Botulinum A exotoxin ( Botox® ) is derived from the bacterium Clostridium botulinum, which was discovered in 1897 and found to cause the disease of botulism. This was described when 3 members of a Belgium music club from the town of Elezelles succumbed to a paralysing illness after consuming contaminated sausages, hence the name bolulinus ( latin ) = sausage. The disease caused gradual muscle weakness spreading from head to body. In 1976, thanks to the ingenuity of Science, this potentially fatal toxin was turned to good use in treating medical conditions where there was muscular overactivity, such as squint, torticollis, facial tics and spasticity. In fact, Great Ormond Street Hospital are now using botox in large doses to treat children with cerebral palsy. By injecting the muscles involved with controlled amounts of the toxin they could be made to relax and become normal again. Today thousands of patients with these conditions are successfully treated thanks to botox.

Use of Botox® in Cosmetic Dermatology

It is only in the past 10 years that botox has been used in cosmetic and aesthetic medicine. It was discovered that patients with the condition Bell's palsy ( where one side of the face becomes weak due to temporary nerve damage ) would lose all the lines and wrinkles on the effected side. To understand how botox works, you need to understand a little of how wrinkles appear in the first place. The human face is made up of many muscles that are responsible for all of our facial expressions. The actions of these mimetic muscles become conditioned in childhood and persist throughout adult life. Repetitive use of these muscles will cause predictable creases to appear in the skin around about age 30 to 40 due to weakening of the dermis and will lead to the facial furrows and wrinkles with which we are all too familiar. These lines are known as hyperfunctional lines because they are due to muscular overactivity causing facial expressions of sadness, anger or worry which can be off-putting to those around us. When the muscles responsible relax, the lines either disappear or dramatically improve giving the face a pleasant, relaxed, bright appearance bringing about a positive effect in social interactions and an increase in self confidence. If minute amounts of botox are injected into these tiny individual muscles they can be made to relax causing either complete loss or improvement of the hyperfunctional line. Only 20 units or so of toxin are required to treat an individual set of lines. In February 1998 Madonna made the headlines of The News of The World when she was spotted leaving a well known Botox clinic in London. Five days later she was noted to be looking " brighter and refreshed ". Botox is completely safe because of the small dosages used. We would like to take the opportunity at this point to reassure you of the safety of this procedure, despite it's " dark history " ! Nearly 3,000 units ( 30 whole vials ! ) would need to be injected into an adult to cause botulism-like illness.