Botox® neurotoxin treatment helps control the symptoms of severe underarm sweating when topical medicines do not work well enough by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. When the sweat glands don’t receive chemical signals, the severe sweating stops. Botox® injections are expected to temporarily stop the production of excessive sweat in the treated areas only. Sweat continues to be produced elsewhere.
It's also not approved by the U.S. Food and Drug Administration (FDA) for depression, not that that stops doctors from prescribing it that way. Such off-label use of Botox, like that of any FDA-approved drug, is legal in the U.S. That's because once a drug has been approved by the FDA for a condition, licensed physicians are legally allowed to prescribe it for any medical issue they think it could benefit, regardless of whether it's been proved to work for that condition.
This medication is given by injection by an experienced health care professional. It is injected into the affected muscles (intramuscularly) when treating eye disorders, muscle stiffness/spasms, and wrinkles. When used to prevent migraines, it is injected into the muscles of the head and neck. It is injected into the skin (intradermally) for the treatment of excessive sweating. For the treatment of drooling/excess saliva, this medication is injected into the salivary glands. When treating overactive bladder, it is injected into the bladder.
So what exactly are you putting into your face? John Paul Tutela, MD, a board certified plastic surgeon, explains, “Botox is a cosmetic injectable neurotoxin that is a very diluted form of Botulinum Toxin, which is found in the bacteria Clostridium botulinum. In this diluted format, it is used to relax your muscles—typically in your forehead, in between your eyebrows, and around your eyes.” The idea is that if you temporarily block local nerve impulses to specific muscles within your face, you won’t make certain facial expressions, so you won’t form the wrinkles that come with them, explains dermatologist Tsippora Shainhouse, MD, FAAD. These are the 7 signs you’re ready for Botox? (And 6 signs you aren’t.)
The effects of botulinum toxin are different from those of nerve agents involved insofar in that botulism symptoms develop relatively slowly (over several days), while nerve agent effects are generally much more rapid and can be instantaneous. Evidence suggests that nerve exposure (simulated by injection of atropine and pralidoxime) will increase mortality by enhancing botulinum toxin's mechanism of toxicity.
With small children, I find that being prepared allows us to function better. My family food preps for the week with fruits, veggies and snack-size portions. I keep the snacks on a shelf that my children can easily reach, so they can choose a healthy option if they’re hungry and I’m unable to get up. Meals are well-thought-out and prepared ahead of time, in case of a migraine attack. I always have a back-up plan for my children. I have alternative arrangements for them after school if I am unable to care for them or myself. I also have activities planned. I keep crafts around that occupy my children’s time but also keep sound and stress to a minimum. We color, build Legos and play with Play-Doh all while sitting in rooms with strategically placed lights and brightness. I save screen time for when I need a few moments of quiet. We keep a routine and schedule, but also stay flexible. A schedule allows my family to know what to expect for our days and evenings. My children are able to continue their day if I have a migraine attack because they know what needs to be done and in what order. We have strict bedtimes that allow my children’s brains to grow and mine to recover. Along with this, I have taught them that moms don’t always feel well, and we may need to adjust the schedule from time to time to accommodate my migraine. I keep medication that can fight a migraine attack with me for use on the go and safely at home. I see a neurologist on a regular basis who helps me manage my migraine symptoms and medication.
Make sure your practitioner is very experienced at Botox injections and is a respected medical professional. A salon stylist, for example, is not an appropriate person to administer Botox, because he or she would not have emergency equipment or sufficient medical knowledge if something went wrong. Some disreputable people have reportedly administered injections that were over- or under-diluted with saline, as well as counterfeit solutions that didn't contain Botox at all.
Before using this medication, tell your doctor your medical history, especially of: bleeding problems, eye surgery, certain eye problem (glaucoma), heart disease, diabetes, signs of infection near the injection site, urinary tract infection, inability to urinate, muscle/nerve disorders (such as Lou Gehrig's disease-ALS, myasthenia gravis), seizures, trouble swallowing (dysphagia), breathing problems (such as asthma, emphysema, aspiration-type pneumonia), treatment with any botulinum toxin product (especially in the last 4 months).
