Botulinum toxin (BTX or BoNT) has been used in medicine for both medical and cosmetic purposes for many years. It was first seen in the early 1980s to prevent excessive muscle contraction in small doses in the treatment of strabismus, and in 1989 it was approved for use in the treatment of various diseases in ophthalmology and neurology. Its use in dermatology began in the early 1990s, when it was determined that facial wrinkles improved after ophthalmological use.
BTX, produced by a Gram-positive anaerobic bacterium called Clostridium botulinum, has 7 different types with similar structures. Among these, type A onabotulinumtoxin (generic name Botox) and abobotulinumtoxin (generic name Dysport) are widely used in cosmetic applications as well as in medicine for excessive sweating, strabismus, migraine, neck muscle contraction and spasticity.
BTX shows its effect by blocking the substance called acetylcholine, which serves to transmit signals into the cells of the nerves, at the nerve attachment points, ultimately preventing nerve-muscle transmission. This effect ensures that the muscles in the application area do not contract or sweating stops. The purpose of using BTX is to weaken the contraction of some targeted muscles while not causing muscle weakness in non-targeted muscles. For maximum response and minimum side effects, it is necessary to apply the most effective dose in the smallest volume. The doses used in therapeutic applications are far below toxic doses.
Cosmetic use:
In cosmetic use, BTX is most commonly used on the forehead, between the eyebrows (glabellar region) and the outer part of the eye, which are located in the 1/3 part of the face. It is used to correct eyebrow lifting, frown lines and smile lines (crow's feet). Other areas of use include vertical lines on the lips, lifting the corners of the lips, neck and décolleté lines. Dynamic lines formed during movement are prevented by restricting the movement in a controlled manner. The lines that exist when at rest are very little affected by BTX. The application is performed with very thin needles, and local anesthesia is not required in the majority of patients. The dosage and application points required by each patient vary. After application, the effect begins in 3 days and lasts for 7-10 days. e reaches its highest level and lasts 4-8 months, which varies from person to person. If the effect is to continue, the application must be repeated.
Use for the treatment of excessive sweating (hyperhidrosis):
BTX is used for hand and foot sweating, especially in the armpit. After pain control is achieved with cold application, local anesthetic cream or nerve block with local anesthetic drugs, botulinum toxin is injected into the skin. The application takes approximately 30 minutes. The effect of the treatment appears after a few days and continues for 4-8 months depending on the application area. If the effect is to continue, the application must be repeated.
It has been shown that repeated BTX applications do not cause atrophy (shrinkage) or degeneration in muscles. The most common side effects are headache, rash, mild swelling, bruising, redness and mild swelling at injection sites. Rarely, eyelid drooping, eyebrow drooping, and allergic reactions may occur. It is not used in pregnant or breastfeeding women and people with muscle diseases.
Do not consume alcoholic beverages before the application, at least three days before; Ginko biloba, blood thinners, green tea, aspirin and non-steroidal anti-inflammatory (rheumatic) drugs should be discontinued.
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