Skin and Beauty

Botox - a Toxin with Great Cosmetic Result for Removing Wrinkles

Written by Dr. Suvash Sahu and medically reviewed by iCliniq medical review team.

Image: Botox - a Toxin with Great Cosmetic Result for Removing Wrinkles

Botulinum toxin is a neurotoxin derived from Clostridium botulinum. There are eight distinct antigenic serotypes of exotoxins and among these only A and B are used for various medical indications. Exotoxin A is the most commonly used and it is more potent than exotoxin B.

How does It work?

Botulinum toxin inhibits the release of neurotransmitter (Acetylcholine) at nerve terminal, so it impedes the nerve impulse and leads to paralysis of muscles.

Cosmetic Use of Botox:

  • Elimination or cosmetic correction of wrinkles and rhytides on the upper face like crow’s feet wrinkles at the side of our eyes, frown lines or angry lines on the forehead and mid and lower part of the face like the line below eyes, lines around the mouth, chin irregularities and correction of mouth corner.
  • Eyebrow lift - Due to aging if there is a descent of eyebrows, then it can be raised back.
  • Horizontal necklace lines or vertical platysmal band can be corrected.

Other Uses of Botox:

It is utilized for the treatment of muscle spasm like in torticollis, palmoplantar and axillary hyperhidrosis (excessive sweating).


  • In the case of neuromuscular disorder like myasthenia gravis, autonomic dysfunction, muscle weakness, etc.
  • History of hypersensitivity to this toxin.
  • Local infection at the injection site.
  • Pregnancy and lactation.
  • Individuals on treatment with aminoglycoside antibiotics like Amikacin, Gentamicin, Kanamicin, Neomycin or Spectinomycin, antimalarials, D-Penicillamine and Cyclosporine in the past three days as these drugs accentuate the effects of Botox.

Preparation of Botox:

Your treating doctor will mix 1 to 2.5 mL of preservative-free normal saline to reconstitute the 100 unit of neurotoxin. This prepared solution can be stored at 2 to 8 degrees Celsius for up to four weeks. Its 0.1 mL contains four units of Botox.


For forehead wrinkles and frown lines use 10 to 25 units, for crow’s feet use 9 to 15 units per side, for bunny lines 3 to 5 units per side, for chin correction use 5 to 15 units and neck bands 20 to 50 units.

The Technique of Injection:

Usually, local anesthesia is not required for cosmetic correction of the face, but in the case of palmoplantar or axillary hyperhidrosis, it is required. The toxin is injected with an insulin syringe, which causes very minimal pain. The needle should be used at 45 degrees to a depth of 2 mm to avoid the back flow of toxin

Instructions to Follow After Procedure:

  • An individual whom toxin is injected should not recline for 3 to 6 hours to prevent unwanted diffusion of the toxin.
  • Not to massage or manipulate the treated area for 4 hours to avoid bruising.
  • Not to exercise the treated muscles for first 2 to 3 hours like not to frown or raise the eyebrows or smile.
  • Wipe off any toxin immediately if present on the skin.
  • Maximum effects are seen after 7 to 10 days and last for approximately three months and in some cases much longer.

Side Effects of Botox:

Common side effects are redness, bruising and pain at the injection site. Other side effects include eyelid drooping, eyebrow drooping, ectropion (lower eyelid turn outwards), weakness of hands and deep injection in neck muscles can lead to difficulty in swallowing or bending of the neck.

To know more about botulinum toxin, consult a botulinum toxin therapy specialist online -->

Last reviewed at: 07.Sep.2018



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