BOTOX® Injection

What is Botox and what does it do?

Botulinum toxin A (Botox) is purified toxin protein from bacterium Clostridium Botulinum. It blocks contraction of muscles by blocking the exocytosis of vesicles containing acetylcholine at the motor endplate. Botox can also block pain transmission by blocking exocytosis of vesicles containing glutamate. Botox onset is about 1w post injection. Peak effect is achieved at 2-4w. It wears off by 12-16w. In addition, Botox injected into the masseter muscles reduces volume of hypertrophy by 10-20%.

What are the indications of Botox?

Indications of Botox include:

Local anesthetic injection resistant trigger points
Focal persistent neuropathic pain
Focal spasm secondary to local neuropathic pain
Focal involuntary oral motor dyskinesia
Dystonia and spasticity
Trigeminal Neuralgia
Reduce skin wrinkles
Headaches
Muscle hypertrophy

What are the complications of Botox?

Adverse reactions of Botox injection can occur occasionally. These include:

Weakness of adjacent muscles causing talking or swallowing problems
Bruising, bleeding, pain, redness or swelling at the injection sites
Dizziness, drowsiness and tired feeling

How much Botox should I get?

The amount of Botox that is needed varies depending on the conditions and the size of muscles.

10 units per injection site is usually needed for trigger points of myofascial pain.
25-50 units are needed for large muscles such as masseter or temporalis
2 units are needed per 1cm grid for neuropathic pain

References