Body Basics - your health in Spain

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What is Botox? (Botulinium Toxin)

Botox has been used for years to treat muscular problems, including eye deviation, eyelid spasm as well as facial spasms. Ageing is associated with the development of wrinkles and furrows on the face. These lines may develop as a result of weakened dermal collagen from sun exposure and gravity, or due to facial muscle action on the skin.

Botox or Botulinium toxin reversibly freezes or paralyses muscles; it therefore may be used to treat facial lines caused primarily by the action of the muscles in the skin. The ideal areas to treat are those wrinkles caused by muscles that have no significant function. Examples include the deep crease between the eyebrows, crow's feet wrinkles and forehead lines.

Treatment involves injecting a small amount of Botox into the area concerned which may cause a mild, temporary discomfort. Immediately after the injections there may be a mild swelling, which usually subsides within 24-48 hours. A "bump" or swelling is normally present for 12-24 hours at each treatment site and is often accompanied by a small "needle stick" mark. This is normal and should not cause concern. It is not uncommon to experience some localised tenderness, aching, stiffness and heaviness at treatment sites. This is normal and should not cause concern.

Obviously, the area needs a bit of T.L.C for a few hours after treatment. For example, to relieve discomfort, you may lay a cool wet washcloth or gauze pad over treated areas if you wish, but do not place heavy ice packs (frozen peas etc.). This may result in unwanted spreading of injected Botox to adjacent areas. You may take an over the counter pain medication such as paracetamol, Aspirin or Ibuprofen if you wish. Do not press, rub or massage the treated areas for about 24 hours. This also may result in unwanted spreading of Botox to adjacent areas. Wash your face gently for the first 12 hours, using your regular skin care products. Doctors recommended that you avoid flying within 24 hours of having treatment.

Side effects are rare, but as with all cosmetic treatments, can happen. Studies have shown an occasional and temporary drooping of the eyelid may occur, but this is only known to last a few weeks. Rarely, a transient numbness may develop in the treated area, or a temporary weakness of the muscles moving the eye may cause double vision, but this is also short-lived. Some patients have developed antibodies or allergies to the botulism toxin, causing generalised weakness or fatigue. Mild bruising may occur and if you are prone to cold sores at the injection site, treatment may bring out another eruption. Certain antibiotics should not be taken at the time of treatment so check with your practitioner. Finally, any injection carries a small risk of infection so if you are pregnant or breast feeding, it is probably best to wait.

The effect of Botox treatment is not immediate. Relaxation of the treated muscles often takes 3 to 10 days, sometimes longer. Initially, the Botox effect will be evident only as a reduction in the strength of the muscle contraction in the treated area and not a reduction of wrinkles and lines. In time, a softening of wrinkles and lines is usually noted as the skin undergoes self-repair. Deep lines that are heavily etched in the face, may not completely disappear with Botox treatments alone and may require additional treatment with collagen or Hylaform Gel - speak to your practitioner.

The goal of the treatment is reduction in muscle hyperactivity - not a complete absence of muscle movement. Most patients will still be able to move injected areas slightly after successful treatment by using untreated muscles located nearby. Occasionally, excessive hyperactive muscles will require a "booster" treatment at around 3-4 weeks.

Botox treatment is not permanent and generally lasts approximately 3 months. Duration of effect will vary however from patient to patient. Treatment will be most effective when patients get on a regular treatment schedule and receive their next injection before Botox effect wears off.

As with all cosmetic surgeries, you must check that the practitioner is specifically qualified to undertake such treatment. Ask to see their qualifications and if you are at all concerned - don't do it.

Dr. Karen Gardner holds a monthly Botox Clinic at her surgery in Javea.
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