Many wrinkles are actually creases that have been worn into the skin by making the same expression thousands of times. These "expression lines", often called frown lines or crow's feet, are due to the contraction of a muscle under the skin in that area. We have known for years that surgically cutting that muscle will improve the wrinkle.
Botox® is a purified protein toxin produced by the clostridium botulinum bacteria. Although Botox® is a toxin, there have been no serious side effects. This is because, for the treatment described, it is used in extremely small amounts and does not spread throughout the body.
A few drops of Botox® are injected with a tiny needle into the muscle that creates a wrinkle. When Botox® is injected into a muscle, it blocks the nerve impulse from reaching that area, and as a result, the muscle weakens. As the muscle weakens, the skin overlying the muscle relaxes and the wrinkles in the skin gradually soften and often disappear.
When Botox® is injected there is an initial minor sting for a few seconds. Once the injection is complete, there is usually no discomfort.
The most common areas for the use of Botox® are the frown lines between the eyebrows, the horizontal forehead lines, and the crow's feet. On occasion, some other areas may be treated as well.
Botox* doesn't affect the nerve, so there is no numbness in the area of the injection. Also, the effect of the Botox® is only in the immediate area of the injection. Therefore, the muscles related to other expressions are unaffected.
The effects of Botox® usually last three to five months, at which time another injec¬tion is required. After several treatments, the effects of Botox® may begin to last longer, sometimes up to six to eight months.
Botox has been used safely and successfully in ophthalmology for over 10 years, and for wrinkle therapy for over 6 years. In the amounts used for wrinkle therapy, the only possible side effects are temporary and localized to the area of injection.
There are very few restrictions regarding Botox® treatments. Patients who are pregnant or have a neurologic disease should not be treated.
XEOMIN (incobotulinumtoxinA) is a prescription medication Injected into muscles and used to temporarily improve the appearance of moderate to severe frown lines between the eyebrows (glabellar lines) in adults. XEOMIN contains botulinum toxin type A, a protein purified from the bacterium Clostridium botulinum.
When you squint or frown, the muscles between your eyebrows contract, causing the skin to furrow and fold. Over time, as your skin ages and loses some of its elasticity, these repeated contractions can cause persistent frown lines. Botulinum toxin type A— the active ingredient in XEOMIN— acts on nerve endings in muscles to prevent muscle fibers from contracting. By reducing these contractions, XEOMIN can temporarily reduce the lines between your eye-brows.
XEOMIN was proven effective in two randomized, double-blind, multicenter, placebo-controlled clinical trials of 547 healthy, adult patients. The average age of patients in the study was 46 years. Patients received 20 Units of XEOMIN and were classified as responders if they had a 2-grade improvement on a 4-point scale as assessed by the physician and patient. Using these criteria, treatment success was higher with XEOMIN than placebo on Day 30 in both studies (60% and 48% vs. 0% for placebo in both studies). Based on these trials, XEOMIN received FDA approval for use in glabellar lines in 2011.
If you are an adult with moderate to severe glabellar lines, XEOMIN may be right for you. Talk to your doctor to discuss the benefits and risks of treatment. Do not take XEOMIN if you are allergic to botulinum toxin or any of the other ingredients in XEOMIN. You should also not take XEOMIN if you have had an allergic reaction to any other botulinum toxin product or have a skin infection at the planned injection site.
Before receiving treatment with XEOMIN, you should tell your doctor about all of your medical conditions, including whether you have a disease that affects your muscles and nerves, have allergies to any botulinum toxin product, or have experienced any side effect from any other botulinum toxin in the past. In addition, tell your doctor about your medical history and all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you have received any other botulinum toxin product in the last four months or in the past. Be sure your doctor knows exactly which product(s) you received and when you received them.
During treatment, which usually takes about 10-20 minutes, your doctor will inject XEOMIN into the muscles in your forehead that cause frown lines between your eyebrows. No anesthesia is required; however, your physician may use a topical anesthetic or cold pack to reduce any discomfort.
You may begin to see visible smoothing as early as 3-4 days after injection. The median first onset of effect was less than a week. The maximum effect occurred at 30 clays. The typical duration of effect was up to 3 months in clinical trials but may last significantly longer or shorter in individual patients.