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Writer's pictureRachel Cootes

What does Botulinum toxin actually do?


images of different botulinum toxin brands







So when I first told people I was going to give up my ‘traditional’ nursing job to pursue a career in aesthetics there were two common comments:


‘You’re going to inject jellyfish poison into peoples faces’ and ‘Doesn’t botox come from mouldy sausages’….


I suspect most clients don’t really know what Botulinum Toxin (BTX) is/does, they just know what the results are and that they like these results. It may surprise you to know that the chemical effect of BTX is barely discussed on training courses, the emphasis is on learning a technique in a short space of time. Its up to the injector to learn the rest in their own time, and I bet your bottom dollar there are a still some practitioners who really don’t know what this prescription medication is doing to the body as we inject it….


Botulinum comes from the latin word for sausage ‘botulus’, due to its discovery in the 18th century -after a rise of deaths from (rancid) sausage consumption in Germany- so the sausage link isn’t totally inaccurate!


Modern BTX saw its first medical use in 1970’s when it was used to treat eye ‘squints’. It was a total surprise to all the physicians involved to see that this radical treatment also reduced the fine lines around their patients eye area. Nowadays BTX is used every day in clinical practice for all sorts of treatments- migraine relief, overactive bladder, muscle spasticity, I’ve recently heard of a patient who had it for oesophageal spasm - totally transformed her life meaning she could swallow more safely.


It really is incredibly clever stuff- clients are always surprised when I tell them of its medical use though as botox is often considered a ‘dirty’ and taboo word.


So what actually happens when you come for cosmetic toxin injections?

We use a very small needle to inject a very low and diluted dose of Botulinum Toxin A into a muscle that has associated unwanted lines/wrinkles. The toxin affects the journey of ‘acetylcholine’ - a neurotransmitter responsible for the induction of muscles movement. If this process is interrupted (by the use of toxin) then the muscle will not contract as it usually would. As a result the lines/wrinkles associated with this muscle group will soften and reduce. Overtime this biological ‘journey’ is restored and neurotransmitters will start to move the muscle again- this is when you will start to see movement returning. The effects are temporary - usually lasting around 12-16 weeks.


Fun things to know about Botulinum Toxin


  • It is one of the most poisonous substances in the world- in large quantities and during the Second World War, attempts were made to weaponise the drug

  • It is a prescription drug, just like an antibiotic- everyone considering the treatment should be assessed for suitable by a medical prescriber

  • ‘Botox’ is actually a brand name just like ‘Panadol’ is for paracetamol and so you will often here clinicians refer to the treatment as ‘anti-wrinkle’ or ‘wrinkle relaxers’ to avoid using a brand name. There are a number of available brands in UK- all with their pros and cons

  • Due to being a prescription drug, it is illegal to advertise Botulinum Toxin as a treatment option. Practitioners should not be advertising offers/reductions/ give aways of Toxin injections.

  • Toxin injections have traditionally been mostly used in the upper third of the face, however lower face toxin treatments are becoming increasingly popular and offer amazing transformations.


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