Botox is the brand name everyone knows, but the product itself is called Botulinum Toxin Type A. This is a purified neurotoxin, specifically produced by a bacterium known as clostridium botulinum.

Although Botulinum toxin is a lethal, naturally occurring substance, it can be used as an effective and powerful medication. Researchers discovered in the 1950s that injecting overactive muscles with minute quantities of Botulinum Toxin type-A would result in decreased muscle activity. This will effectively weaken the muscle for a period of three to four months.

In cosmetic applications, a Botulinum toxin injection, consisting of a small dose of Botulinum toxin, can be used to prevent development of wrinkles by paralyzing facial muscles. As of 2007, it is the most common cosmetic procedure, with 4.6 million procedures in the United States, according to the American Society of Plastic Surgeons.

Although Botulinum toxin is best known for its beneficial role in facial aesthetics but recent literature has highlighted its usage in multiple non-cosmetic medical and surgical conditions. In the early 1980s, university-based ophthalmologists in the USA and Canada further refined the use of botulinum toxin as a therapeutic agent. Botulinum toxin is currently approved for the following conditions:

• Cervical dystonia (a neuromuscular disorder involving the head and neck)

• Blepharospasm (excessive blinking)

• Severe primary axillary hyperhidrosis (excessive sweating)

• Strabismus (squints)

• Achalasia (failure of the lower oesophageal sphincter to relax)

• Local intradermal injection of BTX-A is helpful in chronic focal neuropathies. The analgesic effects are not dependent on changes in muscle tone.

• Migraine and other headache disorders, although the evidence is conflicting in this indication

• Bruxism is treated by injecting the toxin into the muscles of mastication, such as the masseter.

Novel uses for this unique substance will continue to permeate many medical and surgical specialties. Health insurers sometimes cover medical uses of Botox; a treatment for a clenched jaw might cost Dhs 5000 every three months, for example. But for cosmetic treatments, consumers must pay cash.

The success of any Botulinum toxin procedure begins with finding the right doctor to perform it. Each formulation of Botulinum toxin is unique with distinct dosing, efficacy and safety profiles for each use to which it is applied. For these injections, consult with an experienced, credentialed physician. Botulinum toxin delivered using more precise techniques may permit improved results without undesired consequences.