Botox

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Chapter 2 What Is Botox and How Can It Rejuvenate Your Skin? We have seen how the skin ages, forming lines, wrinkles, and creases on your face, making you look much older and less attractive than you want to look. Although you can improve your skin through better care, including protecting it from further damage, you cannot restore your youthful appearance or make any major improvements without some kind of medical treatment. Until the appearance of Botox, most treatments for skin rejuvenation involved either major surgery or potential problems with unwanted side effects (see chapter 8). Without a doubt, Botox is revolutionary: an inexpensive, rapid, minimally invasive procedure that can literally take years off your face. Let's find out exactly what it is, how it was developed, and how it works its miracles. Q: What is Botox? What is in that little bottle and how is it made in the laboratory? A: Botox is a purified protein, a diluted form of the botulinum toxin, which, in its concentrated form, causes the potentially deadly disease botulism. It is produced from fermentation of the Hall strain of Clostridium botulinumtype-A toxin, sterilized and vacuum-dried in the laboratory, and grown in a medium containing casein hydrolysate, glucose, and yeast extract. Botox is sold in bottles or vials containing 100 units. It is kept in a freezer in the doctor's office and is reconstituted with saline solution before being injected. Q: But the toxin that causes botulism is so dangerous. How can Botox be safe? A: It is not a practical concern because the amount of the botulinum toxin in Botox is known to be well within the safe limit. Any toxic chemical is only toxic at a certain level. For example, the local anesthetic lidocaine that we get in the dentist's office could kill us if it were given in a much higher concentration. Even aspirin can kill at a toxic level. So almost any chemical in a concentrated form has the potential for being fatal. In order for a product to be approved by the FDA, the parameters must be documented by the researchers and the safe levels versus the toxic doses for administration proven. The Botox dose that we use for reversing signs of aging skin is extremely small and well within the safe level. In addition, according to the manufacturer Allergan, the toxin is broken down and leaves the body within twenty-four to forty-eight hours, so there is no possibility of a buildup over time with continued treatments. Botox has been used by neurologists for decades in much higher doses than we use for skin treatments. Neurologists may use 400 units in a session, and we use only 30 to 100 units on average. Yet there has not been one single case of botulism created by any of these injections. And now millions of people have been injected with Botox, the number one cosmetic medical treatment. The studies show that there are very few side effects and that it is a remarkably safe drug. Q: Can you tell us a little about the history of Botox? How was it discovered and what were its uses in the past? A: The actual bacterium, Bacillus botulinus, was identified in 1895 by a Belgian researcher. It was purified in crystalline form in 1946 by Dr. Edward Schantz. In the 1970s, Dr. Schantz, working with Dr. Alan Scott of the Smith-Kettlewell Eye Research Foundation, discovered that the toxin, botulinum toxin A, corrected crossed eyes in laboratory monkeys. A few years later, Dr. Scott began to test the toxin's effectiveness in treating muscle spasms around the eyes of humans. But the real breakthrough came in 1987, when Dr. Jean Carruthers, a Canadian ophthalmologist, noticed that after she used the drug to treat eye muscle spasms, the crow's-feet lines around the eyes of her patients improved dramatically. When she mentioned this side effect to her husband, dermatologist Alastair Carruthers, he decided to