What is Botox?

What is Botox?

Clostridium botulinum, the bacterium from which Botox is derived, is found in many natural settings, including soil, lakes, and forests.

The bacterium can also be found in the intestinal tracts of mammals and fish and in the gills and organs of crabs and other shellfish. Such naturally occurring instances of Clostridium botulinum bacteria and spores are generally harmless. Problems only arise when the spores transform into vegetative cells and the cell population increases. At a certain point, 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.

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Function

Botulinum toxin is one of the most poisonous substances known to man. Scientists have estimated that a single gram could kill as many as 1 million people and a couple of kilograms could kill every human on earth. In high concentrations, botulinum toxin can result in botulism, a severe, life-threatening illness. Botulism, left untreated, may result in respiratory failure and death. Despite botulinum toxin being so toxic, Botox is in huge demand.

Despite this, botulinum toxin has proven to be a successful and valuable therapeutic protein.

Botulinum toxin can be injected into humans in extremely small concentrations and works by preventing signals from the nerve cells reaching muscles, therefore paralyzing them.

In order for muscles to contract, nerves release a chemical messenger, acetylcholine (a neurotransmitter), at the junction where the nerve endings meet muscle cells. 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. Botulinum toxin causes a reduction in abnormal muscle contraction, allowing the muscles to become less stiff.


Uses

Botox is most commonly used for cosmetic purposes to improve the appearance of fine lines and wrinkles.

Botulinum toxin is predominantly used as a treatment to reduce the appearance of facial wrinkles and fine lines.

Beyond aesthetic applications, Botox is used to treat 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.

Botulinum toxin is currently approved for the following therapeutic applications:

  • Blepharospasm (spasm of the eyelids).

  • Idiopathic rotational cervical dystonia (severe neck and shoulder muscle spasms).

  • Chronic migraine.

  • Severe primary axillary hyperhidrosis (excessive sweating).

  • Strabismus (crossed eyes).

  • Post-stroke upper limb spasticity.

  • Detrusor (bladder wall muscle) overactivity - causing urinary incontinence.

  • Overactive bladder.

  • Hemifacial spasm.

  • Glabellar lines (frown lines between the eyebrows).

  • Canthal lines (crow's feet).

Botulinum toxin is also used off-label (not approved) for:

  • Achalasia (an issue with the throat that makes swallowing difficult).

  • Anal fissure and anismus (dysfunction of the anal sphincter).

  • Sialorrhea (producing too much saliva).

  • Allergic rhinitis (hay fever).

  • Sphincter of oddi (hepatopancreatic) dysfunction (causes abdominal pain).

  • Cerebral Palsy.

  • Oromandibular dystonia (forceful contraction of the jaw, face, and/or tongue).

  • Laryngeal dystonia (forceful contraction of the vocal cords).

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).