Botulinum Toxin

Normal facial gestures cause wrinkles between the eyebrows, across the forehead, and at the corners of the eyes ("crow's feet").

Dermatologists can quickly and safely inject botulinum toxin during an office visit to diminish these wrinkles and lines that create an angry or sad look and detract from a pleasant facial appearance.

What is botulinum toxin?

Botulinum toxin type A and botulinum toxin type B are purified substances, derived from a bacteria, that block muscular nerve signals. Injecting very small amounts into specific facial muscles blocks the muscle's impulse. This temporarily weakens the muscle and diminishes the unwanted lines.

Botulinum toxin has been used since 1980 to treat many muscle disorders such as lazy eye and uncontrolled blinking. It was pioneered by dermatologic surgeons for cosmetic use in 1987.

How does it work?

Once the muscle is weakened and relaxed, it cannot contract. Since there is no way to make the undesirable facial expression, the lines gradually smooth out from disuse, and new creases are prevented from forming. Other muscles such as those needed to raise the eyebrows are not affected, so a natural expression is maintained.

For optimal results, botulinum toxin therapy may be used in combination with other cosmetic skin procedures such as dermal fillers. Combination therapy also can help prevent the formation of new lines and wrinkles.

The treatment

Before treatment, the dermatologist obtains the patient's medical history, including any medications taken. Treatment involves injecting very small amounts of botulinum toxin directly into the underlying facial muscles to relax them. A tiny needle is used; the procedure is well tolerated and takes just a few minutes with no "down time" or prolonged recovery period.

Botulinum toxin takes effect about 3 to 7 days after treatment. The improvement generally lasts about 3 to 4 months; the effect gradually fades as muscle action returns. With repeated treatments, atrophy (thinning) of the muscle may occur. This usually produces longer-lasting results.


Side effects are generally minimal, temporary, and typically relate to the local injection. Mild bruising may occur at the injection site. Makeup may be applied after the treatment, but care should be taken to avoid pressing or massaging the area for several hours. In rare instances, patients may develop weakness of the neighboring muscles leading to a temporary droopy brow or eyelid. All of these possible effects are mild, reversible, and self-limiting.

Other Applications

Hyperhidrosis (excessive sweating) can be treated with injections of a highly diluted form of botulinum toxin which is superficially injected directly into the underarm skin, skin on the palms of the hands, or on the soles of the feet. This weakens the action of the skin's sweat glands which are responsible for excessive perspiration. A single treatment session can provide months of relief, and injections can be repeated when the excessive perspiration returns. Twitching muscles also can be treated by injecting botulinum toxin into the appropriate muscle.

Botulinum toxin can make a great difference in a person's life. Its uses in combination with other modalities achieve successful results.

Adapted from the American Academy of Dermatology

The information above is a partial and general information and cannot replace the needed specific medical examination and consultation