Medical Uses of Neurotoxin "Botox”

Neurotoxins commonly known as "Botox" is very popular in the beauty industry to treat unwanted wrinkles and fine lines, lip flips and for facial slimming; however it can also be used medically to treat TMJ (temporomandibular joint dysfunction/pain); migraine; tension headaches and hyperhidrosis (excess sweating).

Studies to support the use of neurotoxin medically:

TMJ

  • 70% response rate to neurotoxin (1), reducing pain medication use.

Migraine

  • Two multicentered randomized controlled studies including 679 patients and 705 patients that lasting 24 weeks showed positive outcomes to treating chronic migraines with onabotulinumtoxinA (PMID 20647170; 20647171)

Tension headache

  • Tension headache studies are more gray in results. Study by Jackson JL (PMID 22535858) showed positive results but was not statistically significant. Unfortunately insurance does not cover treatment but clinically depending on the cause of the tension headache I've seen benefits!

Hyperhidrosis

  • Hyperhidrosis (aka excessive sweating) can be treated with botox! Botulinum toxin works by blocking the release of acetylcholine to neuromuscular and cholinergic autonomic neurons. Multiple studies have shown positive outcomes to reduced sweating post botulinum toxin injections (PMID 11557704; 25152343; 12810503; 11531794; 11557704)

Safety:

-Contraindication:

  • Allergy to botulinum toxin

  • Pregnancy, planning to be pregnant in two weeks, breast feeding

  • Pre-existing neuromuscular disorders: those with amyotrophic lateral sclerosis, myasthenia gravis, Lambert-Eaton syndrome may have increased risk for side effects including muscle weakness, diplopia, ptosis, dysphonia, dysarthria, respiratory compromise.

  • Skin treatment within past 2 weeks

  • Current sunburn

  • Taking aminoglycoside antibiotics: this class of medication interferes with neurotoxins and potentiate the effect.

-Warning/Precautions:

  • Uncontrolled cardiovascular disease: reported adverse events of arrhythmias and heart attacks

What to expect:

  • After treatment:

    • You cannot lie down for 3 hours = this is to ensure the botox doesn't move to a unwanted location

    • No exercising until the next day = to prevent increasing metabolism of the botox and reducing the effect time

    • If sexually active, you need to use protection for 2 weeks

  • Neurotoxins can be effective for 4-6 months depending on the individual

Fun fact:

  • 3000 units of neurotoxin is the lethal dose... to note, the max we typically inject is 100 units for hyperhidrosis.

 

Have questions or interested in trying botox? Give our office a call: 808-465-3000.

References

1. Bentsianov B., Francis A., Blitzer A. Botulinum toxin treatment of temporomandibular disorders, masseteric hypertrophy, and cosmetic masseter reduction. Oper. Tech. Otolaryngol.—Head Neck Surg. 2004;15:110–113. doi: 10.1016/j.otot.2004.02.002.





MEDICAL DISCLAIMER: the information in this blog post is for informational and educational purposes only. The information and education provided is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis

Health and WellnessKalin Suzuki