Botulinum toxin (botox): characteristics and uses of this substance

Botulinum toxin, better known as "botox", is a substance widely used in aesthetic medicine, but also in other health fields such as ophthalmology or pediatrics.

In this article we will know what it consists of, what its effects are and the main applications that this substance has. We will also see how, in addition to producing benefits, it can also end up generating an addiction in people obsessed with their physique or afraid of aging.

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Botulinum toxin: what is it and how does it work?

Botulinum toxin, commonly known as "botox", is a substance widely used in aesthetic medicine. On a chemical level, It is a neurotoxin made by a bacterium called Clostridium botulinum.

What this substance does is block the release of acetylcholine (a neurotransmitter needed to produce muscle contraction), resulting in temporary muscle paralysis. That is to say, has the function of paralyzing or decreasing the function of the muscle (or muscles) on which it is applied.

What is it for?

Its aesthetic use was approved in 2002. At the moment, It is considered a very minimally invasive cosmetic treatment, and the most requested worldwide. Furthermore, botulinum toxin is considered a safe substance if it is administered correctly and by a professional.

In addition to being very present in the field of aesthetic medicine, it also helps to solve other health problems, such as childhood spasticity.

Let's see how botulinum toxin has various uses and applications. Some of them are:

1. Correct or smooth wrinkles

Mostly, used on the face to correct dynamic or static wrinkles (expression). Dynamic wrinkles are those that originate from muscular activity itself, and static or expression wrinkles are those caused by the natural aging of the skin.

But where exactly is botulinum toxin applied to the face? It is mainly applied to the upper half of the face. Generally, the most frequent areas of application are two: crow's feet and between the eyebrows.

2. ophthalmological problems

Botulinum toxin is not only used for aesthetic purposes, but is also used in pathologies of a functional type. In the field of ophthalmology, used to treat exophthalmos, and blepharospasms.

2.1. exophthalmus

An exophthalmos is the projection or exit of the eyeball outwards; They are the well-known “bulging eyes”. It can involve one eye or both, depending on the cause that causes it.

2.2. blepharospasms

Is about a spasmodic contraction of the muscle around the eyes (orbicularis muscle), involuntary and repetitive. This contraction causes dystonias, which are strange or abnormal postures and movements.

3. infantile spasticity

Botulinum toxin as well allows to treat certain neurological diseases that occur with muscular hyperactivitysuch as infantile spasticity. This appears especially in childhood cerebral palsy, and consists of a movement disorder, associated with the nervous system, which causes some muscles to tense and contract.

Here what the botulinum toxin does is reduce hyperactivity and muscle tone, allowing the longitudinal growth of the muscle, which helps to avoid the fixed contractures typical of the spasticity.

4. Squint

Strabismus is the deviation from the normal visual line of one of the eyes (or both), making that the visual axes do not have the same direction (this is what is commonly known as being "cross-eyed").

Botulinum toxin can also be applied to strabismus. How does it act? Exerting a paralyzing effect on cholinergic nerve endings, which block the release of acetylcholine, causing the muscle to relax.

pharmacological effect

But, specifically, how and where does botulinum toxin work? At the pharmacological level, what it does is act at the level of the neuromuscular junction; In this transition zone or "junction" between the muscle and the peripheral nerve, the release of acetylcholine occurs.

Botulinum toxin blocks the release of acetylcholine in the injected area, resulting in temporary muscle paralysis.

The effect it produces does not entail any physical injury to the nervous structuresThat is why it is said to be a fairly safe substance.

botox addiction

But botulinum toxin also has the "other side of the coin." And it is that, especially in the field of aesthetic medicine, many people become addicted to it.

People who are addicted to botox end up hooking on its effects, resorting repeatedly to cosmetic surgery to avoid aging at all costs. That is why you must be prudent and take into account the possible harmful effects of misusing it, since, like everything, nothing in excess is good.

Thus, although it is true that botulinum toxin itself is a safe and minimally invasive substance, addictions will always be harmful, and an addiction to botox is often linked to some other psychological disorder, such as dysmorphophobia or body dysmorphic disorder. This is a somatoform disorder characterized by excessive preoccupation with a real or imagined defect perceived in some part of the body.

Bibliographic references:

• IMO. Institute of Ocular Microsurgery. (2018). Botulinum toxin.
• Moguel-Ancheita, S. (2000). Treatment of strabismus with botulinum toxin. Mexican Journal of Pediatrics, 67(4): 166-171.
• Pascual-Pascual, A. Herrera-Galante, P. Póo, V., García-Aymerich, M., Aguilar-Barberà, I. Bori-Fortuny, P., García-Ruiz, R. Garreta-Figuera, G, Lanzas-Melendo, I. by Miguel-León, F., Miquel-Rodríguez, F., Vivancos-Matell, l. (2007). Therapeutic guide for infantile spasticity with botulinum toxin. Neurological Journal, 44 (5): 303-309.