What is it? 

Botox is a prescription only medication made from a bacterium called Clostridium botulinum – the toxin that causes botulism, a form of severe food poisoning. For medical purposes the toxin is modified and used to treat a variety of different conditions includinghyperhidrosis (severe underarms sweating), blepharospasm (uncontrollable blinking), chronic migraine, overactive bladder and cervical dystonia (severe neck and shoulder contractions.) As it acts as a muscle relaxant it is also widely used in the cosmetic industry to temporarily smooth out lines and wrinkles, usually on the forehead or around the eyes.

Botox, the most commonly known drug of this type, is a trademarked name for a specific botulinum toxin (type A), but other brands that work in a similar manner include Vistabel, Dysport and Bocouture.

Botox injections work by blocking nerves signals to muscles, relaxing or making their ability to contract weaker. The effects last about three to twelve months, depending on what you are treating.

Is the toxin safe?

Anti wrinkle injections using the neuro toxin has been used for decades and is one of the most studied medicines in the world. More than 2000 medical research papers have confirmed it is generally very safe and effective. But it should always be given by, or under the supervision of, a qualified medical professional to minimise any risks.

What is it for?

It is available on the NHS for chronic migraine, excessive sweating and overactive bladder.

Botox is also the most common cosmetic procedure in the UK for people who want to minimise wrinkles and lines across the forehead, frown lines and crow’s feet. Although it won’t correct other signs of the ageing process like sagging eyelids.

What does it cost?

In the UK botulinum toxin injections cost between £200 and £350 for a treatment depending on the practitioner and the amount of product used.

What is the procedure like?

First you should meet with the doctor, prescribing nurse, pharmacist or dentist who is qualified to perform the treatment. They will want to know your medical history as not everyone is suitable for the procedure.

You will need to tell your doctor if you have had any botox within the past four months. They should know if you are taking any muscle relaxants, sleeping aids or allergy medications which can interact badly with Botox. If you regularly take aspirin or ibuprofen or supplements such as fish oil or vitamin E, which all thin the blood, you may be advised to stop taking these for two weeks before the procedure to reduce the risk of bleeding or bruising.

If you are pregnant or breastfeeding you should not have botox.

Some physicians delegate the injections to clinic staff but for best results it is recommended you go to a doctor who is experienced at this procedure and performs it themselves.

There is no need for an anaesthetic. Your skin is cleaned and small amounts of Botox are injected into the area chosen for treatment.

The procedure normally takes between 10 to 30 minutes. People’s pain thresholds differ but it is generally painless. For some people the injections may cause some discomfort and there may be short-term soreness, mild swelling or bruising around the injection site immediately after treatment.

What happens next?

There will usually be an improvement in your wrinkles within three to ten days with the full effect being seen within two weeks.  And results typically last three to four months. There is no downtime, although you shouldn’t massage or rub the treated areas for three days as this can cause the toxin to spread to a different area which could cause problems such as blurred or double vision if it spreads to the eyes.

What are the side effects?

• Bruising at the injection site is the most common side effect and is generally gone within one to two weeks
• Flu-like symptoms, including headache, for up to 24 hours after treatment
• In very rare instances (around 5%) people can experience drooping eyelids or eyebrows if the medicine moves into these areas but this problem can be treated and resolves within a few months.

Your body can develop resistance to the product. Some UK doctors have reported the treatment becomes less effective if used for 10 years or more and a German study found one in 200 Botox users develop antibodies against the treatment over time.

Can everyone have Botox?

You shouldn’t have Botox if:

• The infection site is infected
• You are pregnant or breastfeeding
• You have a neuromuscular disorder such as myasthenia gravis.

What should you do if you are unhappy with the results?

The NHS advises you contact the practitioner who treated you to deal with any complications. You can also report any side effects through the Yellow Card Scheme website which provides more information on the safety of medicines.