Is Botox a poison?

What is Botox?

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The toxin primarily affects the nervous system and muscle function. The beauty of Botulinum Toxin is that by using it in very small doses, we can utilize this toxin to our advantage.

Highly diluted

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Botulinum Toxin is so toxic that 1 gram of pure Botulinum Toxin could make approximately one million people severely ill. It is important to know that the Botulinum Toxin used in a cosmetic treatment is highly diluted, making it one hundred percent safe for use. The dilution of Botulinum Toxin takes place in specialized laboratories and is an extremely precise process.

Tip: Despite very strict controls on Botulinum Toxin, it is wise to always ask a doctor which products he or she uses. I also always advise people to only seek treatment in a reputable clinic by an experienced physician.

Applications of Botox

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In medicine, Botulinum Toxin is often applied for nerve and muscle spasms. About twenty-five years ago, it was discovered that it can also have an aesthetic effect. The aesthetic world recognized that the paralyzing aspect can have a positive effect on reducing facial wrinkles (source: A clinical study of facial wrinkles affected by facial expression muscles treated with botulinum toxin(Botox®) [1]). From that moment on, Botox was also used in the cosmetic sector. By relaxing muscles, wrinkles can disappear or be prevented.

Botox is a brand name

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Botox is a brand name for the substance Botulinum Toxin. Colloquially, Botox is used for all brands of Botulinum Toxin, but besides Botox, there are other brands on the market that produce Botulinum Toxin such as Azzalure, Bocouture, and Dysport.

Botulinum bacterium can also occur in food

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The Botulinum bacterium (Latin: Clostridium botulinum), which lives primarily in the mud of ponds and ditches, can occur in improperly sterilized or incorrectly preserved food. In cases of food-related Botulinum Toxin poisoning, the first symptoms usually appear about 12 to 72 hours after infection; these can last up to 8 days. The first symptoms are:

• blurred vision
• difficulty swallowing
• difficulty speaking

After the initial symptoms, a progressively expanding paralysis can occur. If it spreads to the respiratory muscles, the patient will need to be ventilated to survive (RIVM, Botulism, 2019). According to Toxicologist Marjorie van Duursen, Botulinum Toxin is one of the most poisonous substances in the world. If you ingest too much of it, your muscles will become paralyzed and you can die.

Subtypes of Botulinum Toxin

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There are a total of seven subtypes of Botulinum Toxin, two of which are available as medicine, namely Botulinum Toxin A and B. In a Botox treatment at a cosmetic clinic, Botulinum Toxin A is used (source: Botulinum toxin (Botox) A for reducing the appearance of facial wrinkles: a literature review of clinical use and pharmacological aspect [2]).

Botox in powder form

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In the clinic, Botox is supplied in glass vials in powder form. Supplying Botox in powder form gives it a longer shelf life. For each treatment, the Botox is made liquid by mixing the powder with sodium chloride (saline solution), as powder cannot be injected. The manufacturer specifies the dosage, so the concentration is always the same. Subsequently, the highly diluted Botulinum Toxin is injected into the muscle that causes the wrinkles. After an average of 5-7 days, the Botox begins to work, and the connection between the muscle and the nerve is temporarily interrupted. This prevents the muscle and nerve from communicating with each other, and the muscles relax.

For this reason, Botox is used to counteract signs of aging.

Applications of Botox in the clinic

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In the clinic, we use Botox for a large number of varied treatments:

• Wrinkles Because the small muscles in the skin are no longer (fully) tensed after a Botox treatment, wrinkles disappear, such as: frown lines, forehead wrinkles, crow's feet etc.

• Gummy smile Visible gum tissue when smiling is also called a gummy smile. If you prefer not to have this, a few injections into the gum are enough to ensure that the small muscles that pull the upper lip up relax.

• Migraine People with chronic migraines can greatly benefit from a Botox treatment. By reducing muscle tension in the forehead, headaches can decrease. Source: Migraine and botulinum toxin. [3]
• Excessive sweating Sweat production decreases by injecting Botox into the armpits. Botox breaks the connection between the sweat glands and the nerve, thereby reducing sweat production. Source: 'Doctor, I sweat too much': hyperhidrosis in practice. [4]
• Teeth grinding By injecting Botox into the jaws, muscle tension decreases, and teeth grinding can be reduced. Source: Treating severe bruxism with botulinum toxin. [5]
• Acne Botox can reduce sebum production in the skin, which can reduce acne. Source: Cosmetic dermatology. [6]

The effect of Botox

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The qualified doctor treating you will initially look at muscle strength and the desired effect. One muscle requires a higher dosage than another muscle. If the effect is not optimal, the doctor can always provide follow-up treatment. The duration of action of a Botox treatment varies per person, but on average it is 4-6 months. In addition, there are other factors that can influence the duration of action of Botox. These include:

• Fast metabolism
• Smoking
• Alcohol or drug use
• Frequent exercise
• Too much sunlight
• Hormonal changes

If you are treated with Botox more often, over time you will find a balance of which dosage works effectively for which muscle. Always seek advice from a qualified doctor. Although the Botulinum Toxin bacterium is one of the most toxic substances, when used by a qualified doctor and according to the correct dosage, it can produce good results. The toxin does not destroy tissue; it is merely a blockade between the nerve and the muscle. This effect is temporary. After approximately 4-6 months, the muscles function completely normally again.

References

[1] Youn, S. W., Seo, K. I., Yoo, J. Y., Park, K. C., & Eun, H. C. (2002). A clinical study of facial wrinkles affected by facial expression muscles treated with botulinum toxin(Botox®). Korean Journal of Dermatology, 40(4), 386-392. [2] Bagus, K, S. (2019). Clin Cosmet Investig Dermatol., 12, 223–228. [3] Dekker, F. (2019). Migraine and botulinum toxin. General practitioner and science, 65, (6), 56. [4] Genders R. ‘Doctor, I sweat too much’: hyperhidrosis in practice. General Practitioner Sci 2015;58(9):492-5. [5] Jankovicm, J. & Tan, E. (2002), Treating severe bruxism with botulinum toxin. The Journal of the American Dental Association, 131 (2), 211-216. [6] Smitt J., van Everdingen J., Starink T., van der Horst H. (2014) 40 Cosmetic dermatology. In: Dermatovenereology for primary care. Bohn Stafleu van Loghum, Houten.