Preventative Benefits of Botox - Identical Twin Study

I wanted to share this often-referenced study that compared the effects of Botox on facial lines in identical twins where one twin had undergone regular Botox treatments over the preceding 13 years, and the other twin only had Botox treatments twice, several years prior to the study.

The results found that the twin treated with Botox regularly (image on the right) did not show as many of the signs of aging as her minimally-treated sister (image on left). Neither twin received treatment in the lower 1/2 of their face and a similar degree of aging was seen giving support to the belief that the differences that are seen in the upper face are related to Botox.

Of course there are many factors that can contribute to skin aging, something I highlighted in another recent post with a different study of twins. But in this study the researchers concluded that long-term treatment with Botox could in fact prevent the development of facial lines like forehead lines and crow’s feet that are otherwise more visible at rest when left untreated.

Are You Sweating Too Much? Learn more about treating hyperhidrosis

Sweating is normal and necessary to help regulate body temperature, but excessive sweating can be a sign of a condition called hyperhidrosis. People with hyperhidrosis may produce up to 4-5 times the amount of sweat required to cool the body. This condition has been estimated to affect between 2-5% of the population.

If you are dealing with excessive sweating there are a few options to consider. First, an antiperspirant containing aluminum can be considered and can be more effective if applied at night. There are other treatment options to consider, both in office or at home, but Botox injections are one of the most effective.

Botox is FDA approved to treat excessive axilla or underarm sweating but may also be used “off label” in other areas such as palms of the hands. Botox works by temporarily blocking the nerve signal responsible for producing sweat. The effect can last 4-12 months and there is over 80% reduction in sweat. Most people comment they are completely dry and it is one of the treatments I perform with consistently high patient satisfaction!

Basics of Botox

Botox may not be for everyone but if you’re trying to decide if it’s right for you and want to understand a bit more about it, here’s some more information:

First, Botox is a brand name but the name is often used to describe a whole class of neuromodulators that includes Dysport, Xeomin and others that work in a similar manner. I will use “botox” here to describe these products generally.

With botox, the effect occurs at a specific location where it is injected in the muscle and attaches to nerve endings. Once attached it inhibits the release of the neurotransmitter responsible for triggering muscle contractions. This reduces the strength of the muscle, thereby minimizing the appearance of wrinkles as muscles remain relaxed. The effects will generally last for 3-6 months.

One of the most common uses for botox is to treat lines in the upper third of the face. These lines are formed due to repetitive muscle movement. One location is the glabella, where botox is used to treat the “11s” (the lines made when you frown). Botox can also be used to treat horizontal forehead lines, “crow’s feet” and "bunny lines."  There is a large list of areas that can be treated, both on and off label, but these are some of the most common.

“Baby botox” is a term sometimes used to describe treatment with smaller doses but the number of units needed varies from person to person depending on their goals, the treatment areas and strength of muscles. In general though botox can be used to soften the appearance of lines and wrinkles while maintaining natural movement and not “freezing” the face.

It's important to understand that botox works primarily to treat dynamic wrinkles, not static wrinkles. Dynamic wrinkles appear when you make facial expressions, for example when you furrow your brow or smile. For deeply etched in static lines (present at rest), botox may not help reduce completely and hyaluronic acid fillers could be considered to soften these lines further.

5 Surprising Uses for Botox

Most often when we think about Botox it is for cosmetic use. However, Botox has many uses in medicine that people are often unaware of. Botox was first approved for medical use in the treatment of two eye muscle disorders more than 30 years ago. It was during use for treating eye conditions that the power of Botox for cosmetic reasons to minimize wrinkles was accidentally discovered. Botox is currently FDA-approved for 11 therapeutic indications and used “off label” for a number of other conditions.

Here are five uses of Botox you may not have known:

Chronic migraines - Botox injections are believed to interrupt pathways of pain transmission that cause headaches and migraines. Treating migraines generally requires multiple injections in the forehead, temple and neck. You should get this type of Botox treatment from a doctor who is trained in placement for best effect.

Hyperhidrosis - Excessive and often unpredictable sweating. People with hyperhidrosis may sweat even when the temperature is cool or when they are at rest. Botox is approved for use in the axilla (armpits) and is used off label in other areas, most commonly the palms. It can significantly reduce sweating and typically lasts 6-12 months.

Cervical dystonia - A painful condition in which neck muscles contract involuntarily causing the head to turn to one side. Botox injections to these muscles can relieve these muscle contractions.

Overactive bladder - Botox injected into the bladder can help relieve urge incontinence or overactive bladder symptoms (involuntary loss of urine).

Depression - Of the 5 mentioned this is the only one that is not currently FDA-approved and has been the subject of much debate. There are several theories as to how Botox may help, one of the most popular being the “facial feedback hypothesis” which has roots all the way back to Charles Darwin and rests on the idea that by reducing frowning (through botox injections or otherwise) you can reduce negative emotions.

There are a number of other uses beyond these, in addition to of course helping to deal with unwanted wrinkles. In 2017 Botox made the Time Magazine cover as “The Drug That’s Treating Everything.” It is one of the most well-researched medicines in the world with an amazing list of current and potential future benefits!