Botulinum toxin - a toxin obtained with the help of bacteria Clostridium botulinum , popularly called botox. It is used not only in aesthetic medicine, but also, in particular, in neurology. It is a fairly strong poison, however, administered in small quantities, is completely safe.
What is botulinum toxin?
Botulinum toxin is a substance produced by the anaerobic bacteria Clostridium botulinum . It is produced in soil, bottom sediments, as well as in improperly prepared and stored meat and vegetable cans. Eating such canned food can lead to botulism. It has an adverse effect on neuromuscular tissue and affects muscles. This substance is sensitive to high temperatures (breaks down at temperatures above 60 o ).
There are several types of this toxin, which are indicated by the letters from A to G. In order to improve the appearance of it, it is used in very small doses, which do not cause side effects. In aesthetic medicine, botulinum toxin type A is used.
Poisoning with this substance occurs much less frequently than in the past. This is due to the fact that food began to be stored in better conditions. When there is a chance of poisoning with this poison, you should perform a gastric lavage and take a laxative to remove as many toxins from the gastrointestinal tract as possible. In case of poisoning, an anti-toxin (anti-botulinum serum) is administered to the patient. It is very important to maintain proper hydration and diet during treatment.
There are also cases of poison entering the wound, for example, through the soil. In such cases, the necessary action is surgical cleansing of the wound and antibiotic therapy.
The mechanism of action of botulinum toxin
The mechanism of action of this substance was used first in the treatment of neurological and ophthalmic diseases. The toxin was used, in particular, to relieve excessive muscle tension in children with cerebral palsy, or people who have had a stroke. When they started treating them with squint, it was noticed that it not only improves the condition of the eyes, but also smoothes wrinkles. By trial and error, doctors have developed dosages, as well as methods of injecting the drug. In the 80s of the last century, the drug began to be used in aesthetic dermatology. It was a very popular complex.
Type A botulinum toxin suppresses the release of acetylcholine, the neurotransmitter responsible for the generation of impulses between nerves and muscles. It acts by blocking the connection between nerve endings and muscles, that is, it blocks the so-called neuromuscular synapses. Botulinum toxin binds to the membrane of presynaptic receptors and blocks the release of acetylcholine. This leads to the fact that the muscles relax, and wrinkles are smoothed for a while. This process is used in medicine.
In diseases such as strabismus, neurological pathologies that occur with excessive muscle tension, hyperhidrosis, facial wrinkles, botulinum toxin is used. The drug works with this substance locally, but since nerve fibers have the ability to create new compounds, the therapeutic effect decreases and disappears 4-6 months after the toxin injection. Therefore, the procedure must be repeated.
The drugs used in medicine are made in laboratory from isolated strains of bacteria, cleaned and placed in vacuum packaging in strictly measured doses. They are safely and effectively used in many fields of medicine.
In aesthetic dermatology, doses of about 20-60 units are used for smoothing wrinkles during one procedure. Their toxicity is out of the question, since the toxic dose for humans is from 2.5 to 3 thousand units.
Dermatology Application
Botulinum toxin type A-hemagglutinin complex (Botulinum toxin type A - hemagglutinin complex) is known in aesthetic medicine under the names Botox, Dysport, Xeomin.
In order for a drug with this substance to begin its action, it must be injected into a specific muscle. Injections of botulinum toxin block neuromuscular conduction, prevent muscle spasm and cause their relaxation. In the end, a good cosmetic effect is obtained, that is, after muscle relaxation, small wrinkles cease to be noticeable. In addition, existing wrinkles will not become deeper, which is a kind of prevention that allows you to extend youth. Also, people whose wrinkles are not yet visible can use botulinum toxin. Its timely use will help the skin of the face stay young and smooth for a long time. This does not mean that teenagers should go through the procedure. The introduction of botulinum toxin is performed only after consultation with a specialist in aesthetic medicine. The doctor should explain to the patient how the procedure goes, tell about the results and possible side effects. The final decision on the operation must be made consciously by the patient.