Treatment with botulinum toxins may weaken neck muscles that serve as accessory muscles of ventilation. This may result in a critical loss of breathing capacity in patients with respiratory disorders who may have become dependent upon these accessory muscles. There have been postmarketing reports of serious breathing difficulties, including respiratory failure.
The needle should be inserted approximately 2 mm into the detrusor, and 30 injections of 1 mL (~6.7 Units) each (total volume of 30 mL) should be spaced approximately 1 cm apart (see Figure 1). For the final injection, approximately 1 mL of sterile normal s aline should be injected so that the remaining BOTOX in the needle is delivered to the bladder. After the injections are given, the saline used for bladder wall visualization should be drained. The patient should be observed for at least 30 minutes post -injection.
Results can vary depending on who is performing the injection on the patient. It is very important to go to a physician who is experienced at this procedure, does it him- or herself (rather than having a nurse, physician's assistant [PA], or other nonphysician do it), and has a good reputation for performing this type of procedure. The manufacturers of Botox recommend physicians inject the medication themselves. As with most procedures, the skill of the practitioner is related to how often he or she performs the procedure.
Receiving Botox injections for migraines is a straightforward outpatient procedure. The skin in the area to be injected is cleaned. Most injections are administered in the forehead area, usually above the eyes or where “worry lines” might occur. Because this area may be sensitive or patients may be experiencing hypersensitivity to pain, a topical anesthetic may be applied before the injection.
Laser tattoo removal has minimal side effects. Lasers break up the pigment of the tattoo with a high-intensity light beam. During the procedure, the patient wears protective eye shields and may be giving anesthesia. The pulse of the laser feels like the snapping of a rubber band against the skin. Possible side effects include a risk of infection, hypopigmentation, and hyperpigmentation.
Clinical diagnosis of depression or other mental health disorders, including body dysmorphic disorder and eating disorders. Please discuss any history of mental health disorders prior to surgery. Patients with a diagnosis of depression, or other mental health disorders, should wait until resolution or stabilization of these conditions prior to undergoing breast implantation surgery.
* LS mean change, treatment difference and p-value are based on an analysis using an ANCOVA model with baseline weekly endpoint as covariate and treatment group, etiology at study entry (spinal cord injury or multiple sclerosis), concurrent anticholinergic therapy at screening, and investigator as factors. LOCF values were used to analyze the primary efficacy variable.
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Please note, there are no guaranteed results with BOTOX and results may vary from patients to patient. Though BOTOX is not effective for all types of headaches, about 90% of MRC’s patients report that their migraines are less frequent and not as severe after BOTOX treatment. In clinical trials, patients reported seven to nine fewer headaches per month. In a study by A. H. Elkind, P. O’Carroll, A. Blumenfeld, R. DeGryse, and R. Dimitrova, a standard course of treatment brought patients these results:
Breast reconstruction. Breast reconstruction includes primary reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality. Breast reconstruction also includes revision surgery to correct or improve the result of a primary breast reconstruction surgery.
The cost of Botox injections varies widely, with most clinics in the United States charging between $9 and $20 per unit. The variation in cost can be influenced by a number of factors, including the location of the clinic or medspa, and the reputation and expertise of the injector. For example, board-certified plastic surgeons who specialize in administering Botox and dermal fillers are likely to charge more because they generally guarantee better results. That is not to say, however, that injectors charging $10 per unit aren’t capable of delivering excellent results as well, but there is far less risk of any complications arising when you choose an injector who has been board-certified. It is always the smartest, safest way to proceed with any cosmetic enhancement.
After a muscle has been injected, the nerves still send the signal to the muscle to contract, and the acetylcholine is still released, but is unable to bind to the muscle, resulting in a reduction of muscle activity and temporarily preventing contraction of the muscles that cause frown lines. The binding process typically begins within about 48 hours from the time it is injected into the muscle, and results typically become noticeable within 7 to 10 days. While results are often most noticeable in dynamic wrinkles (wrinkles that appear when a muscle contracts), it can also help soften wrinkles that are present even without muscle contraction. If you’re serious about improving the appearance of moderate to severe frown lines, it may be just the right treatment option for you.
