Some of the most frequent questions I get asked are about Botox and how it works, so I wanted to share some basic information for anyone thinking about getting botox treatment. Botox can be used for many things, including treatment of migraines and excessive sweating, but this post will focus on cosmetic Botox treatments for reducing wrinkles.
Botox is a brand name for botulinum toxin A, a neurotoxin that causes the condition known as botulism. The type of botulism most people have heard about is food borne and can be very serious if not treated as it can spread through the blood stream. In the use of injectable Botox, botulism occurs in a contained location, specifically where it is injected in the face. Here the botulinum toxin attaches to nerve endings. Once attached to the nerve endings it inhibits the release of the neurotransmitter responsible for triggering muscle contractions.
Essentially Botox “freezes” the muscle, thereby reducing the appearance of wrinkles as muscles remain relaxed. The effects of Botox will last for 3-6 months.
One of the most common uses for cosmetic Botox is to treat the hyperdynamic lines, often called “worry lines” or "frown lines" found in the upper third of the face. These lines are formed due to repetitive muscle action in specific areas. A specific area of use is the glabella, where Botox is used to treat the “11s” (the lines made when you furrow your eyebrows). Botox can be used to treat horizontal forehead lines, “crow’s feet” and "bunny lines." We also use Botox to provide a lateral eyebrow raise, to help with dimpling of the chin, and to minimize large masseters (the muscle on the lateral face that we use to chew). There is a large list of areas that can be treated with Botox but these are the most common.
Many people think of wrinkles and assume Botox is the best treatment. However, it’s important to understand that Botox works to treat dynamic wrinkles, not static wrinkles. Dynamic wrinkles only appear when you make facial expressions, for example when you furrow your brow, frown, or smile, so you don't see them when your face is still. Static wrinkles, on the other hand, are wrinkles you have even when your face is at rest. For example, if you have 11s in between your brows without moving your face, those are static wrinkles.
If Botox were to freeze the muscles around a static wrinkle, it wouldn't make that much of a difference in the appearance since the wrinkle would still be there with or without any muscle contraction. However, with long term use, Botox can help prevent shallow static wrinkles from growing deeper.
The bottom line is that Botox can help reduce wrinkles in motion, not wrinkles at rest. Botox will not help for lines that are deeply etched in your skin. For these static wrinkles we often need to consider soft-tissue fillers.
Obviously the decision of whether or not Botox (or any other cosmetic treatment) is right for you is one that deserves careful consideration and should include consultation with a dermatologist trained in the use of injectables. My hope with this post was simply to provide a better understanding of how Botox works. For additional information, there is a good post on Real Self that addresses some common myths about Botox.