Botulinum toxin is made from a type of bacteria. It is toxic to the nerves. An injection puts this toxin into muscle. There, it blocks the chemical signal from the nerves to muscles. This will decrease the muscle contraction.
Botulinum toxin is used for cosmetic and medical reasons.
The injection process is often called
, although any brand of the botulinum toxin may be used.
The injection is FDA-approved to treat: Cervical dystonia—abnormal spasms of neck musclesBlepharospasm—spasm of eyelid musclesStrabismus
The injection has also been used to treat other conditions, such as: Migraine headaches
—spasm of esophageal muscles causing difficulties in swallowing
Muscle spasms due to
cerebral palsySpasticity associated with multiple sclerosisSpasticity in leg and arm muscles due to brain injury/strokeFocal limb dystoniasIncontinence due to bladder problemsAnal sphincter disordersPeripheral nerve painTemporomandibular disorder
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Complications are rare. When they occur, they are temporary and mild. Side effects are related to the site of injection. For example, if injections take place near the eyes, there may be complications with eyelids or brow line.
Temporary issues may include: RednessBruisingStinging around the injection sites
The following are less common reactions. They are generally mild and do not last long. NauseaFatigueFlu
Other complications that may occur include: Excessive weakness of the muscle around the eyes—can cause drooping of the eyelids or obstruction of visionDifficulty swallowing—can occur in patients receiving injections in their neckCompensatory hyperhidrosis—people being treated for hyperhidrosis may develop increased sweat production at another area of the bodyExcessive weakness or wasting in certain muscles—the injection may slow any improvement in the muscleNeck weakness in people with long, thin necks
Risk of the botulinum toxin spreading beyond the injection area—may cause botulism symptoms, including difficulty breathing and death in severe cases. Children with
may be at a higher risk for this side effect.
This procedure may worsen nerve or muscle disorders, such as:
Amyotrophic lateral sclerosis
The toxin can also interact with medicines, such as antibiotics. Tell your doctor about all of the medicines that you are taking.
You should not have botox if you: Have an infection or inflammation in the area where botox will be injectedAre sensitive to the ingredients in botoxAre pregnant or breastfeeding
Most often, none is given. Some patients may prefer to have the area numbed for comfort. In this case, a topical anesthetic may be used.
A thin needle will be used. The doctor will inject the toxin through the skin into the targeted muscle. You will often need several injections in a small area.
There is very little recovery needed, but remember to: Remain upright for several hoursAvoid alcohol
The length will depend on the number of sites involved. It is often less than 20 minutes.
You may have some minimal discomfort.
Normal activities may be resumed after the procedure. For the best recovery, follow your doctor's
The toxin temporarily weakens targeted muscles. The treatment lasts up to four months. With repeated use, the effects may last longer.
Contact your doctor if any of the following occurs: Difficulty breathingDifficulty swallowingDifficulty speakingSevere lower eyelid droop or obstructed visionExcessive weakness around the injection siteRash or any other sign of an allergic reaction
In case of an emergency, call for medical help right away.
Allergan Physician Production Information. Botox cosmetic (botulinum toxin type A). Published April 2008.
Ondo WG, Gollomp S, Galvez-Jimenez N. A pilot study of botulinum toxin A for headache in cervical dystonia.
Ward A, Roberts G, Warner J, et al. Cost-effectiveness of botulinum toxin type A in the treatment of post-stroke spasticity.
J Rehabil Med
5/17/2012 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Jackson JL, Kuriyama A, Hayashino Y. Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: a meta-analysis.
Last reviewed September 2013 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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