Injections of botulinum toxin have been used since 1980 in the treatment of abnormal spasms*. In recent years, it has become increasingly popular in the treatment of facial lines and wrinkles and has recently received a product license for this purpose.

Botulinum toxin is produced by Clostridium botulinum bacteria. Commercially, there are two preparations of botulinum toxin which are commonly used, Botox, manufactured by Allergan in the United States and Dysport, manufactured by Ipsen in the United Kingdom. The toxin acts on the junctions between the nerves and muscles, preventing the release of one of the chemical messengers called acetylcholine from the nerve endings, which would normally cause the muscle to contract. If the messenger is prevented from being released, this results in a weakened muscle and helps to reduce some of the abnormal muscle contractions. Injections of very small quantities of botulinum toxin to localised areas of the face cause a reduction in muscle activity responsible for the lines of facial expression. In the forehead region, the injection can mimic the effects of brow lifting surgery.

Research indicates that the most beneficial age group is from 30 to 50 years and that it is most effective in the upper third of the face. It should be remembered that botulinum toxin (Bo-Tox/ Dysport) is not 100% effective in all patients and it is not possible to guarantee the results of botulinum toxin (Bo-Tox/ Dysport) injection.

*The conditions which in some instances are amenable to treatment are: blepharospasm, writer's cramp, spasmodic torticollis, oro-mandibular dystonia, laryngeal dystonia, spasmodic dysphonia, certain tremors, tics, MS, cerebral palsy, Parkinson's disease and spinal cord injuries.