If you view Botox® as a one-dimensional cosmetic treatment for laugh lines and crow’s feet, you’re vastly underestimating this tiny toxin. Botulinum neurotoxin type A (often abbreviated as BoNT and commonly referred to as Botox®, or other brands such as Dysport®, Jeuveau® and Xeomin®) offers relief for a wide range of conditions affecting the eyes, the jaw, the bladder, psychological wellness, and more.
Although Botox® has become increasingly mainstream over the past few years, researchers have studied its effects since the 1920s. After observing Botox®’s ability to inhibit sympathetic and parasympathetic nervous system activity, they discovered how Botox® decreases muscle contractions by preventing acetylcholine release at the neuromuscular junction. Later, it was determined that Botox® also reduces the release of inflammatory mediators and neuropeptides, effectively blocking pain sensations.
It seems researchers are just cracking the surface of Botox®’s widespread therapeutic potential. Here’s a review of the most notable uses of Botox® in therapeutic and medicinal applications.
Aesthetic clinicians noticed that their patients who used Botox® to reduce facial wrinkles also reported improvements in migraine symptoms. This prompted further investigation and eventually led Botox® to become the first treatment ever approved for chronic migraine prevention.
Scientists don’t fully understand the mechanisms by which Botox® helps with migraines, but they’ve theorized that extracranial injections may travel through the pain fibers, impacting internal processes in the brain. Studies show that after 24 weeks of treatment, Botox® reduces the number of monthly headache days and the occurrence of severe migraines.
There are several advantages to Botox® therapy over other treatment modalities. For one, there’s ample evidence that Botox® injections are safe and well-tolerated. Botox® is also more cost-effective than oral migraine drugs and helps keep headache patients out of the hospital and emergency room. To boost patient compliance, experts recommend scheduling injections on a three-month basis.
Some cases of urinary incontinence are caused by a known neurological condition. Other times, it’s related to a non-specific overactive bladder due to age or genetics. Fortunately, Botox® appears to improve urinary incontinence symptoms from various underlying causes. Bladder injections of Botox® also improve related urinary symptoms, including urinary urgency and bladder pain.
Botox® injections have passed three phases of clinical trials and subsequent extension studies demonstrating safety and efficacy at doses of 100 to 200 IUs for urinary issues. Treatments significantly reduced symptoms and improved the patient’s quality of life with lasting benefits and minimal adverse effects.
Botox® is FDA-approved to treat hyperhidrosis (excessive sweating). By blocking the cholinergic sympathetic nerve fibers responsible for sweat production, Botox® effectively reduces excessive sweating. Studies show that results can last six to nine months.
Practitioners can inject Botox® directly into the sweat glands of the affected area, such as the armpits, palms of the hands, or bottoms of the feet. To determine where to place the injections, clinicians can use the Minor starch iodine test. After applying a 3% to 5% iodine solution to the treatment area (and allowing it to dry) starch is applied. Since sweat turns purple after contact with iodine and starch, it’s easier to pinpoint where to place the injections for the best results.
Problems with the chewing muscles, or the temporomandibular joint (TMJ) can lead to restricted jaw movement, clicking sounds, locked jaw, and persistent pain. These temporomandibular disorders (TMD) are the second leading type of musculoskeletal disorder that causes pain and functional issues. They’re also a common cause of headaches.
A randomized, double-blind, placebo-controlled trial of 21 participants with TMD concluded that Botox® injections were a “relatively effective” treatment compared to saline injections. The toxin works by inactivating the nerve endings that cause the muscles to contract, thereby relaxing the masseter muscles responsible for jaw clenching. In the study, the group that received the Botox® reported significant improvements within one month of treatment, and positive effects persisted for at least three months.
Strabismus was one of the first conditions to receive FDA approval for Botox® treatment in 1989. Up to 5% of the population suffers from some level of strabismus, which is a deviation of ocular alignment.
Strabismus is more common in people with conditions like Down syndrome or cerebral palsy, but can also occur without other underlying conditions. Most people develop it during childhood, but any age can be affected. Strabismus impacts depth perception, vision, and the ability to work and live independently.
By reducing acetylcholine release, Botox® blocks neuromuscular transmission and causes flaccid muscular paralysis. This effect improves ocular alignment and avoids the need for more invasive procedures to correct strabismus.
Studies have shown that Botox® may alleviate the symptoms of major depression by altering central responses to feedback from the facial muscles. By reducing skin movement and the ability to use the muscles needed to create negative emotional facial expressions (such as frowning and scowling) with Botox® injections, it is believed that some patients may see psychological benefits.
As Botox® reduces pain (for a wide array of conditions) and helps slow down and regulate muscle contractions, cardiologists have even begun experimenting with Botox’s potential to prevent atrial fibrillation following heart surgery. Studies are still in the early stages regarding this, but the results seem promising.
Botox® may reduce sialorrhea (excessive drooling) when injected into salivary glands. Children experiencing salivary issues (sometimes related to neurologic disorders) have seen these injections to be a promising alternative to surgical treatment. Injections into salivary glands may reduce activity of these glands and decrease the amount of saliva that is produced.
Since the 1980's, Botox® has been used as a common treatment to reduce symptoms of spasmodic dysphonia (a neurological disorder where muscles of the larynx involuntarily spasm, interfering with the voice). The botulinum toxin can be injected into the vocal folds, acting as a nerve blocker, ultimately reducing the number and severity of spasms that cause communication issues such as weak or stuttering voice.
Botox® has also been used to treat a variety of nasal conditions. It has been reported that Botox® has been used to relieve turbinate hypertrophy and rhinorrhea when injected directly into a turbinate. According to a small cohort study published in the American Journal of Otolaryngology, injections of botulinum toxin A into the inferior and middle turbinates for vasomotor rhinitis showed symptom improvement, including decreased congestion, sneezing, rhinorrhea, and nasal itch. "Allergic rhinitis is the most prevalent and most frequently recognized form of rhinitis. However, nonallergic rhinitis (NAR) is also very common, affecting millions of people." Could Botox® become a widely used, viable treatment for these common complications?
Air Tite has everything you need to expand the therapeutic applications of Botox® in your practice. Always follow the latest best practice guidelines for recommended injection techniques based on your specific use of Botox® and the individual client.
In Air Tite’s shop, you can find MinimLL Syringes, the original 0.5mL Low Dead Space Luer Lock Syringes. Also, shop for low dead space and INVISIBLE NEEDLES from TSK, manufactured in Japan with surgical stainless steel.
Keep your clients happy with high-quality products that require minimal force, while saving money on injectables with the efficient low dead space design. Click below to explore our supplies recommended for Botox® therapeutic uses.