Clinical Pathology: Botulinum toxin type A is a potent neurotoxin produced by the bacterium clostridium botulinum. The toxin inhibits the release of acethylcholine at the nerve terminal producing a flaccid paralysis. This results in a decrease in the strength of facial muscle contraction and reduction in the wrinkle lines. In the aging skin, ridges and wrinkles occur in the skin perpendicular to the underlying muscle fibers. Therefore, Botox injections are commonly used for:
- Glabellar folds: are formed by the action of the procerus and corrugator muscle.
- Midforehead wrinkles: are formed by the repeated contraction of the frontalis muscle.
- Crow’s feet lines: are formed by the repeated contraction of the orbicularis oculi muscle.
- Perioral rhytids: formed by the action of the orbicularis oris.
- Drooping of the outer margin of the eyebrow: is one of the earliest signs of aging, the eye appears crowded and smaller with abnormal fullness of the upper eyelid causing fatigue and tired appearance. The condition can be improved by injecting Botox to the forehead in order to increase the action of the lifting muscle.
- Treatment of focal hyperhidrosis: excessive sweating of the palms, axillae, face and soles of the feet.
- Discomfort during administration.
- Slight frontal headache: resolve within three days.
- Extra fold in the lid (medial brown ptosis): resolve within a few days.
- Bruising at injection site.
- Eyelid ptosis: It is important in glabellar folds injection to press with the thumb below the injection at the orbital rim for five minutes to prevent the leak of the Botox down to the eye lid.