Since it’s the most popular cosmetic treatment out there, Botox is certainly something many people have heard of, though they might associate it more with depictions seen in film and television than with first-hand experience. Still, each year more than a million Americans receive Botox injections — and not all of them are seeking cosmetic support.
While it’s true that most people get Botox injections in the hopes of reducing or preventing wrinkles on their face, there are other medical reasons a patient might seek this treatment. For example, in more recent years those who suffer from migraines have tried to benefit from Botox injections, too. So, whether you’re considering the procedure yourself or just curious about its many medical (and cosmetic) effects, here’s everything you need to know about Botox.
What Is Botox?
Botox, technically Botox Cosmetic, is the trademarked name for a substance that’s injected into a patient’s facial skin to restrict muscle movement. Its purpose? Prevent and reduce wrinkles — at least, that’s its primary use case. The “miracle” wrinkle-reducing substance was actually derived from the lethal neurotoxin botulinum OnabotulinumtoxinA. If ingested, it can cause paralysis and, in severe cases, lead to death.
However, when Botox is administered in specific areas and in regimented doses, it can help muscles relax temporarily. Generally speaking, when people feel any number of emotions, from anger and fear to happiness and sadness, their forehead muscles contract over and over. Eventually, this leads to wrinkles. Since Botox relaxes one’s muscles, this frequent contraction stops, thus limiting — or preventing — the formation of wrinkles.
Approved by the U.S. Food and Drug Administration (FDA) as a cosmetic treatment for frown lines between the eyes in 2002, Botox has grown over the course of nearly two decades to be the most popular cosmetic treatment on the planet. Later, in 2013, the FDA approved Botox to treat crow’s feet, those little wrinkles near the corners of one’s eyes. As it turns out, quite a number of people will do anything it takes to keep looking young, even if that means injecting a toxin into their skin. But Botox isn’t just a trend among older folks. In fact, a lot of younger people are opting into this wrinkle-reducing treatment these days, too. The idea? It’s better to stay ahead of the wrinkles.
The Process of Receiving Botox Treatments
While the procedure is safe, non-surgical, and minimally invasive, Botox must be administered in-office by a licensed professional, such as a physician, physician’s assistant, nurse, or dentist, in the U.S. As a cosmetic treatment, Botox can only be injected into certain areas, which currently include the space between the eyebrows and around the eyes. However, in more recent years, the FDA has approved the use of Botox for several other medical issues, including excessive underarm sweating, overactive bladder, and chronic migraines. Additionally, it can also be injected into other areas for therapeutic reasons.
Regardless, the medical professional providing the Botox procedure should know about any allergies, medical conditions, and prescription drugs you are taking for safety reasons. Additionally, your Botox provider might recommend avoiding medications that thin the blood to minimize the chance of bruising.
The process itself is easy. No general anesthesia is required and no incisions are made. For those who experience pain or discomfort, the use of a topical anesthetic or even ice can help to numb the area beforehand. Using a fine needle, the professional administering the Botox will make between three and five injections between the eyebrows and/or about three injections on each side of the eye. In total, the procedure won’t last longer than 10 minutes in most cases.
Afterward, patients should not touch, rub, or apply pressure to the area of treatment. Furthermore, they should avoid lying down or bending over for roughly four hours after the treatment. Too much movement might allow the substance from the injections to spread into other areas, which can be unsafe. Other than that, most people can resume their day immediately after the appointment.
Results will likely start to show between 24 and 48 hours later and usually last up to four months. For continued wrinkle control, the patient will require follow-up Botox injections.
Side Effects Associated with Botox
When Botox is administered correctly by a licensed medical professional, side effects are either minimal or completely absent. If they do occur, they can include slight bruising or redness near the sites of the injections. Luckily, those issues don’t usually last very long if they occur.
More serious side effects are rare, but can include tiredness, headache, neck pain, eyelid swelling or drooping, dry eyes, double vision, and difficulty swallowing, breathing, and talking. Additionally, if a person has an allergic reaction to Botox, they might experience a rash, itching, or asthma-related symptoms. Should any of these more severe symptoms arise, head to the hospital right away.
How Much Does Botox Cost?
As of 2018, Botox typically costs between $300 and $600 each visit. The price variance has to do with the number of injections given as well as location in which the doses are administered. Each unit of Botox costs anywhere from $10 to $15. The average dose is between 30 and 40 units for treatment to both the forehead and around the eyes.
While it might be tempting to find the lowest possible price for Botox injections, be aware that the price includes having a trained and experienced medical professional safely administer — not just so you can receive the desired, wrinkle-reducing results, but because Botox can be a harmful substance, if not handled properly. In other words, make sure you research your Botox provider beforehand.
The Benefits and Drawbacks of Botox
There are many benefits associated with getting Botox injections. The most obvious, of course, is that Botox can eliminate, reduce, and/or prevent facial wrinkles, which can keep you looking young. While most people seek out Botox treatments for cosmetic reasons, others use it to treat overactive bladder, sweaty palms, psoriasis, migraines, depression, and eye twitching, among other things.
Some of those are FDA-approved uses, while others are not. Interestingly, using Botox for whatever you like is legal in the U.S., as is the off-label use of any FDA-approved substance. What’s more, doctors can legally prescribe any drug that has been approved by the FDA for any medical issue if they feel it would be a good fit for the patient.
For example, Botox has been approved by the FDA to treat overactive bladder, as it prevents the involuntary muscle contractions behind a person constantly feeling like they have to urinate. On the other hand, Botox has not been approved as a lip injection, though it’s a popular procedure for those seeking fuller-looking lips. It has also not been approved to treat depression, though several studies, including a clinical trial from 2017, have shown it to be highly effective. As such, some psychiatrists now prescribe Botox to patients living with depression.
Botox also has some drawbacks that are worth considering. For starters, it’s only been around for 30 years, so the long-term effects of Botox are still largely unknown. Another major drawback? The facial muscles will be impacted by the continuous and prolonged use of Botox injections, meaning those muscles may not work as they once did even after you stop receiving Botox injections. For many, this means they cannot express their emotions as thoroughly. An occasional break from Botox injections will allow those muscles to build back their strength, but it could take some time.
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- “Understanding Unapproved Use of Approved Drugs ‘Off Label'” via U.S. Food & Drug Administration (FDA)
- “Botox (OnabotulinumtoxinA) Now FDA Approved for Overactive Bladder” via American Health & Drug Benefits (AHDB)
- “Efficacy of Botox versus Placebo for Treatment of Patients with Major Depression” via Iranian Journal of Public Health, U.S. Library of Medicine
- “Botox: The Drug That’s Treating Everything” via Time
- “FDA approves Botox to smooth wrinkles” via CNN
- “FDA approves Botox injections to treat ‘crow’s feet'” via The Boston Globe
- “FDA Approves Expanded BOTOX® (onabotulinumtoxinA) Label for the Treatment of Pediatric Patients with Spasticity” via abbvie