July 2023
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It’s not just for wrinkles
Botulinum toxin injections are known for their use in smoothing wrinkles. They are available under brand names such as Botox, Xeomin, Dysport, Myobloc and Jeuveau. While wrinkle removal is the most common use, it is not the only one.
The first use for botulinum toxin injections appeared decades ago. It was for the treatment of certain eye problems. Since then, doctors have found that injections can help treat all kinds of conditions.
Botulinum toxin is a poisonous substance produced by certain bacteria. It is actually one of the most potent toxins found in nature. It causes botulism, a rare but potentially fatal form of food poisoning.
It may sound strange that something so dangerous could be useful. But the very properties that make botulism toxin dangerous also make it useful. It works by blocking the nerve signals that tell muscles to tighten or contract. When this happens to the muscles that control breathing, it can cause you to suffocate. However, some medical conditions involve the muscles contracting too much or at the wrong time. Botulinum toxin injections can treat these conditions by causing the muscles to relax.
Botulinum toxin can also relieve some types of pain. It has been shown to relieve a recurring type of headache called chronic migraines. It can also hinder your body’s ability to produce sweat and saliva. So it can treat conditions in which your body produces too much of one of them. See the Wise Choices box for more about the conditions botulinum toxin is used for.
Two NIH researchers, Drs. Pamela Stratton and Dr. Barbara Karp, have studied botulism toxin for the treatment of pain associated with endometriosis. Endometriosis is when tissue that normally resides in the uterus grows outside of it. This causes pain in the pelvic area. It is usually treated with hormones or surgery to remove the abnormal tissue. But sometimes the pain persists even after these treatments. In a small, proof-of-concept study of women with endometriosis, Stratton and Karp found that botulinum toxin injections helped improve pain.
Botulinum toxin treatments use very small amounts of the toxin and only at the treatment site. When used correctly, injections affect only the muscle or organ being treated.
Side effects are usually mild. They can include pain where the toxin is injected, mild headaches or flu-like symptoms. These usually clear up on their own. “It’s remarkably safe for a deadly toxin,” says Karp.
That said, botulinum toxin is not harmless. If not administered correctly, the toxin can spread beyond the treatment site. Then it can affect other muscles in the body that you don’t want it to. This could cause muscle weakness or vision problems, or make it difficult to speak, swallow or even breathe. Because of this risk, always get botulinum toxin treatments from a licensed health care provider who has experience using it for your condition.
People who have certain health conditions should not get botulinum toxin injections. And it is not recommended for people who are pregnant or breastfeeding. If you are considering botulinum toxin treatment, talk to your health care professional. They can confirm whether treatment could help you and refer you to an experienced provider. They can also tell you if there are any reasons why you should not have the treatment.
