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the poison
that heals
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
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
Written by Dr. Punam Bijlani, Consultant Plastic, Aesthetic and
Reconstructive Surgeon at GMC Hospital, Ajman
toxin is currently approved for the
following conditions:
• Cervical dystonia (a
neuromuscular disorder
involving the head and neck)
• Blepharospasm (excessive
• Severe primary axillary
hyperhidrosis (excessive
• 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
With ongoing research,
the spectrum of clinical
applications and number of
people receiving Botox will no
doubt increase. Botox truly is
not just skin deep.
Oct/Nov 2014