Is Botox® Cosmetic Safe?

There have been several recent stories in the new media that call into question the safety of Botox. Botox®, or botulinum toxin type A, is a purified protein produced by the Clostridium botulinum bacterium, which reduces the activity of the muscles that cause those frown lines between the brows to form over time. Botox, produced by Allergan corporation, is marketed under the names Botox® and Botox® Cosmeti. First approved by the FDA for medical uses, such as cross eyes and facial spasm, Botox® was recently approved for use as Botox® Cosmetic to reduce the wrinkles between the eyebrows.

In February 2008, the United States Food and Drug administration put out an early communication indicating it was researching several reactions to Botox® which mimicked botulinum toxin poisoning. The reactions cited occurred with the use of Botox® for medical reasons and in doses which are much higher than those used for cosmetic purposes. In a response, the American Academy of Facial Plastic & Reconstructive surgery, reiterated that the concerns were raised for large doses and did not occur in cosmetic applications. Given that this procedure is the most common non-surgical cosmetic procedure performed according to the ASAPS survey, and the lack of serious reported consequences, it is likely that the procedure is quite safe.

What are the side effects of Botox® Cosmetic?

As with any medication, there are side effects. According to the prescribing information of the medication supplied by the manufacturer and approved by the FDA, the most common side effects with Botox® Cosmetic are

• Headache
• Respiratory infection
• Flu syndrome
• Blepharoptosis (eyelid droop)
• Nausea
• Pain in the face
• Redness at the injection site
• Paresthesia (numbness)
• Muscle weakness

As with any medication, there is always a chance of allergic reaction and the physician administering the medication should be prepared to deal with this potentially life threatening condition.

Who should be careful with Botox®?

All people should be careful with the medication. Special care should be taken in people with other neuromuscular conditions or previous reaction to the medicine. Administration should be by a licensed, experienced, and trained professional with direct physician supervision if not done by a physician personally. The medication can spread for approximately one centimeter from the area injected and cause muscle paralysis in unwanted areas. This can lead to eyelid droop with brow injection, difficulty swallowing with neck injections, and difficulty talking and drooling with lip injections.