Botox - Muscle Relaxants

Botulinum toxin. Trade names include Botox®, Vistabel®, Dysport® and Neurobloc®

The Purpose of Botox

To reduce the appearance of wrinkles on the forehead, between the brows and around the eyes. Experienced doctors and nurses also sometimes use botulinum toxin on wrinkles on the lower part of the face and neck, often in combination with dermal fillers.

Botox treatments

Botulinum toxin is a prescription-only medicine which can only be prescribed by a doctor or dentist. Since 1 May 2006, Independent Prescribers are also able to prescribe Botox® and Vistabel® independently for a named patient, during a face-to-face consultation. Prescribers may delegate the administration to a suitably qualified and competent other person.

Some brands of botulinum toxin - namely Botox®, Dysport® and Neurobloc® - are not licensed for cosmetic use. Medical, dental and nursing practitioners have a responsibility to explain that these medicines are not licensed for cosmetic use and must ensure that the patient understands this. One brand of botulinum toxin - Vistabel® - has been licensed for cosmetic use on glabellar lines. Glabellar lines are the vertical lines between the eyebrows. Vistabel® is produced by the same manufacturer and to the same formulation as Botox® and patients previously treated with Botox® may be offered future treatments with Vistabel®.

When you smile or frown, this is a result of a nerve signal from your brain to your muscles causing them to move. Botulinum toxin is a purified protein that blocks this signal from the brain to the nerve endings. This means that when you laugh or frown, the overlying skin becomes smoother and unwrinkled, while the untreated facial muscles work normally, and facial expressions are not affected.

Your skin will be cleaned and then small amounts of botulinum toxin will be injected into the area to be treated. You will be advised not to massage or rub the treated area and to treat it gently for 24 hours following treatment.

The results

The area treated should appear smoother and with less wrinkles. Results are often visible by around 8 days, although it may take between 2- 3 weeks after the treatment for the full effects to be seen. The effects of botulinum toxin injections generally last for about three to four months, although the results can last longer with repeated treatments. Botulinum toxin may be less effective for people aged 60 and over because the muscles underlying the skin are not as firm.

The risks

It is very hard to predict exactly how botulinum toxin injections will affect your muscles. You may find that the results are not what you intended. Very occasionally patients who receive botulinum toxin injections in the forehead experience a drooping of the eyelids or eyebrows, although this is temporary and will resolve itself when the effects of botulinum toxin wear off. Rarely double vision or blurred vision can occur, you should seek medical attention if this happens to you. The risk of side effects following treatment is reduced by going to an experienced practitioner.

Before you start

The effects of botulinum toxin injections are temporary. If you are looking for longer lasting solution, you may want to talk to your doctor, dentist or surgeon about alternative techniques. Botulinum toxin treatments should not be advertised to the general public - you should report any advertisements you see for Botox®, Vistabel® or Dysport® to the Medicines and Healthcare products Regulatory Agency (MHRA).