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Skin & Ageing

Wrinkle Reducing Treatments

Wrinkle reducing treatments come from potent neurotoxins which were first discovered in 1817. They come from a large, spore bearing anaerobic bacteria which was isolated after several years of study, called Clostridium Botulinum. It was first used clinically in 1973 for the correction of muscle hyperkineticity and the correction of eye squints. It is used daily, in large quantities in the NHS, for conditions such as hemifacial spasm, blepharospasm, cerebral palsy and cervical dystonia to name a few. Botox® is the most commonly requested non-surgical procedure in the world ahead of Dermal Fillers.

What Is Botox Made Of?

There are seven different serotypes of botulinum toxin, A-G. Type A is the most commonly used for clinical and aesthetic applications. The neurotoxin consists of a heavy chain and a light chain joined by a disulphide bridge. It acts at the level of the neuromuscular junction, and inhibits the transmission of acetylcholine from motor nerve terminals. This happens in four stages: binding, internalisation, blocking, and re-establishment of neuromuscular transmission. The last stage happens after approximately 3 months.

The Different Brands Of Botox®

There are several different brands of Botox® such as Xeomn, Botox®, Dysport, Bocouture, Vistabel and Azzalure. Botox® works on dynamic lines, i.e. lines caused by underlying muscle activity. It stops frowning so there is no new wrinkling, and plenty of time for the body to remove the existing lines. In short, it can stave off the need for surgical procedures to deal with the effects of ageing. It starts to take effects after 2-3 days and reaches full effect by 14 days. The effects last 3-6 months, but with repeated treatments the effects tend to last longer.

Areas Where  Botox® Is Used

There are 3 main areas where Botox® can be used – the lines between the eyebrows, the horizontal lines of the forehead, and the lines around the eyes (Crow’s Feet). Botox® also produces excellent results for excessive sweating under the arms (hyperhidrosis). It is for these reasons that Botox is the most popular non-surgical cosmetic procedure in the world.

Botox Side Effects

Botox® is extremely safe, but like every medicine there are possible side effects.  The most common of these are bruising, swelling, tenderness and pain at the injection sites. These all resolve over a matter of days. The risk of this is reduced by using a very fine needle.  There is a small risk (about 1 in 100) of a droopy eyelid. This will resolve completely, usually after 3-4 weeks. There is a very small risk of allergic reactions to Botox®, this is rare. There are also contra-indications to treatment. These include pregnancy and lactation, a history of anaphylaxis, in anyone with Myasthenia Gravis or Eaton Lambert Syndrome or in those with a known hypersensitivity to Botox®. Cautions for treatment with Botox® include individuals with coagulation disorders, anticoagulant use and the presence of amyotrophic lateral sclerosis or peripheral neuromuscular disorders.

Botox® Assessments

Before any Botox® treatment an assessment takes place, looking at the expectations of the patient, the extent of their lines and wrinkles and their suitability for treatment. The client is then consented for treatment and  photographs are taken before and then 2 weeks after the procedure. The injections sites are marked carefully with a skin pencil. These sites are then injected with small quantities of Botox®. The injection procedure takes approximately 20 minutes. Afterwards, the client can continue their day as normal. We advise avoiding alcohol and exercise for several hours after treatment. Long haul flights and facials should be avoided for 24 hours and the client should avoid touching or massaging the area for a few hours.

Author Info

Dr Lynn Kelly

Doctor Lynn Kelly graduated from Aberdeen Medical School in 1999 and qualified as a GP in 2004. She is currently working as a GP in an Inverness practice which she joined in 2006.