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How Does Botox Work?

Botox is a drug made from a neurotoxin produced by the bacterium Clostridium Botulinum. It is used medically to treat certain muscular conditions and cosmetically remove wrinkles by temporarily paralyzing muscles.

Botulinum toxin is sold commercially under the names:

Botox, Vistabel, Botox cosmetic (OnabotulinumtoxinA or botulinum toxin type A)

Dysport (AbobotulinumtoxinA or botulinum toxin type A)

Bocouture, Xeomin (IncobotulinumtoxinA or botulinum toxin type A)

Myobloc (RimabotulinumtoxinB or botulinum toxin type B).

The origin of botox

Clostridium Botulinum, the organism from which Botox is derived, is found in inactive form in the natural environment, including in the forest and cultivated soils, and in the sediment of lakes, streams, coastal and untreated waters. The bacterium can also be found in the intestinal tracts of mammals and fish and in the gills and viscera of crabs and other shellfish. Such naturally occurring instances of Clostridium Botulinum bacteria and spores are typically relatively harmless. Problems only usually arise when the spores transform into vegetative cells and the cell population increases to the point where the bacteria begin producing botulinum toxin, the deadly neurotoxin responsible for botulism.

Neurotoxins target the nervous system, disrupting the signaling processes that allow neurons to communicate effectively. The neurotoxin involved in producing Botox, botulinum toxin (abbreviated either as BTX or BoNT), is subdivided into eight types A, B, C [C1, C2], D, E, F, G and H. Of these, types A, B, E and, in rare cases, type F cause botulism in humans, while types C and D cause illness in other mammals, birds and fish. Although type G has been isolated from soil in Argentina, no outbreaks have been identified involving this toxin. Type H was discovered in 2013 in the feces of a child suffering from botulism. Researchers withheld the specific DNA sequence of type H from public databases, as there was no known antidote for what they believed was a novel type of botulinum toxin. Subsequently, Researchers from the Centers for Disease Control and Prevention (CDC) and the University of Wisconsin (UW) found that type H may in fact not be a novel toxin, with a paper published in the Journal of Infectious Diseases (JID) reporting that the toxin can be blocked by antitoxins already in use.

How does botox work?

In order for muscles to contract, nerves release a chemical messenger, acetylcholine (a neurotransmitter), at the junction where the nerve endings meet muscle cells. The acetylcholine attaches to receptors on the muscle cells and causes the muscle cells to contract or shorten. Injected botulinum toxin prevents the release of acetylcholine, preventing contraction of the muscle cells. The effect of botulinum toxin causes a reduction in abnormal muscle contraction allowing the muscles to become less stiff.

Medical and cosmetic uses of botox

Botulinum toxin is predominantly used as a treatment to reduce the appearance of facial wrinkles and fine lines in older adults. Beyond aesthetic applications, Botox has been found useful in treating a variety of medical conditions including eye squints, migraines, excess sweating and leaky bladders. Botulinum toxin is currently used to treat over 20 different medical conditions, with more applications under investigation.

How is the botox procedure performed?

Botulinum toxin is administered by diluting the powder in saline (sodium chloride) and injecting it directly into neuromuscular tissue. It takes 24-72 hours for botulinum toxin to take effect, which reflects the time needed for the toxin to disrupt the synaptosomal process. In very rare circumstances, it may take as long as 5 days for the full effect of botulinum toxin to be observed.

Risks and side effects of botox

Injections with botulinum toxin are generally well tolerated and there are few side effects. In rare cases an individual may have a genetic predisposition that results in a mild, transient unusual response to the drug. Because of that Botulinum toxin should not be used in pregnant or lactating women, or by people who have had a previous allergic reaction to the drug or any of its ingredients.

Along with its intended effects, botulinum toxin may cause some unwanted effects. These can include;

-Mild pain, local edema and/or erythema at the injection site

-Transient numbness



-Mild nausea

-Temporary unwanted weakness/paralysis of nearby musculature caused by the action of the toxin

-Temporary upper lid or brow ptosis (drooping)

-Weakness of the lower eyelid or lateral rectus (a muscle controlling eye movement)


-Neck weakness

-Influenza-like illness

-Brachial plexopathy (a condition affecting the nerves either side of the neck and chest)

-Gallbladder dysfunction

-Diplopia (double vision)


-Blurred vision

-Drooping of the eyelids

-Decreased eyesight

-Dry mouth






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