What you should know before having your treatment

What exactly is Botox?

Botox is the name most people associate with the world's  leading anti-wrinkle treatment.

This product uses a formula of botulinum toxin to temporarily paralyse muscles, ironing out wrinkles and frown lines.

Botox,  in the brand name owned by pharmaceutical company Allergan which has the largest share of this market - some 85%.  But there are other products containing different formulations -  Dysport from Valeant Phamarceuticals, Myobloc from Solstice Neurosciences and Xeomin from Merz, which have a combined 15% market share.  And Johnson & Johnson is also on the verge of launching its own version.


Since the formulations for each product are unique they are not interchangeable. But they all contain a certain amount of botulinum toxin, which has been laboratory manufactured by the same microbe that causes botulism, a serious form of food poisoning.

As well as treating wrinkles, Botox injections are also used for several chronic health problems as mentioned in the Questions & Answers that follow:

Here we answer your questions

 Q. What is the purpose of have one of these injections?

 A. Botulinum toxin injections block certain chemical signals from the nerves - those that cause muscles to contract. The most common use of these injections is to temporarily relax the facial muscles that cause wrinkles, such as:

  • Frown lines between the eyebrows
  • Crow's-feet, the lines at the corners of the eyes
  • Forehead furrows, the horizontal lines that form when you raise your eyebrows

 As well as purely cosmetic procedures, toxin injections have also been used to treat conditions that affect several other body functions. Examples include: 

  • Neck (cervical) dystonia: An extremly painful condition, your neck muscles contract involuntarily, causing your head to twist or turn into an uncomfortable position.
  • Lazy eye: The most common cause of lazy eye is an imbalance in the muscles responsible for positioning the eye. This can result in a condition known as 'crossed eyes.'
  • Muscle contractions: Some neurological conditions, such as cerebral palsy, can cause your limbs to pull inwards. In some cases, these contracted muscles can be relaxed with botulinum toxin injections.
  • Hyperhidrosis:  This is when a person experiences excessive sweating even when the temperature isn't hot - sweat can drip off the person and is accutely embarrasing.
  • Chronic migraine: Those who get more than 15 migraines a month have found that  botulinum toxin injections may help reduce headache frequency.
  • Bladder dysfunction. Botulinum toxin injections can also help reduce urinary incontinence caused by an overactive bladder.

Q. Are there risks associated with having an injection for cosmetic reasons?

 A. Botox injections are relatively safe when performed by an experienced doctor. The most common side effects include swelling or bruising at the injection site, headache or flu-like symptoms. If the injections aren’t carried out correctly, the medication may spread and cause problems such as:

  • Eyelid droop
  • Crooked eyebrows
  • Crooked smile
  • Dry eye or excessive watering

Severe problems are very rare and would normally wear off over a period of time. But there have been cases of botulinum toxin spreading to other parts of the body, resulting in botulism-like symptoms.

You should never have this treatment if you are pregnant/breastfeeding or a blood donor.  You should also see a doctor as soon as possible if you have any of these symptoms within hours or weeks of having a botulinum toxin injection:

  • Muscle weakness all over the body
  • Vision problems
  • Trouble speaking or swallowing
  • Trouble breathing
  • Loss of bladder control

 The importance of selecting your doctor

These injections should be administered a medical or aesthetic doctor - that is a medical doctor who is skilled in administering this procedure.  Even though nurses and beauty assistants in some country's may legally be able to carry out this procedure. And you should check your doctor's reputation and clinical outcomes by speaking with previous patients, checking on the intranet and with any professional bodies of which he/she is a member. Check that they hold a medical insurance certificate.

How you prepare

Your doctor will need to know if you've received any type of botulinum toxin injections within the past four months. If you take anti-coagulants, muscle relaxants, sleeping pills or allergy medications you must tell your doctor in advance of the procedure. 

What to expect before the procedure

The injection is carried out with a very small needle and most patients experience minimal pain and its over in seconds.  But you can ask to have you skin made numb beforehand. 

Here are your options

  • Injections - worthwhile if you are having a lot of areas treated
  • A prescription cream can be applied about 1 hour before
  • A blast of very cold air is directed at the skin and makes it momentarily numb 

During the procedure

 The doctor will inject the clear liquid into your skin - the amount of  injections needed depends on the size of the area being treated. 

 After the procedure

 You may get a tiny bit of redness.  You will be told not to rub or massage the treated area. 

Botulinum toxin injections usually begin working a few days after treatment. Depending on the problem,  the effect may last for three to 12 months. To maintain the effect, you'll need regular follow-up injections. The cost of having injections varies.