Indications for use
This medication is often used in patients with facial wrinkles on the forehead and eye area. They can occur even in very young people and are associated with the usual facial expressions. If the wrinkles are very deep, sometimes an additional procedure is required - filling them with hyaluronic acid (for example, Dethail, Juvederm). It can be combined with other methods of facelift.
The drug is used to remove:
- wrinkles between the eyebrows (forehead);
- around the eyes (crow's feet);
- others: lower eyelid, the area around the mouth, on the chin, neck.
In dermatology, it is also used to treat hyperhidrosis of the palms, feet and armpits. Injections are recommended in the treatment of diseases associated with muscle cramps and nerve tics, in the treatment of spasticity in children with cerebral palsy, in ophthalmology for the treatment of strabismus. The introduction of Botox into the corresponding areas of the forehead and neck treats headaches.
Procedure
Botulinum toxin is injected into the muscle using a disposable syringe with a special needle. A small amount of the drug is accurately injected into several places on the face. The procedure does not last long. Depending on the number of injection points, it takes about 15-20 minutes. The pain associated with the introduction is minimal. Many patients compare it to the bite of an ant or mosquito. The procedure does not require local anesthesia. For patient comfort, local cream anesthesia (e.g., EMLA) is sometimes used for approximately 1 hour before the procedure.
After operation
Wrinkles are completely or partially eliminated, facial expression becomes softer, it looks natural, the overall facial expression is preserved. The dose used for cosmetic purposes is many times lower than therapeutic doses and is completely safe. It is selected individually depending on your needs.
The toxin begins to act after 2-3 days from the moment of injection. A full therapeutic effect will be noticeable only after 7-10 days. The effect after the procedure lasts an average of 6 months. It depends on the individual characteristics of the body.
After a while, the facial expression gradually becomes the same. After the injection has expired completely, treatment should be repeated. A person after one procedure - that is, about a half-year period of the action of injections - looks younger, more rested.
Therapy with the use of botulinum toxin for aesthetic purposes is relatively simple, performed on an outpatient basis, does not require any special diagnostic tests. Immediately after its completion, the patient can return to his daily activity.
Contraindications
Absolute:
- disorders of neuromuscular conduction;
- hypersensitivity to the components of the drug (human albumin);
- skin inflammation;
- pregnancy, lactation period.
- the use of other drugs: aminoglycosides (streptomycin, gentamicin), aminoquinolines (chloroquine, hydroxychloroquine), D-penicillamine, Cyclosporin, Tubocurarine, lincomycin, tetracycline, polymyxins.
Relative:
- clotting disorders;
- the use of anticoagulants (e.g. aspirin).
Treatment is not practiced in children under 12 years of age (with the exception of some neurological and ophthalmic indications).
Lack of indications for the operation is also a contraindication, which should be remembered. Not every person needs cosmetic procedures with this drug to reduce wrinkles, and the task of a competent doctor is to explain this fact to the patient.
Side effects
During and after the procedure, you may see:
- pain at the time of injection;
- small hematomas at the injection site if the needle enters the vessel;
- excessive decrease in the level of the eyebrow or its too much rise;
- small swelling with the appearance of a slight tingling at the injection site;
- excessive sagging muscles (when lowering the eyelids, corners of the mouth);
- headache after using an anesthetic.
Note: these reactions usually disappear after a few days. There is no risk of any scars or damage, and the injection site remains invisible. The risk of side effects depends on the muscle into which the drug is administered, so the procedure should be discussed in detail with the doctor before performing it.
Postoperative Behavior
After botulinum toxin injections:
- it is impossible to train facial muscles for an hour;
- avoid massage at the injection site for 4 hours;
- after the procedure, do not tilt your head down (for example, when putting on shoes or during sleep).
Repetition of the procedure
Injections can be repeated every 6-8 months, but not more than once every 3 months. This is one of those procedures that patients return with joy, because it gives a very quick and long-term result, noticeable to everyone. At the same time, this procedure is non-invasive and easy to perform.