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When it comes to cosmetic procedures, Botox or botulinum toxin injection is the most common cosmetic procedure performed today. The American Society of Plastic Surgeons estimates that in 2018 more than seven million people received botulinum toxin injections.
Most people associate botulinum toxin injections with the treatment of wrinkles. However, it is used for many other conditions, including spasticity, twitching of the eyes (blepharospasm), twitching of the neck (cervical dystonia), migraines, and overactive bladder. The Botox is also used to treat severe underarm sweating (hyperhidrosis).
The story of how we came to inject this microbial toxin into our bodies to treat wrinkles is fascinating.
What is Botox?
Botox or botulinum toxin is produced by bacteria Clostridium botulinum. In nature, infection with Clostridium botulinum causes botulisma rare but disabling paralytic disease. THE Botulism begins with paralysis of the muscles of the face, mouth and throat before spreading to the rest of the body. When botulism paralyzes the muscles used in breathing, death can occur.
Although the Clostridium botulinum available in different strains – eight serotypes A, B, C1, C2, D, E, F and G – only serotypes A and B are used to create clinical preparations.
How does it work:
After injection into the muscle, the botulinum toxin diffuses the nerve ending and binds thereby preventing the release of acetylcholine, a neurotransmitter. Without acetylcholine, muscle activity stops. It is this focal, or site-specific, paralysis that smoothes wrinkles and stops spasms. In other words, Botox works by “paralyzing” wrinkles.
The unwanted side effects after botulinum toxin treatment include bruising, swelling, headaches, discomfort as well as muscle weakness that can affect the muscles surrounding the injected muscle.
Before the botulinum toxin injection, the use of anticoagulants should be discontinued for two weeks to minimize bruising. THE pain at the injection site can be minimized by using a small-gauge needle, applying local anesthetic, or freezing the area prior to injection. In addition, botulinum toxin treatment should be started at a lower dose and increased gradually.
The effects of botulinum toxin wear off over time.
The origin of botox
Clostridium botulinum first discovered by a Belgian scientist name Emile-Pierre van Ermengem following an outbreak of botulism in Belgium. Beginning in the 1920s, scientists at the University of California, San Francisco, first attempted to isolate the botulinum toxin. However, it took 20 years before botulinum toxin was finally isolated in crystalline form by Dr. Edward Schantz.
In the 1970s, scientists began using botulism toxin to treat it strabismus. After botulinum toxin proved successful in treating strabismus, Allergan licensed the treatment and named it Botox. Subsequently, Botox received FDA approval for a variety of medical and cosmetic uses.
Here are the dates of the various FDA approvals for botulism toxin:
- Strabismus and blepharospasm in 1989
- Cervical dystonia in 2000
- Glabellar lines in 2002
- Axillary hyperhidrosis (excessive sweating) in 2004
- Chronic migraines and upper lip spasticity in 2010
- Urinary incontinence in 2011
- Crow’s feet το 2013
In the annals of medicine, botulinum toxin is probably most notable for being the first microbial injection used to treat disease. The injection of bacterial products into the human body represents a new invention.
With each passing year, researchers are developing more formulations of this versatile agent and finding more uses for it.
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