July 2023

Print this issue

The Benefits of Botulinum Toxin

It’s Not Just for Wrinkles

Botulinum toxin injections are well-known for their use smoothing out wrinkles. They’re available under brand names such as Botox, Xeomin, Dysport, Myobloc, and Jeuveau. While wrinkle removal is the most common use, it’s not the only one.

The first use for botulinum toxin injections came out decades ago. It was for treating certain eye problems. Since then, doctors have been finding that the injections can help treat all kinds of conditions.

Botulinum toxin is a poisonous substance that’s made by certain bacteria. It’s actually one of the most potent toxins found in nature. It causes botulism, a rare but potentially lethal form of food poisoning.

It may sound odd that something so dangerous could be helpful. But the very properties that make botulinum toxin dangerous also make it useful. It works by blocking the nerve signals that tell muscles to tighten, or contract. When this happens in the muscles that control breathing, it can cause you to suffocate. But some medical conditions involve muscles contracting too much or at the wrong time. Botulinum toxin injections can treat these conditions by forcing the muscles to relax.

Botulinum toxin can also relieve certain kinds of pain. It’s been shown to relieve a recurring type of headache called chronic migraines. It can block your body’s ability to make sweat and saliva, too. So, it can treat conditions in which your body makes too much of either of these. See the Wise Choices box for more about the conditions that botulinum toxin is used to treat.

Two NIH researchers, Dr. Pamela Stratton and Dr. Barbara Karp, have been studying botulinum toxin for treating pain associated with endometriosis. Endometriosis is when tissue normally found in the uterus grows outside it. This causes pain in the pelvic area. It’s usually treated with hormones or surgery to remove the abnormal tissue. But sometimes the pain remains even after these treatments. In a small, proof-of-concept study of women with endometriosis, Stratton and Karp found that botulinum toxin injections helped improve the pain.

Botulinum toxin treatments use very small amounts of the toxin, and only at the treatment site. When used properly, the injections only affect the muscle or organ being treated.

Side effects are usually mild. They can include pain where the toxin is injected, mild headaches, or flu-like symptoms. These usually clear up on their own. “It’s remarkably safe for a deadly toxin,” Karp says.

That being said, botulinum toxin isn’t risk-free. If it’s not given properly, the toxin might spread beyond the treatment site. Then it can affect other muscles in the body that you don’t want it to. This could cause muscle weakness or vision problems, or make it harder to talk, swallow, or even breathe. Because of this risk, always get botulinum toxin treatments from a licensed health care provider who has experience using it for your condition.

People who have certain health conditions shouldn’t get botulinum toxin injections. And it’s not recommended for people who are pregnant or breastfeeding. If you’re considering botulinum toxin treatment, talk with your health care professional. They can confirm if the treatment could help you and guide you to an experienced provider. They can also tell you if there are any reasons you shouldn’t get the treatment.