Botulinum Toxin (BOTOX) treatment – Side ffects and Recovery

A bacterium known as Clostridium botulinum produces a botulinum toxin used in BOTOX. These toxins affect nerves and also cause muscle weakening. Botox injections use a toxin called OnobotulinumtoxinA to temporarily prevent a muscle from moving. Botox was originally FDA-approved in 1989 for the treatment of blepharospasm and other eye muscle problems. Botulinum toxins are naturally found in soil and also in contaminated foods. The consumption of large amounts of toxins or bacteria, the person can develop botulism. For safety, botox is produced in a lab by diluting and sterilizing the toxin so it would not cause botulism. Clinicians use Botulinum toxin by diluting the powder in saline and injecting it directly into neuromuscular tissue. Botox injections are used for cosmetics or medical reasons. These injections basically improve appearance by relaxing muscles that cause wrinkles.

The injections can also treat medical conditions, including migraines, hyperhidrosis, overactive bladder, and eye problems. Vials of Botox contain three main ingredients: botulinum toxin type A, human albumin, and sodium chloride. The active ingredient, which has the greatest effect, is botulinum toxin A. Healthcare providers inject small amounts of Botox into specific muscles. But to maintain effective results, treatments should be repeated every three to six months.

These injections work by blocking nerve signals to muscles. Due to this, the injected muscle cannot contract. These substances target the nervous system, disrupting the nerve signaling processes that stimulate muscle contraction. This is how the drug causes temporary muscle paralysis. In order for any muscle to contract, the nerve releases a chemical messenger called acetylcholine at the junction where the nerve endings meet muscle cells. Acetylcholine attaches to receptors on the muscle cells and causes the cells to contract, or shorten. So Botox injections prevent the release of acetylcholine, which stops the muscle cells from contracting. In this way, the toxin helps the muscles to become less stiff. These effects are always temporary but sometimes last for several months.  The effects last about three to twelve months, depending on what you are treating.

Why BOTOX treatment is done ?:

The most common use of the injections is to temporarily relax the facial muscles that cause wrinkles in the forehead and around the eyes known as botox for eyes. Botox injections are also used to treat conditions that affect how the body functions. The examples include:

  • Cervical dystonia: In this condition, the person’s neck muscles contract involuntarily causing the head to twist or turn into an uncomfortable position. So botox for the neck is done.
  • Lazy eye: The most common cause of this is an imbalance in the muscles responsible for positioning the eye.
  • Muscle contractures: Some neurological conditions, such as cerebral palsy, can cause limbs to pull in toward your center. In some cases, these contracted muscles can be relaxed with Botox injections.
  • Hyperhidrosis: In this condition, excessive sweating occurs even when the temperature isn’t hot and you’re not exerting yourself.
  • Chronic migraine: If the person is experiencing migraines more than 15 days a month, Botox injections can help reduce headache frequency.
  • Bladder dysfunction: Botox injections can also help reduce urinary incontinence caused by an overactive bladder.
  • Eye twitching: Botox injections can also help in relieving contracture or twitching of muscles around the eye.

Cosmetic Injection:

Botox injections are the most popular cosmetic procedure nationwide. In 2016, about 7 million people had Botox treatments. The cosmetics injections of botox are used to treat signs of aging. This treatment can smooth fine lines on the face across the lips or around the eyes and wrinkles in several areas of your face with the help of botox needles. People often request the injections in the following areas of the face

  • wrinkles between the eyebrows usually called frown lines, glabellar lines, or elevens
  • crow’s feet: wrinkles around the eyes
  • Forehead: horizontal creases in the forehead
  • lines at the corners of the mouth
  • “cobblestone” skin on the chin
  •  Jawline

The procedure is a minimally invasive procedure. It does not involve incisions or general anesthesia. If the person is concerned about pain or discomfort, a topical anesthetic or ice can numb the treatment area. During this procedure, the provider will use a thin needle to administer 3-5 injections of botulinum toxin type A. They will inject the targeted area between the eyebrows in case of treating crow’s feet. The person will usually need three injections on the side of each eye to effectively smooth out crow’s feet. The whole procedure takes approximately 10 minutes.

Medical injection:

Botox has been used for decades in medical fields. These are used to treat medical conditions such as:

  • Dystonia (excessive muscle contractions)
  • Eyelids twitching
  • Strabismus (crossed eyes) in those older than 12 years
  • upper limb spasticity, in anyone older than 2 years
  •  if the anticholinergic medications do not help then reduce symptoms of an overactive bladder due to a neurological condition

What are the Botox side effects?

The side effect varies as it depends on the receiving area. Depending on the reason for the injections and the person’s response, Botulinum toxin can cause some unwanted effects. Most of the issues are mild and can improve in a day or two. Possible side effects are:

  • Flue-like symptoms
  • Headache
  • Swelling, and redness at the site of injection
  • Fatigue
  • Indigestion
  • Ptosis ( drooping eyelids)
  • Numbness
  • temporary unwanted weakness or paralysis in nearby muscles
  • urinary problems after treatment for urinary incontinence
  • a worsening of neuromuscular disorders
  • spatial disorientation or double vision after treatment for strabismus
  • corneal ulceration after treatment for blepharitis
  • cardiovascular events, such as arrhythmia and myocardial infarction

People should not use Botox if they have:

  • a sensitivity or allergy to it
  • an infection at the injection site

Some people cannot get this treatment as they are at high risk of getting side effects. These include pregnant women or those who have a neuromuscular disease, weak facial muscle, etc. Depending on the type of treatment, there are concerns that the effects of Botox may extend beyond the injection site, possibly leading to symptoms such as difficulty breathing.
This is more likely to occur in some individuals than others, and genetic factors may play a role. Also, some people who are receiving injections of Botulinum toxin type A may develop antibodies to the toxin that make subsequent treatments ineffective.

 After treatment, do avoid rubbing, massaging, or applying any pressure to the treated area. These actions can cause Botox Cosmetic to spread to other areas of the body. This can negatively affect your results. When being injected between the eyebrows, do not lie down or bend over for three to four hours. Doing so may cause the Botox to slip under the orbital rim. This could possibly cause an eyelid droop.


Most people notice their desired effects usually around the third or fourth day. But the clear results of this treatment will be visible within 10-14 days. The treatment lasts for 6 months and after the desired time period, toxins wear off and the muscles regain movement. Due to this, wrinkles return and medical issues like migraine resume. To maintain effective results a person should be in contact with their healthcare providers to receive further treatments.


The cost of Botox depends on various factors, including:

  • whether it is for medical or cosmetic purposes
  •  depends on who provides the treatment
  • where the treatment takes place
  • the number of Botox units involved


Botox has cosmetic and medical uses. If someone wants to try Botox treatment, it is a good idea to speak to a healthcare provider about the risks, costs, and other considerations.

Hadia Amjad
Hadia Amjad

Hadiya Amjad is currently pursuing her master's degree in microbiology at the University of Veterinary and Animal Sciences in Lahore.
She is actively researching how the lumpy skin disease virus adapts on various host systems and their comparative evaluation because she has a strong interest in virology. She has experience in cell culturing techniques in the Influenza Lab at UVAS Lahore. She has experience working in a biosafety level 3 lab at the Institute of Microbiology, UVAS Lahore, and she has laboratory management capabilities. She not only excels in her studies but also in scientific writing and debates. She earned her undergraduate degree from UVAS Lahore and also worked at Chugtai Lab, and is familiar with the ISO 17025 standard that is applied there to manage samples and conduct microbiological testing.

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