Botox is a trade name for botulinum toxin type A, a substance that blocks signals between nerves and muscles. In medicine, Botox is used to treat a variety of muscular disorders, including neck dystonia, migraine, bruxism or hyperhidrosis but unfortunately also for wrinkle removal in aesthetic medicine.

We have examined what science says about it and whether it is worth using fast-food-like solutions associated with significant risks to extend our youthful appearance. 

It is worth knowing that botulinum toxin type A, also known as sausage poison, was invented by a Belgian scientist in 1897 and isolated in 1944 at the US biological weapons research center in Fort Detrick. It belongs to neurotoxins and is produced by strictly anaerobic bacteria called Clostridium botulinum and a few other representatives of the Clostridium genus. Depending on the dosage, this substance can be highly toxic to the human body, causing muscle paralysis due to the disruption of acetylcholine secretion. Let's take a closer look.

Botox, the muscle-paralyzing neurotoxin Scientific studies published in journals such as the Journal of Neuroscience have shown that injections of botulinum toxin lead to significant disruptions in the functioning of healthy muscles. Researchers have found that paralyzed muscles contract and atrophy instead of returning to their normal state after the toxin's effects wear off, as previously believed. There is a substantial body of research confirming this hypothesis.

Among the complications identified in a literature review conducted by Omprakash et al., dysphagia, botulism, and breathing problems resulting from the potential spread of the drug in the body were found. Ward et al. indicated that injections of botulinum toxin lead to a decrease in contractile function in the injected muscle, contributing to asthenia and muscle weakness, which have been confirmed by numerous clinical studies.

Authors Varghese-Kroll E, Elovic EP confirmed the thesis that one of the most common severe side effects of botulinum toxin is muscle weakness. This can affect both the injected muscles and adjacent muscles or manifest as general muscle weakness. This broad range of symptoms related to muscle weakness or paralysis, dysarthria, dysphonia, dysphagia, and ultimately respiratory arrest is known as botulism. It depends on the dosage and results from the diffusion of botulinum toxin from the injected muscles to neighboring muscles. Interestingly, botulism poisoning can occur even several years after continued injections. The toxic effects of botulinum toxin usually appear at the 10th or 11th injection after previous uncomplicated injections. Clinical symptoms of botulism occur from 0 to 36 days after injection, mainly between the 2nd and 6th day.

Allergic reactions, visual disturbances, and other side effects Another independent study published by Advances in Dermatology and Allergology in 2020 by Witmanowski H, Błochowiak K, not only identified serious side effects following the use of botulinum toxin, including dysphagia and muscle weakness but also allergic reactions. These symptoms include a wide range from swelling, localized erythema or redness at the injection site, extensive erythema, systemic urticaria, to anaphylactic shock. Authors Roy D and Sadick NS confirmed the link between the absorption of small amounts of botulinum toxin into the bloodstream and its systemic effects. In addition to the general mechanism of diffusion, another source of serious side effects is anaphylactic shock due to the chemical structure of the toxin, causing hypersensitivity. Repeated injections may increase pathological innervation, leading to exacerbation of local symptoms and ultimately muscle fibrosis.

Researchers have also confirmed the likelihood of side effects within or around the eye, such as visual disturbances, accommodation difficulties, retinal detachment, and corneal irritation. The mechanism by which botulinum toxin injections cause adverse effects within the visual system most likely results from the blockade of acetylcholine at the parasympathetic nerve endings due to systemic diffusion.

Finally, researchers Hristova AH, Joseph LN, Sathe SA, and others have shown that botulinum toxin may be capable of crossing vascular walls. Experimental studies have confirmed the existence of botulinum toxin receptors in the central nervous system and the fact that even a small amount of botulinum toxin can cross the blood-brain barrier. The diffusion of botulinum toxin into opposing muscles and the risk of accidental intravenous delivery when injecting into a muscle have also been observed.

Source: Compilation of scientific studies on botulinum toxin available in scientific literature prepared by Smart Aging Clinic.