People in search of the facial fountain of youth have long known Botox to be the answer to their prayers — albeit a temporary one. In fact, it remains the leading nonsurgical cosmetic procedure in the United States.
However, Botox isn’t just for wrinkles anymore. Increasingly, physicians are using it for myriad noncosmetic purposes such as excessive underarm sweating, chronic migraines, neuromuscular disorders and overactive bladder, to name a few.
“I have utilized Botox with several patients, many if not most of which have responded favorably, some with a dramatic improvement and reduction in migraine frequency,” said Robb Snider, MD, a neurologist with The Clinical Neuroscience Institute in Dayton, which is part of Premier Health Specialists.
We also interviewed Suzanne Quinter, MD, dermatologist with UC Health Physicians in West Chester to explain the benefits of Botox in treating certain medical conditions.
Botox and Botox Cosmetic — are they one and the same?
Both Botox and Botox Cosmetic contain botulinum toxin type A, a protein formed by the bacterium Clostridium botulinum. Although Clostridium botulinum can cause food poisoning if unintentionally ingested, both Botox and Botox Cosmetic utilize a purified version of the protein, which is not harmful when injected.
The difference between the two lies in how they are used. Botox is a prescription medicine injected into the muscle and is approved by the Federal Drug Administration (FDA) to treat conditions such as overactive bladder/incontinence; chronic migraines; muscle stiffness in elbow, wrist and finger muscles; neck pain; eye muscle issues and excessive underarm sweating. Botox treatments of this nature are sometimes covered by insurance.
Botox Cosmetic is a prescription medicine injected into muscles and is also FDA approved to be used to improve the look of moderate to severe frown lines/wrinkles. These injections are often not covered by insurance.
How does Botox work?
Botox decreases muscle activity by blocking overactive nerve impulses that trigger excessive muscular contractions or glandular activity. For example, in the case of excessive underarm sweating, Dr. Quinter says that the Botox inhibits the signal between the nerves and the sweat glands. “The body does not need underarm sweating to regulate body temperature, which is what sweating does,” said Dr. Quinter. “You’ll just sweat elsewhere — like through the sweat glands located throughout the body’s hair-bearing surfaces.”
When it comes to migraines, the precise way in which Botox works is not known. “However,” said Dr. Snider, “it is thought that Botox affects the area of the brain where migraines originate, making those areas less likely to trigger a migraine attack.”
How long do the effects of the injections last?
The therapeutic effects of Botox are unfortunately temporary and last anywhere from three to10 months, depending on the indication and the individual patient. According to Dr. Snider, the full effect of Botox for the treatment of migraines may take several days to develop. “The full benefit may not be realized after the first series of injections and repeated injections are required to maintain the effect,” explained Dr. Snider. “These beneficial effects usually last 90-120 days although some patients will enjoy a longer benefit between injections.”
How much does Botox cost?
The cost of Botox depends on the area treated and how many units are required per treatment. In some cases, insurance will cover the cost but usually only after other, more conventional treatments have been tried without success.
“Patients do pretty well with two treatments a year, which is good because they (the treatments for underarm sweating) can be kind of pricey, ranging anywhere from $750 to $1,000 per treatment,” said Dr. Quinter.
What are the side effects of Botox?
The side effects are usually minimal and may include pain, bruising, inflammation, bleeding, redness and swelling at the injection site.
“Typically the side effects are minimal and can infrequently include weakness of facial muscles resulting in droopy eye lid(s); weakness of the neck muscles, making it difficult to hold the head upright; or, rarely, difficulty swallowing,” said Dr. Snider.
Both Dr. Snider and Dr. Quinter advise patients to talk with their doctors about whether Botox is a viable option for treatment, as each patient’s health situation is unique.
For more information about Botox, go online to www.botox.com.
What it treats
According to the website at www.botox.com, Botox is a prescription medicine that is injected into muscles and used to treat:
• Overactive bladder symptoms such as a strong need to urinate with leaking or wetting accidents (urge urinary incontinence), a strong need to urinate right away (urgency), and urinating often (frequency) in adults 18 years and older when another type of medicine (anticholinergic) does not work well enough or cannot be taken.
• Leakage of urine (incontinence) in adults 18 years and older with overactive bladder due to neurologic disease who still have leakage or cannot tolerate the side effects after trying an anticholinergic medication.
• Headaches in adults with chronic migraine who have 15 or more days each month with headache lasting four or more hours each day in people 18 years or older.
• Increased muscle stiffness in elbow, wrist, and finger muscles in people 18 years and older with upper limb spasticity.
• Abnormal head position and neck pain that happens with cervical dystonia (CD) in people 16 years and older.
• Certain types of eye muscle problems (strabismus) or abnormal spasm of the eyelids (blepharospasm) in people 12 years and older.
• Severe underarm sweating (severe primary axillary hyperhidrosis) when medicines used on the skin (topical) do not work well enough in people 18 years and older.
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