What is the role of injection of botulinum toxin?
Rhytidectomy, face-lifting, thin the legs, removal of axillary odour. In fact, as a medicine, botulinum toxin is also used to treat dozens of diseases such as eyelids, hemifacial spasm, spastic strabismus, children with cerebral palsy, chronic migraine, trigeminal neuralgia, interstitial cystitis, keloids, etc.
I. Botox, a beautiful accident
“I believe in botulinum toxins more than love, because it works every time.” This is a classic line of the 50-year-old female master of the American drama “Sex and the City”, revealing the secrets of many Hollywood superstars and also revealing the beauty of botulinum toxins. Effect: seductive! short!
The deadly botulinum botulinum can produce seven types of neurotoxins, A, B, C, D, E, F, and G. Among them, type A botulinum toxin is easy to refine and preserve, and has the strongest block on neuromuscular, and is classified as a class A bioterrorism agent by the United States.
In 1979, botulinum toxin type A was approved by the United States for the treatment of strabismus, spastic torticollis and other diseases caused by dystonia. In 1986, because of the accidental discovery of the wrinkle-removing effect of botulinum toxin in the treatment of eyelids, it was rapidly and widely used in the field of beauty.
Of course, type A botulinum toxin used in medical and cosmetic applications has been diluted 400,000 times more than chemical weapons.
II. The cosmetic effect of botulinum toxin, attractive and short-lived
In the field of cosmetic surgery, in 2002, botulinum toxin type A for injection was approved by the US FDA for the treatment of moderate to severe eyebrow wrinkles; in 2004, it was approved for the treatment of axillary hyperhidrosis; in 2013 it was approved for the treatment of crow’s feet.
Mechanism of action: Type A botulinum toxin binds to specific receptors of motor nerve terminals, blocking the release of acetylcholine from the presynaptic membrane of nerve endings, thereby blocking the conduction between nerves and muscles, causing muscles to lose contractility and lead to muscle paralysis. relaxation.
Muscle relaxation occurs usually within 1-3 days after injection of botulinum toxin type A, peaking after 5-6 weeks, and neurological function can be restored within 12 weeks. Therefore, wrinkle removal can generally last for 3 to 4 months, and individual patients can last for 6 months.
Keep in mind that the treatment interval for botulinum toxin type A should not be less than 3 months!
III. “Every time it is effective,” is it true?
“I believe in botulinum toxins more than love, because it works every time.” This sentence is often used by some beauty agencies to promote type A botulinum toxins, but it is not necessarily “effective every time”!
Repeated injection of botulinum toxin type A produces antibodies. The formation of antibodies reduces the biological activity of botulinum toxin, thereby affecting the efficacy, such as wrinkle removal.
Clinical studies have found that high doses are more likely to produce antibodies than low doses, and the more frequently they are used, the more likely they are to produce antibodies. Thus, the antibodies produced can be minimized by injecting the lowest effective dose and maintaining the longest suitable injection interval.
In addition, improper use, or repeated long-term use may cause permanent muscle spasm or muscle necrosis.
IV. Pay attention to adverse reactions
The botulinum toxin type A for injection is a poison. It must be kept, distributed, registered, and used according to the prescribed indications and prescribed doses. It must be used by physicians with relevant professional knowledge and skills.
Injection of botulinum toxin can cause injury at the injection site and local muscle weakness; muscle weakness away from the injection site may occur due to the spread of botulinum toxin injection; if the injection is too deep or the position is wrong, it may cause difficulty in swallowing, paralysis of the breath, or even death. .
Most of the above adverse reactions occurred a few days after the injection.
Medication: If you have general weakness, drooping eyelids, diplopia, difficulty swallowing, speech disorder, difficulty breathing, etc., seek medical attention immediately.
Special reminder: In theory, antibacterial drugs such as aminoglycosides (such as gentamicin, amikacin), spectinomycin, lincomycin, clindamycin, tetracycline can enhance the neuromuscular of type A botulinum toxin. Blocking effect.
V. Wide range of uses
The clinical application of botulinum toxin type A is very extensive, involving dozens of diseases, many of which are super-instructive. An example is as follows:
1. Face-lifting, thin the leg
Type A botulinum toxin is injected into the masseter muscle and calf gastrocnemius muscle. The principle of disuse atrophy can reduce the temporary volume of the previously relatively developed muscles, thereby achieving the functions of face-lifting and stovepipe.
2. Hyperhidrosis, removal of axillary odour
The sweat glands are innervated by cholinergic nerves. When the botulinum toxin type A is injected into the sweat glands, it can selectively act on the peripheral cholinergic nerve endings, blocking the release of the presynaptic neurotransmitter acetylcholine, thereby reducing the secretion of sweat glands.
3. Trigeminal neuralgia and postherpetic neuralgia
Primary trigeminal neuralgia is a recurrent episode of severe paroxysmal pain in the facial trigeminal nerve distribution area. Post-neural neuralgia is the most common complication of herpes zoster. Botulinum toxin type A is a neurotoxin that blocks the conduction between nerves and muscles and relieves various refractory pains.
Animal experiments and clinical studies have found that type A botulinum toxin can prevent scar hyperplasia of the wound, improve the symptoms of intractable itching, and soften the scar to a certain extent. It may be related to the inhibition of tension around the wound by type A botulinum toxin, inhibition of fibroblast proliferation, and reduction of collagen fiber deposition.
5. Interstitial cystitis, overactive bladder
Botulinum toxin type A inhibits the release of substance P by blocking the release of neurokinin and growth factor receptors, and relieves the painful symptoms of interstitial cystitis. It also increases bladder capacity and improves urinary frequency symptoms. In addition, botulinum toxin type A is also used to treat detrusor hyperreflexia with urge incontinence, overactive bladder, and the like.
6. Spastic cerebral palsy
Spastic cerebral palsy is the most common type of cerebral palsy, accounting for 60% to 70%. The child’s performance is muscle spasm, increased muscle tone, etc., resulting in severe damage to children’s activities. Clinical observations have found that local injection of sputum muscles in patients with cerebral palsy can reduce muscle tone and improve motor function.
Others: hand dystonia (effective), laryngeal dystonia (dysfunctional snoring, trial), anal fissure (anal sphincter spasm, may be effective), multiple tears (may be effective), salivation (cerebral palsy, Parkinson’s disease) Related rogues, may be valid) and so on.