Botulinum toxin, better known as “botox” , is a substance widely used in aesthetic medicine, but also in other health fields such as ophthalmology or pediatrics.

In this article we will know what it is, what its effects are and the main applications that this substance has. We will also see how, in addition to producing benefits, it can also end up generating an addiction in people obsessed with their physique or with fear of aging.

Botulinum toxin: what is it and how does it work?

Botulinum toxin, commonly known as “botox”, is a widely used substance in aesthetic medicine. On a chemical level, is a neurotoxin produced by a bacterium called Clostridium botulinum .

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What this substance does is block the release of acetylcholine (a neurotransmitter needed to produce muscle contraction), which results in temporary muscle paralysis. That is, has the function of paralyzing or decreasing the function of the muscle (or muscles) on which it is applied.

What is it used for?

Its aesthetic use was approved in 2002. Currently, is considered a very low invasive cosmetic treatment, and the most requested worldwide . In addition, botulinum toxin is considered a safe substance if administered correctly and by a professional.

Besides being very present in the field of aesthetic medicine, it also helps to solve other health problems, such as child spasticity.

Let’s see how botulinum toxin has various uses and applications. Some of them are:

1. Correct or smooth out wrinkles

Mainly, is used on the face to correct dynamic or static (expression) wrinkles. Dynamic wrinkles are those caused by the muscular activity itself, and static or expression wrinkles are those caused by the natural aging of the skin.

But where exactly is the botulinum toxin applied to the face? It’s mainly applied to the upper half of the face. Generally, the most frequent areas of application are two: the crow’s feet and the space between the eyebrows.

2. Ophthalmological problems

Botulinum toxin is not only used for aesthetic purposes, but also for functional pathologies. In the field of ophthalmology, is used to treat exophthalmos, and blepharospasm .

2.1. Exophthalmos

An exophthalmos is the projection or exit of the eyeball outwards ; they are the well-known “bulging eyes”. It can involve one or both eyes, depending on the cause.

2.2. Blepharospasm

It is a spasmodic contraction of the muscle around the eyes (orbicularis muscle), involuntary and repetitive. This contraction causes dystonias, which are strange or abnormal postures and movements.

3. Child spasticity

Botulinum toxin also allows for the treatment of certain neurological diseases with muscular hyperactivity , such as infantile spasticity. This appears especially in infantile cerebral palsy, and consists of a movement disorder, associated with the nervous system, which causes some muscles to tense and contract.

Here what the botulinum toxin does is to decrease the hyperactivity and muscle tone, allowing the longitudinal growth of the muscle, which helps to avoid the fixed contractures typical of spasticity.

4. Strabismus

Strabismus is the deviation from the normal line of sight of one (or both) eyes, causing the visual axes not to have the same direction (this is commonly known as being “cross-eyed”).

Botulinum toxin can also be applied to strabismus. How does it work? By exerting a paralysing effect on the cholinergic nerve endings , which block the release of acetylcholine, causing the muscle to relax.

Pharmacological effect

But specifically, how and where does the botulinum toxin work? At the pharmacological level, what it does is act at the level of the neuromuscular junction; in this transition zone or “junction” between the muscle and the peripheral nerve, acetylcholine is released.

Botulinum toxin blocks the release of acetylcholine in the injected area, resulting in temporary muscle paralysis.

The effect it produces does not lead to any physical injury to the nerve structures , so it is said to be a fairly safe substance.

Botox addiction

But botulinum toxin also has the “other side of the coin.” Especially in the field of aesthetic medicine, many people become addicted to it.

People who are addicted to botox end up getting hooked on its effects, by repeatedly going for cosmetic surgery to avoid aging at all costs . That is why one must be prudent and take into account the possible harmful effects of misusing it, since, like everything else, nothing in excess is good.

Thus, although it is true that botulinum toxin itself is a safe and non-invasive substance, addictions will always be harmful, and an addiction to botox is often linked to some other psychological disorder, such as dysmorphophobia or body dysmorphic disorder. This is a somatoform disorder characterized by excessive concern for a real or imagined defect perceived in some part of the body.

Bibliographic references:

  • IMO. Institute of Ocular Microsurgery. (2018). Botulinum toxin.
  • Moguel-Ancheita, S. (2000). Treatment of strabismus with botulinum toxin. Mexican Journal of Pediatrics, 67(4): 166-171.
  • Pascual-Pascual, A. Herrera-Galante, P. Póo, V., García-Aymerich, M., Aguilar-Barberà, I. Bori-Fortuny, P., García-Ruiz, R. Garreta-Figuera, G, Lanzas- Melendo, I. de Miguel-León, F., Miquel-Rodríguez, F., Vivancos-Matell, l. (2007). Therapeutic guide for child spasticity with botulinum toxin. Neurological Journal, 44 (5): 303-309.