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Botulinum toxin to treat, reduce or prevent wrinkles

Facial wrinkles can be of two types: expression or static.

The wrinkles of expression are those produced by the contraction of the muscles when gesturing. We have wrinkles in front, frown lines, wrinkles around the eyes (crow’s feet) or wrinkles around the mouth (bar code).


Gravitational or static wrinkles are those produced by the aging of the skin (chronological or photo-aging). The most common are in the area of ​​the nasolabial fold (on both sides of the mouth).

The wrinkles of expression of the forehead, between the eyebrows, around the eyes and some of the neck are treated by the injection of botulinum toxin into the muscular plaque.

Static wrinkles are treated by injecting filler materials such as hyaluronic acid, among others.

Cortesy of Merz

What is botulinum toxin?

Botulinum toxin is a neurotoxin made by a bacterium called Clostridium botulinum.

The ability of the botulinum toxin to produce muscle paralysis by chemical denervation is used as a medicine in the treatment of certain neurological diseases and as a cosmetic product for the aesthetic treatment of facial wrinkles.

How does botulinum toxin work in the treatment to remove, mitigate or prevent facial wrinkles?

The pharmacological effect of botulinum toxin takes place at the level of the neuromuscular junction. In this region of transition between the peripheral nerve and the muscle occurs the release of acetylcholine, a neurotransmitter necessary to produce muscle contraction. Botulinum toxin acts locally by blocking the release of acetylcholine, which translates into temporary muscle paralysis.

Cosmetic applications of botulinum toxin in the treatment for wrinkles

The history of botulinum toxin in the field of aesthetics begins accidentally in 1987 at the hands of Dr. Jean Carruthers, treating a patient affected by blepharospasm.

A diluted form of botulinum toxin type A, is considered today that is one of the treatments that offers better results to eliminate wrinkles.

This form of botulinum toxin, after its infiltration with an extra fine needle into the muscle under the skin of the area to be treated, acts by inhibiting muscle movement by relaxation. With this effect it is intended that wrinkles disappear and therefore provide a more youthful appearance on the skin.

Frequently asked questions about botulinum toxin

Which wrinkles can be treated with botulinum toxin?

Botulinum toxin is applied directly to the wrinkles to be treated, such as fine lines around the eyes, forehead and between the eyebrows.

Its effect relaxes the movement of the muscles, minimizing wrinkles if they are marked, eliminating them if they are soft and even wrinkles can be prevented

Can wrinkles be avoided?

The effect of botulinum toxin relaxes the movement of the muscles. If the toxin is injected in very early stages of the wrinkle, its appearance can be avoided.

Results of botulinum toxin in the treatment for wrinkles

The results of the botulinum toxin injection can begin to be seen after 24 or 48 hours of its application and last approximately 3 to 6 months.

The results depend on the severity of the lines and the reaction of the body to the product. It is observed that the muscle moves less or does not move and therefore the wrinkles are attenuated or eliminated according to their severity.

Patients can continue their normal life after receiving the injections.

Is the injection of botulinum toxin painful for the treatment of wrinkles?

The injection of botulinum toxin to eliminate, attenuate or prevent wrinkles is a painless treatment.

It also has the advantages of not needing a recovery time or care and unlike other skin rejuvenation treatments, there are no problems in exposing the skin to the sun.

How long do the results of botulinum toxin last in the treatment for wrinkles?

The results of botulinum toxin to eliminate, attenuate or prevent wrinkles have a temporary duration, between three to six months, after which time the dose should be renewed if you want to maintain the result.

Side effects of botulinum toxin injection in the treatment for wrinkles

In general, the side effects of the injection of botulinum toxin for the treatment of wrinkles are mild and transient and do not limit the performance of successive infiltrations.

The side effects of the injection of botulinum toxin for the treatment of wrinkles can be:

  • Hematoma that occurs in more than 10% of patients.
  • Little duration of the effect, less than two months. This undesirable effect occurs in less than 10% of patients.
  • Drop of eyebrows or eyelids.
  • Asymmetry on both sides of the face.
  • Headaches or neck pain. This side effect is very rare.
  • Inflammation of the eyelids or soft tissues in the area of ​​the application of botulinum toxin.

Precautions in the use of botulinum toxin in the treatment for wrinkles

Based on the recommendations of the Pharmacovigilance working group (PhVWP), the European Medicines Agency (EMEA), in coordination with other European Regulatory Agencies, recommends the following:

  • Drugs based on botulinum toxin should be administered by doctors with sufficient experience, including the use of necessary equipment.
  • The recommended administration techniques and the specific dosage instructions of each medication and indication should be followed (including the recommendation to use the minimum effective dose and to adjust it taking into account the individual needs).
  • The patient must be timely and clearly informed about the type and brand of the medicine or presentation of the toxin that is going to be applied since not all toxins are approved for use in Spain.
  • Patients should be informed of possible side effects that are usually mild and transient.
  • Do not use it if you are pregnant or think you might be pregnant.
  • Do not use it during breastfeeding.
  • Tell your doctor if you have nerve or muscle diseases.
  • Tell the doctor if you are taking antibiotics, muscle relaxants, anticholinergics, aspirin, anticoagulants or any other medication.