Botox® – Things to Know about Cosmetic Treatment

Published: November 15, 2023
Barbara Young
By Barbara Young, PharmD

Are you bothered by skin creases and wrinkles that you think make you look older? You may be considering cosmetic treatment with Botox® (onabotulinumtoxin A, a form of botulinum toxin) to change your appearance. Here are some things you should know about this treatment to help decide if it is right for you.

What type of cosmetic issues is Botox® used to treat?
Botox® is used to treat moderate to severe appearance of frown lines between the eyebrows, crow’s feet lines, and forehead lines. These wrinkles are caused by movement of facial muscles when you smile, laugh, and squint and they may become more noticeable as you age.

How does Botox® work?
Botulinum toxin is produced by a specific type of bacteria. When injected, it blocks nerve messages that tell your muscles to contract and causes the muscles in that area to relax. The wrinkles and creases on that area of skin then begin to diminish within a few days after the treatment. This change in appearance may not be the same for all individuals.

What should you tell your doctor before treatment?
Be sure to discuss the following items with your doctor before treatment.

  • If you have a disease or condition that affects your muscles and nerves or breathing, bleeding, or swallowing problems.
  • You are pregnant or nursing.
  • You plan to have surgery or recently had surgery on your face.
  • List all the medications that you take.

What should I expect from Botox® treatment?
The muscle relaxation will occur gradually and is temporary, usually lasting about 3 to 4 months. After that time the wrinkles and creases will be noticeable again. A newer, similar botulinum toxin product daxibotulinumtoxinA (Daxi®) has been found to have a longer duration of about 6 months.

What side effects may happen after Botox® treatment?
You may initially have some pain, bruising (particularly around the eyes), headache, etc. Later, unexpected issues may include raised eyebrows, drooping eyelids or lips, and unequal changes in facial expressions (left and right side of face). Repeated use may be associated with a “mask-like” expression.
The spread of toxin to affect other areas of the body sometimes causes serious side effects or other health problems shortly after or up to weeks after receiving the medication. This may include allergic reactions or signs of botulism such as difficulty breathing, swallowing, or speaking.

What else should I consider?

  • You should consider the experience and credentials of the person giving you the injection.
  • Cosmetic treatment is not covered by most insurance providers.
  • Don’t get the injection at a salon, party, non-medical spa, or in someone’s home. Don’t buy online as it may be a counterfeit or alternative product.
  • Don’t get this treatment right before a big event as you may have some redness, bruising, or swelling.
  • Don’t rub the area after getting the injection or exercise or wait at least 2 hours after treatment to do strenuous activity or exercise.

Summary
Taking time to research and discuss your treatment goals with your healthcare provider is an important consideration of successful and safe botulinum toxin therapy.

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