Cosmetic Uses Of Botox

1. Cosmetic Uses Of Botox LEE POLLY 6S (14) YUM SUET YEE 6S(31)

2. Introduction • Recently, dermal fillers are become the new star of cosmetic treatment. Botox is one of the most common dermal fillers and is well-known by people to smooth the wrinkles. Botox is now widely spread in the developed countries with makers Allergan saying it expects Botox product net sales to be between US$1.15 billion and US$1.19 billion this year. When there are so many people have received a Botox injection, a concern of Botox is arisen. For our own sake, we should learn more about Botox before any Botox injection.

3. Botox is the brand name of botulinum toxin A. • It is a paralysing agent. • It produced by the gram-positive, anaerobic bacterium Clostridium botulinum(肉毒桿菌). • It helps diminishing the appearance of facial lines caused by habitual muscle contraction.

4. Botox’s History • Between 1817 and 1822: • Botulinum toxin is firstly described by using the term sausage poison or fatty poison. • 1895: • Dr. Emile Pierre Van Ermengem from Belgium identified strains A through G of botulinum toxin, four of which—A, B, E and F • 1944: • Edward Schantz cultured Clostridium botulinum and isolated the toxin.

5. 1949: • Burgen’s group discovered that botulinum toxic blocks transmission • 1950s: • Dr. Edward J. Schantz and others purified botulinum toxin type A into crystalline form • Dr. Vernon Brooks discovered that small doses of botulinum relax the muscle temporarily. • 1973: • Alan B Scott, MD, of Smith-Kettlewell Eye Research Institute used botulinum toxin type A (BTX-A) in experiments on monkeys believing it could help with crossed eyes. • 1980: • Alan B Scott officially used BTX-A for the first time in humans to treat strabismus

6. 1989: • BTX-A was officially approved by the US Food and Drug Administration (FDA) for the treatment of strabismus, blepharospasm, and hemifacial spasm in patients over 12 years old. • 2000: • Dresseler observed that the effects of botulinum toxin are fully reversible. • 2002: • The FDA announced the approval of botulinum toxin type A to temporarily improve the appearance of moderate-to-severe frown lines between the eyebrows (glabellar lines).

7. How wrinkles works? • Wrinkles forms because of the following factors: aging process, sun damage, garvity , injury, surgery, acne, smoking and muscle movement

8. Aging process • the dermis loses its elastin and collagen • have a difficulty of keeping moisture • have a decreased production of sebum • loss in the fat in the subcutaneous layer formation of wrinkles • Sunlight exposure • the aging rate increased • breaks down skin's connective tissue, collagen and elastin fibers

9. Repetitive facial muscle contraction Each time we use facial muscle, • a groove forms beneath the surface of the skin When skin ages, • it no longer able to spring back in place • groove become permanent features

10. Botox injection as a way to smooth out wrinkles • Approved cosmetic use in 2002 by FAD • Wrinkles can never be removed by Botox. Botox can only diminish the appearance of wrinkles. • Only small amounts (about one-tenth of a teaspoon) of Botox are required. • Botox has a temporary effect and its effect last about 3 months.

11. The common treatment areas are: • Vertical lines between the eyebrows and on the bridge of the • Squint lines at the corners of the eyes • Horizontal lines on the forehead • Muscle bands visible on the neck, commonly known as "turkey neck”

12. General criteria for people who can receive Botox injection • In general speaking, everyone can receive the Botox injection. However, there should be a couple of important criteria:

13. Patient should not… • Be older 65 years old • Be pregnant or plan to become pregnant during the treatment • Be allergic to botulinum toxin • have received a recent Botox injection in the same area. • have an infection, swelling, or muscle weakness in the area where the botulinum toxin will be injected

14. Mechanism of action of Botulinum toxin

15. A set of SNARE protein form a synaptic fusion complex. • The synaptic fusion complex allows the membrane of the synaptic vesicle containing acetylcholine to fuse with the neuronal cell membrane and then acetylcholine is released. • Acetylcholine diffuses across the synaptic cleft down a concentration gradient to the motor end plate • it bound by acetylcholine receptors molecules on motor end plate and changes the structure of receptor molecules on the muscle cell.

