally hurts for a minute but is really nice to sweat less during those really hot months. Injections on the face are much easier, you feel each pinch, but as soon as its done, there is zero pain. There can be a bit of bruising, but its rare, and staying off anything that can thin your blood for 48 hours prior can help minimize bruising. 

How long does it last? Botox typically wears off in three to four months. If you're using it under your arms, it can actually last up to nine months.When it does wear off, everything will go back to normal but it won't happen overnight.  

What are the side effects? Any drug can have side effects. The most common issues are headaches and bruises, poking needles in your face will usually do that..

Are there any alternatives?  Nothing can relax the muscle like Botox, but certain skin care treatments can improve the look of wrinkles. High doses of vitamin A applied topically (like retinoids) are the most studied topical skin care ingredient to improve wrinkles. Treatments like micro-current devices done in a facial, or home care gadgets can improve these types of lines, but need to be done consistently to keep the results looking good.

What age should I start getting Botox? These type of procedures aren't for everyone, and thats ok! If you are interested in anti-aging procedures, and want to stay ahead of pre-mature aging, Botox can be a really great, inexpensive treatment for you. There is no right or wrong age, Botox isn't an age thing, its a muscle thing. I have seen teenage girls with deep forehead wrinkles, that doesn't mean they should be doing it, but just to give an idea that there isn't a particular age when wrinkles appear due to strong muscles. On the flip side, I've seen women in their fifties and sixties with super smooth foreheads, who may never need Botox. Again, its all about how much muscle movement you have. Personally, my forehead has been getting Botox since I was about 25, and can actually go longer now in between treatments instead of exactly every 4 months.

The nurse at my dentist offers Botox, can I do it with them?  I wouldn't. I saw a sign in my gyno's office that they now offered Botox. I get it, everyone wants a piece of the pie. Over 6 million Botox procedures were performed in 2014 and surely reports of next year will be even higher. Your dentist and gyno both get extensive medical training, but there are specialities within medicine for a reason. So even though a nurse can administer this, but they don't have anywhere near the training a doctor has. See a board certified (very important!) dermatologist or plastic surgeon.