Btx is one of the most popular products currently used in aesthetic medicine.
Btx contains botulinum toxin type A in the form of purified protein that has found its use for medical purposes in the seventies of the twentieth century. Btx was originally used in ophthalmology and neurology as well as treatment of strabismus, blepharospasm, facial spasm, neck torticollis and to remove excess muscle tension in children with cerebral palsy or adults after stroke. Currently, btx is becoming widely used not only in ophthalmology and neurology, but also in aesthetic medicine. It has been successfully used for over 15 years in treatments such as removal of facial wrinkles, especially on the upper third of the face: the forehead, the eyebrows and the area around the eyes called ‘crow’s feet’. Btx is increasingly used in the treatment of persistent, severe, primary underarm hyperhidrosis and prevention of headaches in adult patients with chronic migraine, or in the treatment of bruxism (teeth grinding).
Btx – wrinkles treatment
Btx inhibits the secretion of neurotransmitter of nerve endings called acetylcholine within the neuromuscular junctions. It results in vasodilation and relaxation of muscles responsible for the wrinkles that occur during the aging process. Btx causes relaxation of facial muscles so patients acquire natural and rested appearance. A small amount of preparation is injected into specific muscles of the face where the nerve impulses that cause contraction of these same muscles are ihibited. Because the muscles are relaxed – wrinkles simply do not arise in this area. An experienced doctor will choose the amount of preparation so that the face can keep some mobility and it does not lead to so-called ‘face-mask’ effect.
The procedure itself takes about 15-20 minutes and most people can return to normal activities immediately after the injection. Btx has a very good safety profile. Side effects, if any, are usually mild to moderate and are transient. Within a few days after surgery you should see the effects of botoks which can persist for up to 6 months. Please note that this period is unique for each patient. On subsequent treatment this period may be extended. Surgery can not be performed more frequently than every 4 months.
The treatment of wrinkles can be enjoyed not only by those with already visible wrinkles, but also people whose wrinkles just begin to appear. In these cases an injection of btx will intend to prevent the formation of large, deep facial wrinkles. In the case of deep wrinkles visible in the form of furrows it happens that, in spite of properly chosen dose of btx, the furrows will not disappear.
Sometimes there is a need to use two or three treatments in 4-6 months intervals to smooth a deep wrinkle. On other occasions btx is combined with the use of hyaluronic acid in order to fill the furrow.
Btx – treatment of primary underam hyperhidrosis
Sweating is normal physiology but excessive sweating is very embarrassing, causing discomfort for patients and their environment. Fortunately, medicine has found a solution – blocking the activity of sweat glands using botulinum toxin.
Mechanism of action of btx consists in blocking of the nerves that supply the eccrine sweat glands, and thus the secretion of sweat is inhibited. It is given intradermally in the armpit area. The effect is visible after a few days and the effect persists for approximately 7-12 months, then must be repeated. The procedure is performed on both sides to reduce the pain associated with injections in this area. A local anesthetic EMLA cream is also used.
It is recommended to conduct an interview and clinical examination, as well as additional specific tests, to rule out potential causes of secondary hyperhidrosis (eg. hyperthyroidism, pheochromocytoma).
Btx – prevention of migraine headaches
Chronic migraine is one of the most severe forms of headache. Migraine concerns mainly women aged between 25 and 50 years of age and often runs in families. The main symptom is paroxysmal, throbbing headache, usually unilateral, which runs from 4 to 72 hours. Migraine pain is often accompanied by other symptoms as nausea, vomiting, photophobia, excessive sensitivity to smells and sounds. Sometimes, before a migraine attack, a so-called ‘aura’ can occur – a set of symptoms in the form of sensory disturbances (paresis and hypoesthesia, tingling and numbness in the hands and feet), visual disturbances.
Btx is one of the methods of treatment of headache in patients suffering from chronic migraine. Preparation in the appropriate dose is administered into certain muscles around the forehead, temples, the back of the head and the neck. Paralyzed muscles relax and abolish the pressure on the nerves involved in the formation of a migraine. Pain communication to the brain also becomes disordered. The mechanism of action of btx lies in the blockage of neurotransmitter release of pain. Preclinical and clinical pharmacodynamic studies indicate that the supposed mechanism of prevention of a headache lies in blocking the peripheral signals to the central nervous system which inhibits central sensitization.
After administration of btx, the blockadge of the nerve endings of the muscles responsible for the formation of a migraine lasts for about 4 to 6 months. After this period the procedure should be repeated. Btx is effective in treating migraine headaches in 80% of cases. A complete disappearance of seizures can be observed in more than a half of the patients. Among the remaining patients – a significant reduction in migraine attacks. It should be noted that the headaches of migraine-like character may be caused by various diseases, so there has to be prior medical diagnostics. Btx is used only in patients with a diagnosis of a migraine-based headache.
Btx – treatment of bruxism (teeth grinding)
Bruxism is the involuntary overactivity of masseter muscle that leads to clenching teeth and grinding them. Condition applies to most young people, the prevalence of bruxism is estimated at 8-20% of the population.
Bruxism can cause tooth pain, teeth grinding (eating), breaking the tooth crowns, tooth loss, and may lead to pathological changes in the temporomandibular joint in the form of clicking and poping. It changes the appearance of the facial muscles through masseter muscle and temporal muscles hypertrophy, which causes the face look ‘square’. The use of btx in the treatment of bruxism can be treated as a method of supporting the use of relaxation (transparent overlay) put on the teeth or when the patient does not accept to be treated with the relaxation rails.
Btx is injected into the hypertrophic masseter and temporal muscles in the correct dose. The procedure is minimally invasive and not painful. After 3 days of administration, the patient is relieved, muscle tension and pain are reduced. The treatment is repeated every 6 months. Based on 6 years of experience of experts in the field, after 2 years of treatment (the use of relaxing overlays and botox simultaneously) further treatment may be stopped. Usually after such period, the habit of teeth grinding disappears and gnashing muscles are reduced. The face ceases to look ‘square’ and it becomes leaner, rejuvenated and simply prettier.
