Application of Botulinum toxin – removing mimic wrinkles and removing unwanted perspiration – Hyperhidrosis
Botulinum toxin is a neurotoxin produced by Clostridium botulinum bacteria and it has been in clinical practice for 25 years (beside dermatology it is neurology, ophthalmology), its´ use is safe (demonstrated by a number of medical studies), and doses used in aesthetic dermatology are 1000 times lower total toxic doses and 20 times lower than doses used in neurology.
Botulinum toxin to remove mimic wrinkles, after application to the muscle it blocks the transfer of information on the nerve-muscular system in the particular area, thus preventing contraction – the muscle stiffness. When applied in the face area, the muscle immobility and relaxation of the expressions (which causes the appearance of mimic wrinkles) occur within couple of days following. Depending on the technique, the area of application and the amount of substance used, the natural mimic is preserved, so although we can not create wrinkles in the applied areas of the face, it does not make the face to look stiffed. The wrinkles are extinguished, the face seems younger and relaxed. The effect is excellent especially for first wrinkles and wrinkles of middle-aged women. Concerning deep wrinkles, where the ligament has been definitive defected, and which persist even after interruption of the mimic movement, we recommend the application of filling materials.
The effects of botulinum toxin are also used in the treatment of excessive sweating – hyperhidrosis. It most often occurs as a result of emotions (joy, tension, nervousness, fear, stress). In this case, acetylcholine release is blocked – a substance released from the nerve endings which mediate the activity of the sweat glands. The result of blocking is paralysis of sweat gland activity.
Problems to be solved by botulinum toxin application
- Delicate mimic wrinkles on the face
- Excessive sweating – hyperhidrosis (not due to excessive sweating if it is a secondary symptom of another disease, for e.g. thyroid) – suitable for people allergic to antiperspirants and deodorants
When treatment is not appropriate.
- Hypersensitivity to the active substance
- Inflammation at the area of application
- Pregnancy, breastfeeding
- Blood clotting disorder, nerve-muscular diseases (Myastenia gravis, Lambert Eaton syndrome)
- Usage of some medicaments (local anesthetics, aminoglycoside antibiotics, non-steroidal anti-rheumatic drugs, myorelaxants, anticoagulants, calcium channel blockers, antimalarial drugs, cholinesterase inhibitors)
The most common areas for botulinum toxin applications.
- Forehead, the area above the root of the nose between the eyebrows – Glabela, eye area.
- Armpits, palms of hands and feet, face
How does the application of Botulinum toxin work?
Botulinum toxin is applied to the face during the outpatient treatment by a fine needle into the muscle or subcutaneous tissue. Pain is minimal and treatment takes approximately 30 minutes. Within next 2 to 4 days, the muscles in the applied area are becoming immobilized, the full range of effect occurs within 2 weeks after the application and the duration of the developed effect is individual, approximately 3 to 6 months after the first application. Repeated application prolongs the effect. The application of botulinum toxin may be combined with photo-rejuvenation and the use of filler materials being implanted (hyaluronic acid). Occasionally, temporary side effects, such as itching, blue eyes, injection site redness, headache, or flu-like symptoms may occur. Depending on the area of application, the eyelid may be falling a bit (the area of application between the eyebrows), the eyebrow decline (forehead application) – that may last for an average of 3 weeks, but this is a temporary effect that does not require treatment. Exceptionally, the effect of botulinum toxin may not develop due to the presence of antibodies to botulinum toxin in the body.
In the case of hyperhidrosis, botulinum toxin is applied with a fine needle to the subcutaneous tissue at several points at a distance of 1 to 2 cm (depending on the area of application). Anesthesia is generally unnecessary. The effect occurs within 3 days after application, and its´ duration is individual from 6 to 12 months (palms averaging 3 to 6 months, armpits 6 to 12 months).
Recommendations before and after treatment.
The client is thoroughly introduced to the procedure and possible side-effects
- It is advisable to clean the skin from make-up and to disinfect it gently
- It is possible to test the hyperhidrosis zone by iodine – starch test
- It is not recommended to bend over, lie down, touch the treated areas for 4 hours after treatment and it is recommended to thoroughly practice the muscles of the applied areas
- Over 2 days excessive physical activity is not recommended
- It is not recommended to undergo cosmetic skin treatments and facial massages for 2 weeks
- After treatment in order to remove the sweat it is recommended to wear cotton linen and rinse the treated area with only pure water for at least 2-3 days
- after the treatment