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Botox has gained in popularity over the past as a quick and easy procedure to treat deep lines in the face. As with any treatment, Botox is not without its drawbacks. Let's look at what Botox is and why it may not be the best wrinkle treatment.

What Exactly Is Botox?

Although Botox has been used for years, it has only enjoyed FDA approval since 2002 for cosmetic purposes. What exactly is Botox? Botox is a trade name for botulinum toxin A. You may have heard of botulism, a form of food poisoning that occurs when a person eats a food containing a potent neurotoxin which is produced by the bacterium known as Clostridium botulinum.

Botulinum toxin A, or Botox, is just one of the neurotoxins that are produced by C. botulinum. Botulism causes many symptoms, the worst symptom being paralysis, which can sometimes prove fatal. Basically, the botulinum toxins block the nerve signals that instruct your muscles to contract. Why would anyone want to purposely inject such a dangerous substance into their body? The answer is simple: if a muscle is paralyzed, it cannot move; if it cannot move, it cannot wrinkle. Thus, Botox works by freezing the muscles that cause wrinkles, such as the deep groove that often appears on the forehead between the eyes.[1]

Botox is used to treat severe glabellar (frown) lines. It has been approved to treat patients up to 65 years of age. Botox causes frown lines to disappear temporarily, as long as the toxin is active. Botox has become so popular that many people have attended "Botox" parties, where Botox injections are offered to all who attend. In recent years, more and more young people have been using Botox in an attempt to prevent wrinkles from forming, although there is no research to support the theory that Botox can prevent wrinkles. In short, Botox has been hailed as a sort of "fountain of youth" for people wanting to rid themselves of their wrinkles.

Is Botox safe?

Several clinical studies have been done to assess the safety of Botox when used for cosmetic purposes. Some of the common side effects reported include [2, 3]:
  • Droopy eyelids (in up to 3% of people)
  • Muscle weakness (in up to 2% of people)
  • Heartburn or indigestion (in up to 1% of people)
  • Facial pain (in up to 2% of people)
  • Tooth problems (in up to 1% of people)
  • Hypertension (in up to 1% of people)
  • Nausea (in up to 3% of people)
Other side effects may include:
  •  Flu/respiratory symptoms
  • Headache
  • Redness/pain/swelling at the injection site
  • Bleeding
  • Numbness
A new Canadian study has raised concerns that Botox may affect muscles not treated by Botox. Researchers from the University of Calgary in Calgary, Alberta in Canada injected a group of rabbits with botulinum A toxin for a period of 6 months and found that the limbs that were injected lost almost ½ of their muscle mass. Even more concerning, the researchers found that the rabbits lost muscle mass in muscles located far away from where the toxin was injected. The FDA in the United States already requires the manufacturers of Botox to label Botox with a warning that the toxin can travel to unintended parts of the body. Doctors administering Botox are also required to provide patients with a letter outlining the risks.[4]

In 2008, Newsweek reported on a story regarding Botox and its ability to enter the brain. It seems that, prior to this time, researchers refuted the idea that Botox could travel to the brain. This changed in 2008, when researchers discovered that botulinum toxin can travel along the body's neurons from the site of injection to the brain. The study that changed their minds was performed on mice, but has raised concerns regarding the safety of Botox and others like Botox in humans.[1]

Although the number of severe side effects reported seems to be low in comparison to the number of people who have used Botox, these studies raise valid concerns about whether it is a wise idea to inject a known toxin into the human body for simply cosmetic purposes.

Why is Botox a bad idea?

Aside from the health risks outlined above, there are several other reasons why Botox may be a bad idea:
  • Cost. Botox is expensive. Because it is used as a cosmetic procedure, it is not covered under most health plans, meaning the entire cost must be borne by the consumer. The cost of a Botox injection varies, but is generally several hundred dollars. (It may be cheaper if provided by someone who is not a doctor, but getting an injection from someone who is not a health professional is risky). Botox Cosmetic is usually charged by the area. The three most common areas are the crow's feet, forehead, and the lines in-between the brows (glabella). Doctors typically use 60 units for those 3 areas and charge from $10 to $15 per unit. 
  • It wears off. Botox is not a permanent solution, and generally lasts less than 6 months. If you like what Botox does for your appearance, you will have to continue having Botox injections every 3 to 6 months. On the flip side of this coin, if you experience a bad result, it should wear off within 6 months.
  • It is less effective on the elderly. Elderly people may get less of the result they are seeking than younger people, a fact that they may not be aware of. Elderly people may be at higher risk for unwanted side effects than younger adults.
  • Too much Botox can lead to an inability to show expression. We have all seen pictures of Botox gone wrong- people who have received too much Botox and appear plastic, seemingly unable to change expression easily. This can lead to a frozen-appearing facial expression.

Botox is extremely popular, despite studies that have raised concerns about its long-term safety. For most people, Botox has proven safe; however, Botox is expensive, carries the risk of side effects, eventually wears off, is sometimes less than effective on the elderly and may lead to a wooden expression. Given these facts, you may want to think twice if you have been considering jumping on the Botox bandwagon.

When could Botox be a good idea? 

Botox is also used for chronic migraine treatments [5], as a treatment for Bells Palsy patients [6], and to stop hemifacial spasms or chronic eye twitching [7].