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Botox is a botulinum toxin type A injectable solution that has been approved by the FDA for the temporary treatment of glabellar lines and crow’s feet. It is an effective treatment for excessive sweating, urinary incontinence, and continuous muscle spasms in the eyelids, limbs, or neck. Botox is a product of Allergan, a Dublin-based pharmaceutical company.
Botox is ideal for patients with moderate-to-severe crow’s feet or glabellar wrinkles between the eyebrows. Additionally, the injections are suitable for patients who suffer from excessive sweating (or primary axillary hyperhidrosis) and urinary incontinence. Botox is also effective for patients with persistent muscle spasms in the neck, eyelids (blepharospasm) and limbs.
Botox is contraindicated in patients who have a hypersensitivity to any ingredients in the injectable. In addition, do not use Botox if there is an infection at the injection site. If intended as a treatment for urinary incontinence, do not use when there is a urinary tract infection, or if the patients cannot empty their bladders on their own. Botox is not intended for patients less than 18 years of age; however, the treatment of strabismus or blepharospasm in patients over the age of 12 is approved by the FDA. As well, doctors use Botox to treat muscle spasms in the legs of children over the age of 2 with cerebral palsy.
Botox is administered into the muscle to treat:
Botox works by paralyzing the targeted muscles through the blockade of nerve cell signals. Once injected intramuscularly, Botox binds to the motor nerve terminals and prevents the release of acetylcholine. This leads to a partial chemical denervation of the muscle and reduced muscle activity. When the muscle is relaxed, they become less stiff.
Inject Botox is designed intramuscularly. The procedure is associated with minimal discomfort, therefore a topical anesthesia is seldom required. Depending on your patients pain tolerance, apply a local anesthetic as needed. Each condition will require a different dose amount. Refer to the product leaflet to determine the proper dosing requirements for the condition you are treating. For example, the suggested dose for the first treatment of chronic migraines is between 155 to 195 units. After reconstitution, the Botox solution should appear colorless, clear, and particulate-free. Prior to injection, check for discoloration and particulate matter. Store reconstituted Botox at a temperature of 2–8°C (do not freeze). Use within 24 hours after reconstitution. After use, dispose of the used needle and vial. Improvements may not appear for up to 6 weeks after treatment, depending on the condition.
When treating patients with more than one of the above indications, use no more than 400 units in a 3-month period.
Botox can last for 3 to 6 months in the treatment of glabellar lines. The duration depends on the condition being treated. The treatment should be repeated to maintain the results.
Botox may result in adverse reactions, including:
As with all botulinum toxin preparations, Botox may potentially result in the following serious side effects. See the product leaflet for more information.
There is usually no downtime associated with Botox. Most patients are able to resume their daily activities a few hours after treatments.
The unit price of Botox varies, ranging from $11 to $16.
At first glance, Botox may appear more expensive than other botulinum toxin preparations; however, it takes more units for other preparations to achieve similar results to Botox. It is estimated that 1 unit of Botox is equivalent to 2.5–3 units of a competitor.