Botox is composed of botulinum toxin A, derived from Clostridium botulinum bacteria. When injected into a muscle, it functions to temporarily paralyze or weaken that particular muscle. For this reason, Botox is used for cosmetic purposes to improve “hyperdynamic wrinkles”. These are wrinkles formed by muscle movements as in smiling, frowning and raising the eyebrows. It softens but doesn’t completely eliminate “static wrinkles”, which are wrinkles that remain on the face when the face is in resting position. The effects of Botox usually begin 3 to 4 days after treatment, although some individuals report that it takes up to a week. The maximum effect is achieved by 1-2 weeks. Improvement typically lasts 4 months; however, there is individual variation. Follow up treatments are required to maintain the desired results.

Botox is also used for treatment of hyperhidrosis, defined as focal excessive sweating. Botox injected around sweat glands in the skin decreases sweat production and hyperhidrosis. Hyperhidrosis is treated in a stepwise manner starting with over-the-counter antiperspirants, moving onto 10-25% Aluminum chloride antiperspirants then Botox injections. Surgery is reserved as a last resort with local sweat gland resection or endoscopic thoracic sympathectomy. Results of botox treatment last up to 6 months.

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