Simply put, "Baby Botox" uses a lower volume of Botox (a.k.a. botulinum toxin injections) than a traditional injection to smooth fine lines and wrinkles. "Instead of using 25 units in an area, you may use 10 units," Melissa Doft, a board-certified plastic surgeon in New York City, tells Allure. "I have many patients who ask for half the normal dose, as they do not want to look frozen but are tired of wrinkles in photos. First-time Botox patients are perfect for this."
Most insurance providers now cover the expense of Botox injections when they’re used to treat chronic migraines. If you don’t have insurance, or your insurance won’t cover the cost of the procedure, it may cost you several thousand dollars. Before you begin receiving injections, talk to your insurance company. In some cases, they may require you to undergo other procedures or tests before they will cover the costs of Botox treatments.
Galli has been living with migraine for most of her adult life, but recently, her attacks became more severe and frequent. “My whole life went upside down and nothing was the same,” Galli says, upon being diagnosed with chronic migraine. “The person I used to be wasn't there anymore. I didn't even recognize myself.” To cope with the symptoms that often accompany chronic migraine, Galli found herself retreating to a dark room, waiting for the pain to pass, but it never did. In response, Galli says, she asked herself what she could do to feel better but also share her story. “Everyone around me that knew how high energy, and how much of a go-getter I am, asked what was happening? Where was that person?” When she came across the announcement of the Migraine Moment Film Contest, she saw it as her opportunity to bring awareness about what it is like to live with migraine and bust the misconceptions surrounding this invisible disease. Enter: “Invisible Hero.”
Wrinkles, whether they be fine line or deep furrows, typically appear on areas of the body that receive a high amount of exposure to the sun. Smoking, light skin type, hairstyle, the way you dress, your occupational and recreational habits, and heredity are all factors that promote wrinkling. Medical treatments for wrinkles include antioxidants, moisturizers, alpha-hydroxy acids, and vitamin A acid. Cosmetic procedures that treat wrinkles include dermabrasion, microdermabrasion, glycolic acid peels, laser resurfacing, Botox, and fillers.
Botox prevents migraine headaches before they start, but takes time to work. “I look to the second and third treatments to maximize effects,” says Dr. Andrew Blumenfeld. “Patients see increasing benefit with an increase in the number of treatment cycles.” One treatment lasts for 10-12 weeks, and patients reported that two Botox treatments reduced the number of headache days by approximately 50%.
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Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such a reaction occurs, further injection of BOTOX® should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent, and consequently the causal agent cannot be reliably determined.
Sedation is not often used because the injection time is so short. A local numbing cream (anesthetic) is used instead. Young children often behave as if no numbing cream was used. This may be due to not fully understanding what is being done and having a fear of "shots." In these cases, gentle holding (restraint) is done to keep the area of the shot still. Two staff members sometimes give the injections at the same time to decrease the time of the session.
OnabotulinumtoxinA is the only treatment approved by the United States Food and Drug Administration for the prevention of headaches in adult patients with chronic migraine (CM). CM assessment involves a detailed history to rule out secondary sources of headache, establish migraine features, and assess the total number of headache days. In order to diagnose migraine, the patient should have had at least five attacks that involve migraine features, as outlined below. In adults, untreated attacks usually last 4 or more hours.
It takes a village to raise a child. My family members are well aware of how I cope with migraine. They make themselves available to help my children and me often. I rely on people to drive me to doctor’s appointments as well as take my children to sports practices. I arrange carpools and am honest with the people in our lives about how a migraine attack can be unpredictable and suddenly change plans. Every year, I alert my children’s teachers of my chronic migraine and ask them to watch and listen for signs of migraine or stress in my children. I worry about them physically and emotionally and so far, they have handled my disease as they would any other illness. By being honest about the help I need, I find that the people in my life are better equipped to follow through. Many people would like to help but don’t know how. I have given up pride and allowed others to help, which inevitably takes stress away from us all.
