From poison to beauty
Clostridium botulinum is a bacteria that can be found in the environment and cause a rare but disabling paralysed illness. Infection with this toxin can occur by ingestion leading to muscles being paralysed including the muscles required to breath. If you cannot breathe properly this could lead to harm,even death in some cases. It took over 100 years from the time it was first discovered to when it would be used safely administered for beauty purposes.
How was Botox discovered?
Botulism toxin, more commonly referred to as ‘Botox’, was first discovered in the 1895 by Professor Emile Van Ermengem(1). It was not until 1928 in San Francisco that Dr Herman Sommer was able to isolate a purified form, Botulism toxin type A(1). In the 1970s, scientists were experimenting with the treatment for strabismus ( i.e. crossed eyes) on monkeys and they inadvertently found that their glabellar region (i.e. frown lines) showed less wrinkles which sparked the idea for use in the aesthetic industry(2). Allergen was first to gain the licence for the use to treat eye conditions in 1988. This was a huge milestone in medicine as was the first use of bacteria to treat disease.
Allergen continued to research the use for cosmetic purposes and it wasn’t until 2002 the first cosmetic use of botulism toxin in the glabellar / frown region was passed by the Food and Drug Agencey (FDA). Interestingly, the first use of botulism toxin in the UK was in 1994 for frown lines(4).
Botulism Toxin use FDA approval timeline(2):
1989 Strabismus (crossed eyes) and blephrospasm ( eye twitching)
2000 Cervical dystonia/ Neck muscle spasm
2002 Glabellar / frown line
2004 Hyperhidrosis / excessive sweating
2010 Chronic headache and migraines
2011 Urinary incontinence (overactive bladder)
2013 Crows feet / lateral canthal lines
Note that licenced medical aesthetic practitioners use botulism toxin ‘off label’ or ‘out of licence’ to treat many types of facial cosmetic concerns e.g. forehead lines, dimpled chin, down turned mouth, etc. In other words, this means the practitioner is treating you based on their clinical judgement and training.
Is Botox safe for use?
Yes. The FDA approval means this as tests to make sure medicines / products are safe for use on humans. When administered by a trained medical practitioner within safe doses it is safe treatment. The doses required for cosmetic purposes are very small compared to doses that would be required to cause life threatening complications. Too high doses administered can lead to unwanted results and in some cases serious complications requiring medical intervention. To avoid this, please only seek to have treatment performed by a medical practitioner.
How does Botox work?
Botox can be used to stop muscles from contracting. Muscles contract when they receive a nerve signal to do so. Botox blocks this signal. It also blocks signals for pain and inflammatory reactions making it useful e.g. migraines, etc. It starts to work after 1-4 days and after 120 days the effects will wear off. The body regenerates new nerve endings so the nerve signals can be received without the botulism toxin block(2).
Because of this action it can be used for aesthetic purposes to soften wrinkles as stopping muscles moving causes less wrinkling/scrunching of the skin. Its other uses are for excessive sweating, teeth grinding, migraines to list a few.
Who should not have botox?
Trying to concieve women/pregnant or breastfeeding
Treatment site infection
You have a neuromuscular condition e.g. myasthenia gravis
Taking certain medications e.g. Gentamicin antibiotics
How is the treatment done?
Treatment site numbed using numbing cream. The site is cleaned and then botulism toxin is injected into the muscles in your face using a very fine needle. You ill be injected in numerous sites depending on the area treated. You will be asked to move your face in order to make sure you are injection in the correct places. The procedure takes around 10-15 mins. The effect is not immediate and will take up to 5 days to start to work gaining full effect in 2 weeks.
Common side effects
These all normally settles within 24-48 hrs.
Very rare, serious problems like double vision if treating near the eye area and breathing difficulties if the neck is being treated.
What should you do if you are concerned you have a problem?
Contact your practitioner immediately to assist you. If you are concerned you have a serious side effect, such as breathing difficulties, call or attend emergency services locally(3).
My Norwich Aesthetic Clinic provides advanced botulism toxin / Botox treatments. My clinic is doctor only and Save Face regulated so you will be in a safe hands. Please contact to book your wrinkle consultation.
Learn more about what wrinkle treatments my clinic offers here.
1. History of Botulism Toxin – https://emedicine.medscape.com/article/325451-overview#:~:text=In%201895%2C%20Professor%20Emile%20Van,as%20a%20stable%20acid%20precipitate.
2. The remarkable history of Botulism Toxin – https://www.verywellhealth.com/how-botox-came-to-be-1124145
3. Cosmetic procedures NHS choices – Botox injections – https://www.nhs.uk/conditions/cosmetic-procedures/botox-injections/
4. Consulting room blog post – https://www.consultingroom.com/Blog/241/botox-granted-cosmetic-license-for-glabellar-lines,-with-50-unit,-100-unit-and-200-unit-vials-available.