Botulinum toxin (botox): characteristics and uses of this substance.

A substance that acts on the body's nerve cells, relaxing the muscles.

Botulinum toxin, better known as "botox", is a substance widely used in aesthetic medicine, but also in other fields.is a substance widely used in aesthetic medicine, but also in other health fields such as ophthalmology or pediatrics.

In this article we will learn what it consists of, what its effects are and the main applications of this substance. We will also see how, in addition to producing benefits, it can also end up generating an addiction in people obsessed with their physique or afraid of aging.

Botulinum toxin: what is it and how does it work?

Botulinum toxin, commonly known as "botox", is a substance widely used in aesthetic medicine. At the chemical level, it is a neurotoxin produced by a bacterium called "botulinum toxin". Clostridium botulinum.

What this substance does is to block the release of acetylcholine (a neurotransmitter necessary to produce Muscle contraction), which results in temporary muscle paralysis. In other words, it has the function of paralyzing or decreasing the function of the muscle (or muscles) to which it is applied.

What is it used for?

Its aesthetic use was approved in 2002. It is currently it is considered a very minimally invasive cosmetic treatment, and the most requested worldwide.. Furthermore, botulinum toxin is considered a safe substance if administered correctly and by a professional.

In addition to being very present in the field of aesthetic medicine, it also helps to solve other health problems, such as infantile spasticity.

Let's see how botulinum toxin has various uses and applications. Some of them are:

1. Correcting or smoothing wrinkles 2.

Mainly, is used on the face to correct dynamic or static wrinkles (expression wrinkles). (expression wrinkles). Dynamic wrinkles are those caused by muscular activity, and static or expression wrinkles are those caused by the natural aging of the skin.

But where exactly is botulinum toxin applied on the face? It is mainly applied to the upper half of the face. Generally, the most frequent areas of application are two: crow's feet and between the eyebrows.

2. Ophthalmologic problems

Botulinum toxin is not only used for aesthetic purposes, but also for functional pathologies. In the field of ophthalmology, it is used to treat exophthalmos and blepharospasm..

2.1. Exophthalmos

An exophthalmos is the projection or protrusion of the eyeball outwards.It is known as "bulging eyes". It can involve one or both eyes, depending on the cause.

2.2. Blepharospasm

It is a spasmodic spasmodic contraction of the muscle around the eyes (orbicularis oculi muscle), involuntary and repetitive. (orbicularis oculi muscle), involuntary and repetitive. This contraction causes dystonia, which are strange or abnormal postures and movements.

3. Infantile spasticity

Botulinum toxin also can also be used to treat certain neurological diseases involving muscular hyperactivity, such as spasticity, spasticity of the spinal cord and spasticity of the spinal cord.such as infantile spasticity. This appears especially in infantile cerebral palsy, and consists of a movement disorder, associated with the nervous system, which causes some muscles to tense and contract.

Here what botulinum toxin does is to decrease hyperactivity and muscle tone, allowing longitudinal muscle growth, which helps to avoid the fixed contractures typical of spasticity.

4. Strabismus

Strabismus is the deviation of the normal visual line of sight of one of the eyes (or both), causing the visual axes not to have the same direction (this is commonly known as being "cross-eyed").

Botulinum toxin can also be applied to strabismus. How does it work? By exerting a paralyzing effect on cholinergic nerve endingswhich block the output of acetylcholine, causing the muscle to relax.

Pharmacological effect

But, specifically, how and where does botulinum toxin act? At the pharmacological level, it acts at the level of the neuromuscular junction; in this transition zone or "junction" between the muscle and the peripheral nerve, the release of acetylcholine takes place.

Botulinum toxin blocks the release of acetylcholine in the injected area, resulting in temporary muscle paralysis.

The effect it produces does not involve any physical injury to the nerve structures.It is therefore said to be a fairly safe substance.

Addiction to Botox

But botulinum toxin also has the "other side of the coin". Especially in the field of aesthetic medicine, many people become addicted to it.

People who are addicted to Botox become hooked on its effects, repeatedly resorting to cosmetic surgery to avoid aging at all costs.. That is why one must be cautious and take into account the possible harmful effects of misusing it, since, like everything else, nothing in excess is good.

Thus, although it is true that botulinum toxin itself is a safe and minimally invasive substance, addictions will always be harmful, and an addiction to botox is often linked to some other psychological disorder, such as dysmorphophobia or body dysmorphic disorder. This is a somatoform disorder characterized by excessive preoccupation with a real or imagined perceived defect in some part of the body.

Bibliographic references:

• IMO, Institute of Ocular Microsurgery. (2018). Botulinum toxin.
• Moguel-Ancheita, S. (2000). Treatment of strabismus with botulinum toxin. Mexican journal of pediatrics, 67(4): 166-171.
• Pascual-Pascual, A. Herrera-Galante, P. Póo, V., García-Aymerich, M., Aguilar-Barberà, I. Bori-Fortuny, P., García-Ruiz, R. Garreta-Figuera, G, Lanzas- Melendo, I. de Miguel-León, F., Miquel-Rodríguez, F., Vivancos-Matell, l. (2007). Therapeutic guideline for infantile spasticity with botulinum toxin. Revista Neurológica, 44 (5): 303-309.