Most physicians pay roughly the same amount of money to purchase a vial of Botox. However, the cost of a Botox treatment is not the same among all providers. Botox is not an ordinary commodity such as wheat or sugar or flour. Botox is a medical procedure that requires nuance, experience and expertise. All Botox providers are not equal in education or skill and some are actually quite poor. Most Botox providers charge either by the amount of Botox used or by the region of the face treated. I feel that charging by the amount of Botox used is the most equitable.
Botox only lasts three to six months—and yet what's less commonly discussed is this: Facial muscles naturally weaken over time and going overboard in a certain area could have unwanted consequences. "If you do too much Botox on your forehead for many, many years, the muscles will get weaker and flatter," cautions Wexler, adding that the skin can also appear thinner and looser. Moreover, as your muscles become weaker, they can start to recruit surrounding muscles when you make facial expressions. "If one stops using their forehead muscles, they may start squinting using their nose and have wrinkles along the side of their nose," she explains. Translation: You need even more Botox for the newly recruited muscles, says Wexler. To avoid these kind of missteps, researching a doctor diligently is essential, as is approaching injectables conservatively, and asking questions about how the treatment will be tailored to your needs.
There are no limits on therapy or activity after the session. For patients that don’t normally use a device to help them walk, at first it may seem like their walking has gotten worse. They need some time to get used to the feeling of the sudden change in the way their muscle contracts when they walk. This most often improves quickly over one to two weeks. Some very young children may have discomfort in their heel cord from rapid stretching. The child may limp or refuse to put weight on it. Again, this most often resolves quickly in the first week.
Postmarketing Experience: The following adverse reactions have been identified during postapproval use of LATISSE®: dry skin of the eyelid and/or periocular area, eye swelling, eyelid edema, hypersensitivity (local allergic reactions), lacrimation increased, madarosis and trichorrhexis (temporary loss of a few eyelashes to loss of sections of eyelashes, and temporary eyelash breakage, respectively), periorbital and lid changes associated with a deepening of the eyelid sulcus, rash (including macular and erythematous), skin discoloration (periorbital), and vision blurred.
According to the PREEMPT injection paradigm, one injection of 5 units of onabotulinumtoxinA is administered to one site in the procerus muscle. The procerus injection site is approximately midway between the two corrugator injections. In order to confirm the location of the procerus muscle, the patient is asked to furrow the brow, which will activate the belly of the muscle causing the medial furrowing to occur. Once identified, 5 units of onabotulinumtoxinA is injected superficially into the belly of the muscle at a 90° angle to ensure the injection is administered into the procerus rather than the frontalis. Injections placed too superiorly may inadvertently lead to penetration of the frontalis muscle.
Tell your doctor about all your medical conditions, including if you: have or have had bleeding problems; have plans to have surgery; had surgery on your face; weakness of forehead muscles; trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® can harm your unborn baby); are breastfeeding or plan to (it is not known if BOTOX® passes into breast milk).
It's a remarkable arc for a drug that only a few years ago was associated with Hollywood cocktail parties where guests came for Bellinis and left with a forehead full of Botox injections. It highlights the advances that can occur when physicians, seeking new therapies for their patients, explore creative new uses for approved drugs--basically, real-world experiments that take place largely beyond the reach of federal regulators. That, in turn, raises questions about the risks of deploying medicines in ways that have not been fully vetted. But it happens all the time.
Other side effects of BOTOX® and BOTOX® Cosmetic include: dry mouth, discomfort or pain at injection site, tiredness, headache, neck pain, eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of eyelids, dry eyes, and drooping eyebrows. In people being treated for urinary incontinence other side effects include: urinary tract infection, painful urination, and/or inability to empty your bladder on your own. If you have difficulty fully emptying your bladder after receiving BOTOX®, you may need to use disposable self-catheters to empty your bladder up to a few times each day until your bladder is able to start emptying again.