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BotoxBotox is a household name, and most everyone knows it as an injection that reduces wrinkles. This is valid information, but it’s not the whole story. Botox doesn’t work on all wrinkles, and it has other applications, both cosmetic and medical. Botox works on muscles to cause temporary relaxation (3-4 months). For this reason, it is best used to treat lines of expression (caused by underlying muscle activity). It doesn’t work well for lines or folds on the lower half of the face: those between the nose and the mouth (naso- or Melo labial folds) or lines between the corners of the mouth and the jawline (marionette lines).

Botulinum toxin was first used as a treatment for blepharospasm (twitching of the eye). A husband and wife team (he was the dermatologist, she the ophthalmologist) made the discovery in 1987 when a patient she was injecting for blepharospasm has lessening of her wrinkles. Since then, Botox injections have sky-rocketed for cosmetic use and continue to gain in popularity every year.

What’s more is that we, as dermatologists, are discovering new uses of Botox as time proceeds. Most are aware that Botox is a home-run for the glabella (frown lines or “11’s” between the brows). Many know that it also treats forehead horizontal lines and crow’s feet around the eyes. What may be news to you is that Botox can also adjust the height of your eyebrows, widen the aperture of your eyes, change the slope of your nose, reduce a down-turned mouth, sharpen a jawline, unfurl a wrinkly chin, or change a square-shaped lower face into an oval one. Lots of subtle changes artfully achieved with Botox can transform a face into one looking more relaxed, at ease, and beautiful without an obvious change to the casual observer!

Medically, Botox is now being used quite successfully to treat underarm, hands, feet, and scalp sweating (hyperhidrosis). Although medical in nature, it’s often quite difficult to get this procedure covered by insurance. Botox for hyperhidrosis works well and usually lasts about 6 months. Botox is also used to treat some headaches.

Since Botox was first FDA-approved in 2002, other similar neurotoxins have arrived at market. Dysport gained FDA approval in 2009 and Xeomin in 2011. These products are both valid and safe to use, and they have slightly different qualities than Botox. In addition to being less-expensive than Botox, Dysport has an earlier onset of action (3-5 days) than Botox (5-7 days) and tends to last longer (4months, as opposed to 3.5 months). In our practice, we currently offer both Botox and Dysport.