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Botox® Treatment

What is BOTOX® Cosmetic?

BOTOX® Cosmetic is the product name for Allergans cosmetic wrinkle removing drug. BOTOX® Cosmetic is a therapeutic muscle-relaxing agent that works at motor nerve endings (nerves that lead to muscles). BOTOX® Cosmetic is a drug used for the temporary improvement in the appearance of moderate to severe glabellar lines (frown lines). These frown lines come from muscles called corrugator and/or procerus muscles. BOTOX® Cosmetic is the name used for the process of injecting the BOTOX® Cosmetic product into the patient.

In April of 2002 BOTOX® Cosmetic was first approved by the U.S. Food and Drug Administration (FDA), following previous approvale for severe medical problems as afr back as 1989. BOTOX® Cosmetic is the trade mark that Allergan decided to use to refer to their botulinum toxin A product. BOTOX® injections are related to botulism. BOTOX® treatments are successfully used to treat blepharospasm and strabismus, and BOTOX® cosmetic are also proven useful in treating cervical dystonia—these are all conditions that in some way involve spasms, involuntary muscle contractions. Within a few hours to a couple of days after the botulinum toxin is injected into the affected muscle(s), the spasms or contractions are reduced or eliminated altogether. The effects of BOTOX® Cosmetic are not permanent, reportedly lasting anywhere from three to eight months. By injecting the toxin directly into a certain muscle or muscle group, the risk of BOTOX® Cosmetic spreading to other areas of the body is greatly diminished.

When BOTOX® Cosmetic—botulinum toxin A—is injected into the muscles surrounding the eyes, for instance, those muscles can not "scrunch up" for a period of time. They are paralyzed. So the wrinkles in that area, often referred to as "crow's-feet," temporarily go away.

What is a BOTOX® Injection?

BOTOX® injection—or botox shot—is the term most widely used to describe the procedure of adminstering the Allergan BOTOX® Cosmetic treatement. BOTOX® injections utilize Botulinum Toxin Type A to treat wrinkles. BOTOX® Injections were originally slated to treat neurological disorders; today, BOTOX® injections are widely used to remove facial lines, especially frown lines, "crow's feet," and forehead lines.

What is a BOTOX® treatment?

BOTOX® treatments—or BOTOX® injection treatments—are a therapeutic muscle-relaxing agent that works at motor nerve endings (nerves that lead to muscles). BOTOX® Cosmetic is a drug used for the temporary improvement in the appearance of moderate to severe glabellar lines (frown lines). These frown lines come from muscles called corrugator and/or procerus muscles. The BOTOX® injection treatment is the name used for the process of injecting the BOTOX® Cosmetic product into the patient.

BOTOX® injection treatments were approved by the U.S. Food and Drug Administration (FDA) for cosmetic use in April 2002. (It has been approved for the treatment of several medical conditions since 1989.)

What about BOTOX® for Migraine Help?

BOTOX® has been found to give relief to Migrane sufferers. The treatment of severe headaches really belongs to neurologists, not plastic surgeons. But the BOTOX® for migraine help is gaining acceptance.

Dr. Richard Glogau, MD, UCSF professor of dermatology had produced a small study of 24 patients and reported that 75 percent of patients in his case study experienced 4 to 6 months of migraine relief following injections of BOTOX® (botulinum toxin A) to muscles of the face and head in a presentation at the American Society of Dermatologic Surgery meeting (held November 2-5). This adds weight to previous reports that botulinum toxin A can relieve headaches. Two previous studies were presented at the 1999 meeting of the American Association for the Study of Headache. One study was reported by researchers at the Michigan Head Pain and Neurological Institute in Ann Arbor and Michigan State University spoke of dosage. Another study, reported by researchers at the University of California, Los Angeles, reported 51 percent of 96 patients reported complete improvement of their migraine pain.

BOTOX® for Migrane

Following this discovery, Glogau and other researchers began to evaluate points and dosages that could alleviate migraine headaches. Glogau's results indicate that botulinum toxin A injected into the muscles of the brow, eyes, forehead, side of the head and back of the head near the neck (a point that earlier investigators have neglected) induce sometimes immediate headache relief and provide benefit for up to six months. Botox dosage in his case studies averaged 80 units per patient. Dr. Glogau's case studies had long-standing diagnoses of migraines, had all seen neurologists, and were taking standard migraine medications, including sumatriptan (Imitrex). Some required narcotic medication to relieve the pain of their frequent headaches. Most suffered migraines on a minimum of once a week and several suffered on a daily basis. In addition to use in prevention of wrinkles, BOTOX® has been used to treat uncontrolled eye twitching, crossed eyes, muscle spasms and, most recently, excessive underarm sweating (reported by Dr. Glogau in the September, 1998 issue of Dermatologic Surgery).

"I think it was accepted pretty quickly," said Emory University neurologist Dr. David Hewitt. "There are a number of people around the country who are using it off-label to treat headache."

In using BOTOX® to treat migraines and other severe headaches, there are still some questions—such as what is the optimal dose, and where should BOTOX® be injected to get the best results?Two large studies are under way at headache clinics around the country that may provide those answers.

Who makes the BOTOX® ?

Allergan is the manufacturer of BOTOX® and the manufacturer of BOTOX® Cosmetic. Allergan has been a BOTOX® manufacturer for over a decade.

Here are some key facts about the BOTOX® manufacturer Allergan from Allergan's website.

How long does BOTOX® last?

This depends entirely on the patient, but a single treatment of BOTOX® will normally be sustained for approximately three months. You will notice a gradual fading of its effects. At this point you will return to your doctor for your next treatment.

Usually, BOTOX® treatment is required only three or four times a year. Symptoms may vary throughout the course of the condition, and so the degree of relief and duration of effect varies from person to person. Consult your doctor, who has special knowledge about how to achieve the best possible results with BOTOX® for your individual case.

Acceptable safety in long-term treatment has been well established. With dosing specific to treat frown lines, this same product is now marketed as BOTOX® Cosmetic. However, formal clinical evaluations of long-term treatment have not been conducted.

Does the injection hurt?

A very tiny needle is all that is needed for the procedure. Some patients report minor and temporary discomfort from the injection.

How long does the BOTOX® injection procedure take, and how long to recover?

Performed in the office, the procedure takes about 10 minutes. Since the procedure is nonsurgical, no recovery time is needed. After BOTOX® Cosmetic treatment, you can get back to work or other activities right away.

What are Glabellar lines (frown lines)?

Glabellar lines are the wrinkles between the brows caused by the contraction of corrugator and/or procerus muscles.

Results from a large, long-term study of patients receiving subsequent injections suggest that Botox® (botulinum toxin type A) may reduce brow furrow (glabellar lines)—deep lines between the eyebrows—and lasts longer with each additional treatment.

How effective is BOTOX® Cosmetic?

In a clinical study with BOTOX® Cosmetic, the majority of patients (82.5%) reported an improvement in glabellar lines after a week. Results were still reported up to 4 months later.

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