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Botulinum Toxin Uses and Side Effects

This post is also available in: हिन्दी (Hindi)

What is Botulinum Toxin?

Botulinum toxin in cosmetic medicine is a popular injectable that is used to temporarily reduce fine lines and wrinkles. Commonly used Botulinum toxin type A are Botox®, Dysport®, Xeomin®, and Jeuveau®. It is a protein produced by fermentation of bacterium Clostridium botulinum which is commonly found on plants, water, soil, and intestinal tracts of animals.

Botulinum Toxin

How does it act?

Botulinum toxin disrupts the nerve signaling that stimulates muscle contraction leading to temporary muscle paralysis. It also prevents the release of acetylcholine (a chemical that is released by the nerves), thereby stopping the muscle to contract. Due to less muscle contraction, the muscle becomes less stiff.

Where all can it be used?

• Forehead lines

• Crow’s feet (wrinkle at the outer corner of your eyes)

• Bunny lines (the fine line that appears on the side of the nose when one laughs or smiles)

• Lip lines/ smokers line/ lipstick lines (vertical fine lines seen around the lips)

• Nasal flare (widen nostrils)

• Necklines

• For browlift

• To soften a square jawline

It has also been used for hyperhidrosis (excessive sweating) of palms & underarms, migraine and, blepharospasm (abnormal contraction/twitching of eyelid muscles).

What are the contraindications for botulinum toxin injection?

• Pregnancy and lactation

• Prior allergic reaction or known allergy to this toxin

• Infection at the site of injection

• Known case of myasthenia gravis or multiple sclerosis

Are there any side-effects associated with botulinum toxin?

• Bruising

• Mild swelling at the site of injection

• Headaches which are more commonly seen if this is given to relax forehead lines and wrinkles due to overactivity of the muscle. It usually subsides within 2-3 days.

• Lid ptosis (drooping) which usually resolves within 1 to 6 months on its own.

• Brow ptosis (drooping)

• Spock brow or excessive brow elevation which can be corrected with 2-4 units of Botox®.

How is the procedure done?

The procedure should be performed by a qualified cosmetic dermatologist.

• This toxin is diluted with saline and injected directly into the neuromuscular tissue.

• The dilution of this toxin depends on the brand being used.

What is the post-procedure precaution that needs to be followed?

• DO NOT rub or massage the treated area for 24 hours as this could result in leakage of product to the adjacent areas.

Is there any downtime associated with botulinum toxin?

• Usually there is no downtime associated with botulinum toxin besides mild swelling at the site of the injection which subsides within 2-3 hours. Sometimes you may develop bruising after the injection.

When can one see the results?

• Results can be appreciated within 2-3 days following the injection and peak result is seen by 1 week.

How often should it be repeated?

The effects last for 3-12 months depending on the area treated, individual’s BMI, and the type of botulinum toxin used.

Dr Rupika

Dr. Rupika Singh

MBBS, MD Dermatology
Fellow in Dermatology Laser Surgery


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