Botox: Not Just for a Pretty Face

Blog #136


Botox is derived from a poison produced by the Clostridium bacterium, the microorganism responsible for botulism in humans and animals.  Botulism—caused by eating foods contaminated with the Clostridium bacterium—is a rare but serious illness that can result in paralysis and is considered a potentially fatal medical emergency. The highly toxic and lethal botulinum toxin was initially identified by Kerner in rancid sausages and was refined and purified by van Ermengen in the Netherlands.

It is shocking that the most poisonous substance known to humanity—Botulinum toxinwhen used in minute quantities in a derivative known as Botox, becomes a magically effective and powerful potion to treat a variety of conditions. Talk about making lemonade from lemons!

Most people are aware of the use of Botox to prevent or improve the cosmetic appearance of facial wrinkles. When injected into the frown lines it paralyzes the facial muscles involved and makes creases, furrows and grooves disappear. Facial Botox injections are among the most common cosmetic procedures performed in the United State and have fostered a billion dollar industry. It is important to know that getting beyond cosmetics, Botox can be beneficial for a variety of medical conditions that have in common some form of localized muscle over-activity.

Technically speaking, Botox is a neuromuscular blocking agent that weakens, if not paralyzes muscles. It has numerous potential uses involving the following: overactive bladder (condition causing urinary urgency, frequency and incontinence); urinary incontinence due to neurological conditions including spinal cord injury and multiple sclerosis; chronic migraine headache; upper limb spasticity; cervical dystonia (involuntary contraction of the neck muscles causing abnormal movements and an awkward posture of the head and neck); axillary hyperhidrosis (excessive underarm sweating); blepharospasm (eyelid spasm with uncontrollable blinking); strabismus (cross-eye or wall-eye); and of course, the cosmetic usage to improve the look of frown lines and wrinkles. For all of the aforementioned conditions, the effect of Botox is temporary and needs to be repeated on an indefinite basis in order to maintain the therapeutic effect.

Overactive bladder and incontinence due to neurological conditions: Botox can be useful in those who have not responded to conservative methods including behavioral methods, pelvic floor exercises and medications. Such persistent and disabling urgency, frequency and urgency incontinence can be effectively managed by injecting Botox into the urinary bladder. It works by paralyzing or weakening the bladder muscle. It is done via cystoscopy (a visual inspection of the bladder with a lighted narrow telescope) and requires injecting the Botox into about 20 sites within the bladder muscle.

Chronic migraine headache: Botox is useful for preventing migraines in adults affected more than 15 days per month with headaches lasting for more than 4 hours daily. It is accomplished by injecting the Botox into different areas of the head and neck including muscles of the following areas: forehead; temples; back of head; and the neck and upper back.

Upper limb spasticity: Botox is helpful to decrease the severity of the excessive muscle tone in the elbow, wrist and finger flexors and works by paralyzing these spastic muscles. It is injected directly into the flexor muscles as well as the biceps.

Cervical dystonia: Botox can be effective to reduce the severity of the abnormal head position and neck pain. It works by paralyzing the dystonic muscles and is injected into the sternocleidomastoid muscle.

Axillary hyperhidrosis: Botox is useful in those with severe underarm sweating that has not been managed successfully with topical agents. The Botox functions to paralyze the sweat glands and is injected in numerous sites to cover the area of hyperhidrosis.

Blepharospasm and strabismus: Botox is indicated when these conditions are associated with dystonia as well as benign essential blepharospasm and facial nerve disorders. It works by paralyzing the eyelid and eye muscles and is injected into the eyelid muscles and extraocular muscles, respectively.

Bottom line: Botox, a toxin produced by Clostridium that causes paralysis, can be beneficial when injected into virtually any muscle in the body that is in a state of hyper-contraction and spasticity and has found utility for a variety of medical conditions.

Andrew Siegel, M.D.

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Author of Finding Your Own Fountain of Youth: The Essential Guide For Maximizing Health, Wellness, Fitness & Longevity  (free electronic download) 

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Author of: Male Pelvic Fitness: Optimizing Sexual and Urinary Health; in press and available in e-book and paperback formats in 2014.

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