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Updated on July 10, 2014


Botox is a prescription injectable medication available in the U.S. and manufactured by Allergan Pharmaceuticals. Botox was first approved by the FDA in December of 1989. The active ingredient in Botox is a neurotoxin known as Botulinum toxin, and is produced by a bacteria, C. botulinum.

In this article I intend to answer the following quesitons about Botox:

  • What is Botox used for?
  • How does Botox work?
  • What are the side effects of Botox?
  • Where can patients obtain Botox treatments?

If after reading this, you still have more questions about Botox, please feel free to ask!


What is Botox used for?

Botox is available only by prescription and is currently approved for 6 different medical conditions and 1 cosmetic condition.


Excessive underarm sweating: Medically known as severe axillary hyperhidrosis, Botox can be used to control this often embarrassing and troublesome condition. A series of shots are administered beneath the arm which, in effect, paralyze the nerves which trigger armpit sweat production. The results, however, are only temporary, and the procedure must be continually repeated for lasting effects.

Crossed Eyes or Lazy eye: Medically known as "strabismus" and defined as a condition where both eyes are not looking in the same direction. It is the result of poor muscle control and often manifests itself at an early age. Botox is only indicated to treat this condition in those who are 12 years old or older. Botox is just one of several ways to treat this condition. For an excellent and detailed document on using Botox for strabismus, CLICK HERE for an article provided by Children's Hospital in Boston, MA.

Muscle Spasms in the Neck or Shoulder: Also known as cervical dystonia, or spasmodic torticollis.This condition results in patterns of involuntary movement of the head and neck. Most often the cause is unknown. It is slightly more common in females than males, and typically begins to manifest itself between the ages of 50-69. Treatment with Botox involves several injections into the neck muscles while in a doctor's office. The effects last typically about 3-4 months, after which they would need to be repeated. The National Spasmotic Torticollis Association has an article on Botox use for this condition.

Muscle Stiffness in Arms and Hands: This is called "upper limb spasticity." This condition can sometimes develop after a stoke, traumatic brain injury or due to multiple sclerosis. The FDA approval for Botox to treat upper limb spasticity was first announced in March 2010. The use of Botox treatments do not eliminate the need for physical therapy. Medscape Medical News has a brief summary of the clinical trials that lead to the Botox approval for this condition.

Twitching around the eye: Clinically identified by the name "blepharosmpasm" this condition causes uncontrolled blinking and closing of the eyes, sometimes leading to a functional blindness. The cause is usually unknown, but may be due to medications or withdrawal from certain drugs. Botox treatment for this condition is effective in about 90% of all cases, and the results last for 3-4 months. The Botox Medical site has a brief review for this conditions and treatment with Botox.

Chronic Migraine Prevention: For individuals with chronic migraines that are not otherwise controlled with medications, Botox is now approved for the prevention of chronic migraines. The FDA announced this approval on October 15, 2010. This approval is not without its critics. The effectiveness of Botox for Migraines is not dramatic. Earlier studies showed virtually no benefit when compared to placebo. This lead to some medical experts believing that Botox was a "dead end" road for preventing migraines. However, studies conducted in North America and Europe, and subsequently published in the March 2010 edition of Cephalon, seemed to indicate that an effective use of Botox for chronic migraines has been found. Even after the FDA approval, however, some doctors remain skeptical. Botox is only approved for truly chronic migraines, which effect patients on 15 or more days per month.


Treatment of Frown Lines: In addition to the 6 medical conditions listed above, Botox is also available for 1 cosmetic indication: wrinkles. This product is specifically known as Botox Cosmetic. It is approved to reduce the severity of "frown lines" between the eyebrows in people 18-65 years of age. To remain effective, treatments must be repeated every 3-4 months indefinitely. The injections are administered in a doctor's office, and the process is generally done within about 10 minutes.

For more information on Botox Cosemetic, visit their website by CLICKING HERE.


The active ingredient in Botox is a powerful neurotoxin known as "Botulinum toxin." The word "Botulinum" (from which "Botox" is derived) is from the Latin "botulus" for sausage (originally known as the "sausage poison"). For a brief history of the discovery of botulinum toxin, CLICK HERE.

Botox works by interrupting the normal communication between nerves and muscles. The actual process is quite complicated. Allow me to try to simplify it. Nerves tell muscles to contract. The nerves do this by means of a messenger known as Acetylcholine (ACh). Nerves are like your biological "Drill Sergeant" who barks out orders to the muscles by means of ACh. Botox goes in and ties up the ACh messages. As long as no message moves from the nerves to the muscles, the muscles relax (like a soldier "at ease").

Botox is strong enough that a single dose can "tie up" the ACh from communicating to the muscles for about 3-4 months. After this time, the effect wears off, and the dose needs to be repeated.

As a side note, this neurotoxin is the same one responsible for what is commonly called "botulism" which can be contracted from eating canned meats that were improperly heated or sealed. Botulism is life-threatening, but rarely fatal due to advanced medical care equipment.


As you can imagine, using Botox dose involve some risk, although the dose used for cosmetic purposes is far less dangerous.

Serious and fatal reactions have occurred, although rarely, with the use of Botox. These have been due mostly to the toxin spreading away from the injection site into the systemic circulation. There have been no reported deaths associated with the cosmetic use of Botox.

Some possible side effects with Botox include:

  • dry mouth
  • discomfort or pain at the injection site
  • tiredness
  • headache
  • neck pain
  • eye problems: double vision, blurred vision, decreased eyesight and swelling of your eyelids
  • dry eyes


The manufacturer of Botox has a helpful website tool which will find a doctor to discuss Botox with in your area:


Just as an example, I typed in a zip code for New York City, and came up with 29 doctors who provide Botox Services. Here are a few of them:


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    Post Comment

    • pharmacist profile imageAUTHOR

      Jason Poquette 

      6 years ago from Whitinsville, MA


      Yes, it is called a neck left. Search for Botox Cosmetic treatment centers online. I don't know the cost.

    • profile image

      Hilda Toby 

      6 years ago

      Can Botox lift skin under chin and where can I get it done and how much it will cost me to have it done

    • nicomp profile image

      nicomp really 

      7 years ago from Ohio, USA

      Good stuff. Most people don't know that Botox has legitimate medical applications.


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