4. HOW BOTOX® WORKS

a. For wrinkle reduction
Wrinkles are formed by a process called ‘dermal atrophy’ and repetitive contraction of the underlying facial musculature. This normal aging process is essentially down to the constant movement of the face and forehead (when eating, blinking, smiling, etc) and a loss of the skin’s elasticity over-time – creating fine lines in the early days and deeper wrinkles later on in life (for the most part)

Botox® allows practitioners to essentially tackle both dynamic wrinkles, those seen during muscle contraction, and static wrinkles, those which are visible at rest.

The Botulinum toxin is used to reduce fine lines and wrinkles and injected in very little concentrations into the desired area by your practitioner using a syringe and a small needle.

These small injections of Botox® work by targeting the nervous system and disrupting the signaling process that allows neurons to communicate effectively with muscles, weakening and paralyzing, thus weakening or paralyzing those muscles altogether.

From a more technical standpoint, this type of treatment relies on the fact that for muscular contractions, they rely on the nerves releasing a chemical component called acetylcholine, at the meeting point between the nerve endings and muscle cells. This chemical messenger travels down the nerves. It is then attached to receptors on the cells of the muscle, bringing about muscle cell contraction.

By injecting botulinum toxin in the treated area, it simply stops the acetylcholine release. This, in turn, means that acetylcholine does not travel down the nerves and therefore cannot attach itself to receptors on the muscle cells – thus thwarting muscle cells contraction.

b. For Hyperhidrosis (Excessive Sweating):
The mechanism of action of Botox is basically the same for all the conditions the drug is used for. The brain controls all the activities in the body by the action of nerves which carry chemical signals. Sweat is produced by the sweat glands after receiving a chemical signal from the brain. Administration of Botox to the underarm region temporarily blocks the transmission of signals from the brain to the sweat glands present in the armpit. This stops sweat production in that region for the period through which the Botox injection acts. Hyperhidrosis is, therefore, adequately controlled.

It would only be logical to ask where the sweat is retained as you probably known that sweat is one of the body’s means of excreting waste products. The sweat technically is not retained in the body. Botox does not cause any significant change in the volume of sweat produced by the body. The sweat is still expelled but it is only produced by some other lands elsewhere. Body odor arises form underarm sweating because of the lack of free air movement in that region. Moisture is retained for longer periods and the bacteria producing the odor is allowed to thrive in the moist conditions. Most other areas of the body are adequately ventilated and production of sweat in those areas does not lead to body odor.

c. For TMJ / Bruxism and Hypertrophic Masseters
For the treatment of TMJ/Bruxism with Botox, the masseter, temporalis and the medial pterygoid muscles are typically injected. Treatment with Botox is being explored since TMJ pain and Bruxism have been discovered to occur as a result of multiple factors. A multidisciplinary approach to management of the pain is advocated. Botox is thought to reduce Bruxism by disrupting the transmission of signals in the trigeminal motor nucleus, inhibiting the central Bruxism generator through the paralysis of the mandibular muscles. Another mechanism thought to be responsible for the activity is the deactivation of the periodontal mechanoceptors during mastication. This would aid the closure of the mandibles by the motor neurons.