What is Botox? How dare you inject it into your face?

People who love beauty must know about Botox. Many celebrities have injected it into their faces. It is said that they look ten years younger, their skin is firmer, wrinkles are eliminated, and their skin is smoother. There is a line in the American TV series "Sex and the City": "I trust Botox more than the nourishment of love, because it works every time." However, some people have heard that Botox is toxic and want to try it but dare not. So what exactly is Botox and can it be injected into the face?

01 What is Botox? Why can it be injected into the face?

Botulinum toxin is a neurotoxin secreted by Clostridium botulinum in nature. Clostridium botulinum itself is not toxic, but the botulinum toxin it secretes is one of the most toxic biological toxins known among all natural toxins and synthetic poisons. Its toxicity is equivalent to 10,000 times that of an equal amount of potassium cyanide, and less than 1 microgram can kill a person.

Botulinum toxin is divided into seven types: A, B, C, D, E, F, and G. Among them, type A botulinum toxin is easy to extract and preserve, and was first used in the medical field. After entering the human body, it can bind to specific receptors at the motor nerve endings, blocking the release of acetylcholine from the presynaptic membrane of the nerve endings, thereby blocking the conduction between nerves and muscles, causing the muscles to lose their contractile force, resulting in muscle paralysis and relaxation. [1]

In 1979, the United States approved its use to treat strabismus and spasmodic torticollis caused by dystonia. In 1986, ophthalmologists accidentally discovered the wrinkle-removing effect of botulinum toxin when using it to treat blepharospasm. However, it was not until 2002 that injectable botulinum toxin type A was approved by the United States for the treatment of moderate to severe frown lines, in 2004 it was approved for the treatment of axillary hyperhidrosis, and in 2013 it was approved for the treatment of crow's feet.

So don't worry, botulinum toxin can be injected into the face. When used for beauty treatments, 400,000 times diluted botulinum toxin type A is used. It can paralyze muscle nerves, prevent muscles from contracting and wrinkling, and stretch the skin, thereby achieving the effect of removing dynamic wrinkles. It is very effective in eliminating forehead wrinkles, 川字纹, crow's feet, nasal dorsum wrinkles, and neck wrinkles.

Botox has more benefits than just removing wrinkles. It can also control oil, shrink pores, inhibit acne growth, and remove scars. It can also be used to slim the face, because injecting it into the masseter muscle relaxes it, makes it softer and thinner, and thus achieves the effect of slimming the face. Similarly, injecting botulinum toxin into other parts of the body, such as the calves, neck, shoulders, and back, can make those areas look thinner.

The cosmetic effect is so good, no wonder everyone likes botulinum toxin so much!

02 Botox cosmetic effects are short-lived

But don't be too happy too soon, Botox injections are not permanent. After the injection, the toxin is slowly released at the injection site, and the muscles will relax within 1 to 3 days. The best effect will be achieved after 5 to 6 weeks, and you will be the most beautiful at this time. But it will also gradually degrade and become inactive, so after you have injected Botox, the wrinkle removal effect can generally only last for 3 to 4 months, and the effect is very short-lived. If you still want beauty, you have to continue to inject it.

There is another problem. Botox injections are not always effective. Because botulinum toxin is a protein from the outside to the human body. After being injected into the human body, the body will produce antibodies, which will affect the efficacy. The more doses you inject each time, the more antibodies your body will produce; the more frequently you inject, the easier it is for your body to produce antibodies. So after multiple injections, the beauty effect will deteriorate. What can you do? Here is the secret: you can only inject the lowest effective dose each time, and try to extend the injection interval to minimize the antibodies produced by the body.

03 Toxicity and adverse reactions of botulinum toxin

Although botulinum toxin is highly toxic, the botulinum toxin type A used in the medical and cosmetic fields has been diluted 400,000 times, and the dosage is generally below 100U. If the doctor performs a standardized injection at a safe dose, there is no safety hazard. But the premise is that it must comply with the safe dose and must be injected in a standardized manner. In recent years, botulinum toxin products from irregular sources have been circulating on the market, and reports of severe systemic poisoning reactions after injection are common. Because the state stipulates that botulinum toxin type A for injection must be kept, issued, registered, and used according to the prescribed indications and prescribed doses by a dedicated person, and must be used by physicians with relevant professional knowledge and skills.

If botulinum toxin is over-diluted, injected in excessive amounts, or the doctor is unfamiliar with the anatomical structure of the muscles, the botulinum toxin may diffuse and cause a series of complications, such as ptosis, brow droop, diplopia, strabismus, etc. If there are irregularities during the injection, such as injecting too deep or in the wrong location, it may cause the person being injected to have difficulty swallowing, respiratory paralysis, or even death. [1]

Adverse reactions may also occur 1 to 5 days after the injection of botulinum toxin (a few people experience 1 to 2 weeks). Mild cases include dizziness, headache, fatigue, blurred vision, drooping eyelids, and severe cases include general weakness, difficulty swallowing, difficulty speaking, difficulty breathing, and urinary retention. If serious systemic adverse reactions occur, you must seek medical attention immediately.

04 Things to note when injecting botulinum toxin

1. Most beauty salons in society are generally not qualified to use botulinum toxin type A. If you want to inject botulinum toxin, you must go to a regular medical institution. If you encounter a private medical institution, you must pay attention to the institution's business license and qualifications to use botulinum toxin type A.

2. Stop taking aspirin, vitamin E, nonsteroidal anti-inflammatory drugs and some Chinese herbal medicines such as evening primrose, ginkgo, garlic, white chrysanthemum, ginseng, etc. 1 week before injection. Women who are pregnant or breastfeeding should not be injected.

3. After the injection, it will not affect your normal work and life. If your face is stiff, your upper eyelids droop, or your expression is unnatural, these are normal complications and will generally recover on their own within 2 to 4 weeks. However, if the drooping upper eyelids affect your normal life, you can go to the ophthalmology department to get the appropriate eye drops to improve the symptoms.

4. The injection itself may cause erythema, edema, ecchymosis, pain and other discomforts, especially periorbital injection is prone to bleeding and ecchymosis. Before injection, you should avoid taking drugs that affect blood coagulation and avoid visible blood vessels. Compression and ice compress after injection can effectively reduce the occurrence of bleeding and ecchymosis. If ecchymosis occurs, it can be covered with makeup. Applying ice compress after injection and avoiding heat, drinking, excessive exercise, sun exposure and other conditions that cause vasodilation can accelerate the disappearance of erythema and edema. [1]

5. The pain of botulinum toxin injection is generally tolerable, while the pain of periorbital injection is relatively obvious. However, since more needles are used, you should be mentally prepared before treatment. The use of anesthetics can reduce the discomfort caused by the injection. [1]

References

Wu Yan. Expert consensus on the application of botulinum toxin injection in skin beauty[J]. Chinese Journal of Aesthetic Medicine, 2017, 26(08): 3-8.

The article is produced by Science Popularization China-Creation Cultivation Program. Please indicate the source when reprinting.

Produced by: Science Popularization Department of China Association for Science and Technology

Producer: China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.

Author: Zeng Xinyue, popular science creator

Review | Feng Jun, deputy chief physician of the Dermatology Department of Sinopharm Tongmei General Hospital