Botulinum toxin (Botox): wrinkles, expression lines and other uses

How it works

Botulinum toxin temporarily blocks the communication between nerve and muscle. As a result, the treated muscle contracts with less force, and the skin over it no longer folds as intensely, which softens expression lines.

Wrinkles that appear only with movement (dynamic wrinkles) respond best to treatment. Over time, repeated contraction can mark the skin even at rest (static wrinkles); in these cases, the toxin reduces the depth of the lines, and combining it with other treatments may be recommended.

The same muscle-relaxing effect is used in other situations, such as a masseter enlarged by bruxism (clenching or grinding the teeth), a gummy smile and neck bands. In the sweat glands, the toxin reduces sweat production in hyperhidrosis.

Indications

• Wrinkles and expression linesForehead lines, frown lines and crow's feet.
• Bruxism and masseterMasseter hypertrophy and the lower contour of the face.
• Gummy smileExcessive gum exposure when smiling.
• Neck and décolletageVertical neck bands and neck lines.
• Excessive sweatingHyperhidrosis of the underarms, hands and other areas.

Treated areas

What a session is like

At the appointment, the doctor assesses the muscles with the face at rest and in motion and marks the injection points. After the skin is cleaned, the toxin is applied with a very fine needle, at a few points per area. Anesthesia is usually not needed; a cold compress can be used for added comfort.

Recovery

You can return to your activities right after the application. Small bumps at the injection points disappear within minutes, and there may be a small bruise at one of the points.

Sessions and results

The effect begins two to three days after the application, peaks in about 15 days and lasts, on average, four to six months. How often to repeat the treatment depends on the dermatologist's individual evaluation and on each patient's clinical concern. The response varies from person to person.

Contraindications

Botulinum toxin is not recommended during pregnancy and breastfeeding, for people with neuromuscular diseases such as myasthenia gravis, for those allergic to the product's components, or over active infections or inflammation in the area. Some medications, such as certain antibiotics, require evaluation.

At the evaluation, the dermatologist reviews your health history, current medications and previous procedures to confirm the indication.