Is Botox Safe?
Within nature lies the most sophisticated medicines. For example, the venom of a marine snail, conus magus, is used to manage pain; venom of a South American snake, Bothrops jararaca, lowers blood pressure; and glia monster saliva contains a hormone that manages diabetes (1). Not to mention the myriad of plants and their beneficial phytochemicals. These same principles are applied to botulinum toxin, a medication produced from bacteria Clostridium botulinum, and used cosmetically to treat wrinkles and therapeutically in the management of migraines, spastic muscle disorders, and other movement disorders, to name a few.
Treatment with botulinum toxin is the most common aesthetic treatment used world wide with nearly 3 million injections per year (2). There are several types of botulinum toxin produced by Clostridium botulinum with botulinum toxin A (BoNT-A) the most common, and most potent! At present, there are 4 approved BoNT-A in the US: Botox, Dysport, Xeomin, and Jeuveau. Treatment with botulinum toxin is widely viewed as safe, effective, and largely void of serious side effects. Most common side effects with BoNT-A injections include: pain, swelling, redness, and bruising and don’t differ from side-effects from other injections. Further, the risk of possible complications goes down with a proper medical history, correct dosage, and correct placement.
Tips for minimizing benign side effects associated with BoNT-A injections:
To minimize bruising: avoid blood thinning agents for 10 days prior to injections. These include aspirin, NSAIDS, vitamin E, ginseng, gingko, garlic, and fish oils. Applying an ice pack prior to injections can also help.
To minimize pain: we can apply a topical numbing cream or ice prior to injections.
To avoid infection: come with your face clean. Rest assured, we always clean the injection area prior to treatment.
To address redness: this typically goes away on its own within 24 hours. If redness persists, you can consider an antihistamine like Benadryl, for support.
You probably have heard about a drooping eyelid from BoNT-A injections. This is a rare side-effect that can happen if the medicine travels unintentionally to the muscle responsible for keeping the eyelid raised. AKA eyelid ptosis, the affected eyelid lowers 2-3 mm and is most affected at night when the muscle is most tired. This typically lasts 2-4 weeks, goes away on its own, and can be managed with prescription eye drops. We can avoid this unwanted outcome by placing the medicine correctly around the eye (2).
There is a need for more research into the effects of applying Botox to someone with an autoimmune disorder. At this time, not many formal studies exist either supporting or debunking the effects of Botox in these cases, but we do have evidence that supports the safety of Botox to those with cancer (3), attesting to the safety of application to those with severely compromised immunity. In a study looking at the autoimmune condition rheumatoid arthritis, the authors concluded that when applied during disease remission, autoimmunity was not exacerbated (4). Ultimately, choosing BoNT-A injections will be an individual’s informed and personalized choice with their doctor.
Serious side-effects of BoNT-A occur from the systemic spread of the toxin leading to botulism-like features or severe allergy to medication; this is extremely rare when we use BoNT-A cosmetically to treat wrinkles. In my research, this outcome occurred when treated in irregular beauty salons and by injecting the same site within too short of a time period, leading to an accumulation of the toxin in the system (5). Such cases are avoidable; here are ways to ensure your safety:
Stick with one practitioner and heed their wisdom in regulating your dosage.
Give yourself at least twelve weeks in between treatments.
Only receive injections from a licensed medical provider with training in injectables.
Make sure that you’re using one of the four FDA approved products in the USA: Botox, Xeomin, Dysport, and Jeuveau.
If you ever have a question as to whether or not Botox is safe for you, consult with myself or your physician for extra guidance and support.
Thanks for reading,
Heather
Resources
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869414/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874868/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8654687/