17. If a person has received a Botox injection into the muscle, the heavy chain of the botulinum toxin type A will bind to neuronal cell membrane at the the motor nerve terminal and enters the neuron by endocytosis, forming a toxin-containing vesicle . • The light chain of the toxin molecule which has been demonstrated to contain the transmission blocking domain is release to the cytoplasm of the nerve terminal.

18. The light chain of botulinum toxin type A cleaves the SNAP-25, a cytoplasmic protein, which is located on the cell membrane, preventing complete assembly of the synaptic fusion complex and thereby blocking acetylcholine release. • The effective terminal is inhibited from stimulating muscle contraction. • Due to the failure of the muscle contraction, the muscles cannot tighten; the skin flattens and appears smoother and less wrinkled. • Video: http://www.youtube.com/watch?gl=HK&hl=zh-TW&v=ufQSPrLhJFw&feature=PlayList&p=16F552D3EED07D51&index=6

19. Potential side-effects of Botox injection • As with any medication, potential side effects of Botox do exists, and vary according to injection site, dose, frequency of injections, and the amount of physician expertise.

20. Less serious side effects may include: • Swelling of your face, lips, tongue, eyelid or throat • Dry eyes, dry mouth • Fever, cough, sore throat, runny nose, nausea, flu symptoms • Muscle weakness near where the medicine was injected • Dizziness, drowsiness, anxiety • Itchy or watery eyes • Increased sensitivity to light • Temporary bruising, bleeding, pain, or tenderness where the injection was given • Headache, muscle stiffness, neck or back pain • Increased sweating in areas other than the underarms

21. Serious side effects, some of which can occur up to several weeks after an injection: • Trouble breathing, talking, or swallowing • Drooping eyelids • Unusual or severe muscle weakness (especially in a body area that was not injected with the medication) • Problems with vision or depth perception • Crusting or drainage from your eyes • Severe skin rash or itching • Chest pain or heavy feeling, pain spreading to the arm or shoulder, general ill feeling

22. Real cases and reflectionsafter Botox injection

24. The views from patient who have received Botox injection show that the effect of the Botulinum toxin might be good or bad for different people. Certainly, the skill of doctor is a key. People satisfy or not depends on what people really need. Doctor could only give us the result he or she thinks that is the best, however, beauty is pectoral. If one decided to receive the Botox injection, he or she should be ready for taking risk. Lucky to those people who fail to have a good result, the effects of botulinum toxin are temporary.

25. TOO MUCH Botox…

26. References • Website: • http://www.rxlist.com/botox-drug.htm • http://www.egeneralmedical.com/info-botox.html • http://vetscan.co.in/v4n1/therapeutic_and_cosmetic_uses_of_botulinum_toxin.htm • http://www.drugs.com/mtm/botulinum-toxin-type-a.html • http://www.aad.org/public/publications/pamphlets/cosmetic_botulinum.html • http://ezinearticles.com/?History-of-Botox-and-How-Botox-Works&id=335993 • http://www.skincare-news.com/b-3080-The_History_of_Botox.aspx • http://www.mayoclinic.com/print/wrinkles/DS00890/DSECTION=all&METHOD=print • http://www.nlm.nih.gov/medlineplus/ency/article/003252.htm • http://dermnetnz.org/site-age-specific/wrinkles.html • http://kidshealth.org/kid/grownup/getting_older/wrinkles.html • http://www.mayoclinic.com/print/wrinkles/DS00890/DSECTION=all&METHOD=print • http://www.neurotoxininstitute.org/chapter_hyperhidrosis.asp • http://www.youtube.com/watch?gl=HK&hl=zh-TW&v=ufQSPrLhJFw&feature=PlayList&p=16F552D3EED07D51&index=6 • http://www.cbc.ca/consumer/story/2009/01/13/botox.html • Book: • Advanced-level Biology for Hong Kong 3 By Y.K. Ho (P.393)