Written by Aleksandra Agranovich
The Dangers of Botox Injections
Botulinum toxin (Botox) has been used for decades to treat varying cosmetic conditions and headaches. Botox is a neurotoxin that is produced by a bacterium called Clostridium botulinum and prevents the release of the neurotransmitter acetylcholine (Ach), thereby inducing muscle stiffness and causing paralysis. Many dermatologists inject their patients with Botox to temporarily relax facial muscles that cause wrinkles. This procedure involves the use of a refrigerated Botox vile, a syringe, and takes approximately a couple of minutes to complete. The effects of Botox injections usually last three to four months before waring off. Although a simple Botox procedure is very quick, it may cost up to fifteen dollars per unit of Botox, which may easily add up…
Most people usually rave about how amazing and flawless Botox looks, but what are the hidden dangers of this product and is it truly safe? There are typically no contraindications for Botox except hypersensitivity or severe allergic reaction. According to the article that has been referenced below, Botox should not be injected into infected skin, wounds, areas with psoriasis or eczema. It is also very important to avoid Botox injections if a woman is pregnant or breastfeeding. The botulinum toxin may potentially cause fetal harm if injected in large amounts.
Another factor that may interact with Botox may include certain drugs like cyclosporin, acetylcholinesterase inhibitors, and specific antibiotics. Cyclosporin, for example, can potentiate the effects of Botox and cause a paralyzing effect (Althawadi,2022). Some of the rare but serious side effects of Botox may include keloid scaring at the injection site, drooping of the skin, respiratory problems, facial weakness, headache, and pain
Botox for Headaches and Migraines
Throughout the years, botulinum toxin has been studied for the treatment of headaches and migraines. Evidence suggests that Botox can be used as a pain management technique in patients who suffer from constant tension-type headaches and neuropathic pain disorders. According to a study conducted by Carruthers MD, patients who were injected with Botox showed a "decrease in the incidence and severity of headaches for a period of three to four months, along with a reduction in the use of short-term analgesics" (Carruthers, 2004). Within this study, Botox was proven to be a safe and effective measure for the treatment of such conditions.
Refrences
Althawadi N, Ujam A, Visavadia B. Botox hidden dangers. Br Dent J. 2022;232(4):192-193. doi:10.1038/s41415-022-4006-3
Carruthers J, Carruthers A. Botox: beyond wrinkles. Clin Dermatol. 2004;22(1):89-93. doi:10.1016/j.clindermatol.2003.11.013
Khawaja HA, Hernandez-Perez E. Botox in dermatology. Int J Dermatol. 2001;40(5):311-317. doi:10.1046/j.1365-4362.2001.01176.x
Botox Injections and Their Side Effects
BOTOX is the trade name for onabotulinumtoxinA for injection. The routes of administration are intramuscular, intradetrusor, or intradermal use. The mechanism of action is to inhibit acetylcholine release and a neuromuscular blocking agent (Botox Package Insert). Botox is a chemically modified derivative of the botulinum toxin that is produced by the bacteria clostridium botulinum, which is a potent neurotoxin. Botulinum toxin is present in 7 different serotypes, but type A is most widely used, especially in the aesthetic and dermatology industries (Nigam PK). For therapeutic use, Botox is produced and harvested via chemical reactions into a sterile lyophilized form that is suitable for injection (Padda, IS).
The approved FDA indications for Botox include treatment of overactive bladder, urinary incontinence, treatment of neurogenic detrusor overactivity, treatment of bladder, migraine and headache prophylaxis, treatment of cervical dystonia, and treatment of severe axillary hyperhidrosis (Botox Package Insert). In contrast to its approved indications for use, Botox is primarily known for its cosmetic benefits in reducing wrinkles and frown lines, which is not an FDA- approved use for the product (Satriyasa BK).
Despite its popularity for minimizing the appearance and development of wrinkles, Botox does have side effects associated with its use. There is a Black Box Warning regarding the risk of distant spread of toxin effect. This means that drug can spread from the injection site and can produce symptoms of botulinum toxicity in other parts of the body within hours to weeks after receiving the product. Symptoms can be life threatening and fatal. Side effects can include bleeding, swelling, redness, and pain at the injection site. Other side effects include malaise, flu- like symptoms, and nausea. Botox can also cause trouble breathing and trouble swallowing, which can be fatal (Botox Package Insert).
To avoid potential complications, patients should be adequately screened for any complications or conditions that may predispose them to severe reactions, including allergies or injecting into open wounds (Botox Package Insert). Additionally, only licensed, and trained individuals should inject the product for cosmetic or therapeutic purposes. The minimum therapeutic concentration should be used, with appropriate doses being injected at least 1 centimeter apart (Satriyasa BK).
Citations:
Botox [Package Insert]. North Chicago, Illinois: Allergan Aesthetics (Abbvie), Revised 11/2023
Nigam PK, Nigam A. Botulinum toxin. Indian J Dermatol. 2010;55(1):8-14. doi:10.4103/0019-5154.60343
Padda IS, Tadi P. Botulinum Toxin. [Updated 2023 Nov 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557387/
Satriyasa BK. Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect. Clin Cosmet Investig Dermatol. 2019;12:223-228. Published 2019 Apr 10. doi:10.2147/CCID.S202919