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What is the history of Botox/dysport? As early as the 1950's researchers discovered that the injection of minute quantities of botulinum toxin type A into overactive muscles decreased muscle activity by blocking the release of acetylcholine at the neuromuscular junction, thereby rendering the muscle unable to contract for a period of 4 to 6 months. Alan Scott, a San Francisco ophthalmologist, first used tiny doses of the toxin therapeutically to treat 'crossed eyes' (strabismus) and 'uncontrollable blinking' (blepharospasm). Allergan, Inc., a pharmaceutical company that focused on prescription eye therapies and contact lens products, bought the rights to the drug in 1988 and received FDA approval in 1989. Allergan renamed the drug BOTOX® Cosmetic. Botox showed its cosmetic potential almost immediately, when patients with their eye on ophthalmologic gains noticed their wrinkles softening. It became apparent that the toxin that could block nerve impulses to temporarily paralyze certain misfiring eye muscles could also be utilized to disable those muscles that form "crow's feet" around the eyes, wrinkle lines on the forehead and frown lines between the eyebrows. This serendipitous discovery was made by Vancouver-based cosmetic surgeons Drs. Alastair and Jean Carruthers when the husband-and-wife team observed the softening of patients' frown lines following treatment for eye muscle disorders, leading to clinical trials and subsequent FDA approval for cosmetic use in April 2002. As of 2006, BOTOX® Cosmetic injection is the most common cosmetic operation in the United States. In May of 2009, the FDA approved the use of Dysport for moderate to severe forehead wrinkles or frown lines. It is only the second drug approved in the US for wrinkle treatment. How does Botox/Dysport work? Botulinum toxin A can be administered in a non-invasive way. Small amounts are injected directly into specific muscles and muscle groups. Botox/Dysport prevent nerve cells from signaling muscles to contract. What are the medical applications of Botox/Dysport? Medically, Botulinum toxin type A has been used to reduce abnormal head position and neck pain in patients with cervical dystonia (spasms of the neck muscles), in the treatment of strabismus (a condition in which the eyes do not point in the same direction), spasms of the eyelids or uncontrollable blinking (blepharospasm), and for the treatment of severe underarm sweating. It has also been used in the treatment of migraine headaches and other disorders as well. What are the cosmetic applications of these products? Botox or Dysport can iron out wrinkles earned over years of repetitive facial movements, such as smiling and frowning, concentrating and squinting. In addition to the most popular complaints - furrows between the eyebrows, crow's feet and forehead lines - women in particular get botox injections to correct some imperfections of their lips and necks. Recently, another use has been found: a "chemical brow lift" to restore the arch to falling eyebrows. (Outside the cosmetic sphere, botox is used not only for muscle control, but also to treat migraine headaches and other types of pain and to eliminate excessive sweating, or "hyperhydrosis.") Is Botox/Dysport safe? Serious heart problems and serious allergic reactions have been reported rarely in the cosmetic application of these drug. If you think you're having an allergic reaction or other unusual symptoms, such as difficulty swallowing, speaking or breathing, call your doctor immediately. The most common side effects following injection include temporary eyelid droop and nausea. Localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising may be associated with the injection. Patients with certain neuromuscular disorders such as ALS, myasthenia gravis, or Lambert-Eaton syndrome may be at increased risk of serious side effects. These products administered by qualified healthcare professionals and is available only by prescription." It has been determined that when used properly and administered by a qualified injector, Botox cosmetic and Dysport cosmetic are generally safe. Recently, a Boxed Warning has been added to the prescribing information to highlight that botulinum toxin may spread from the area of injection to produce symptoms consistent with botulism. It is important to note that no definitive serious adverse event reports of distant spread of toxin effect have been associated with dermatologic use of Botox/Botox Cosmetic at approved doses. How long do the effects of Botox/Dysport last? Although there is independent variation, the effects of Botox last from 3-4 months and effects are seen within hours to days of administration. |
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