Botox: Nonsurgical Wrinkle Remover of the Future?
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Botox: Nonsurgical Wrinkle Remover of the Future?

SAN FRANCISCO, March 21, 1997 -- The past two decades have witnessed an increase of new options for reversing the effects of aging skin. Dermatologists and dermatologic surgeons have been instrumental in developing and refining techniques that have become widely accepted by an eager population.

Speaking at the American Academy of Dermatology's 55th Annual Meeting, Nicholas J. Lowe, M.D., Clinical Professor of Dermatology at UCLA, Santa Monica, California, spoke today about the use of botulinum toxic type A (Botox) in the treatment of hyperkinetic facial lines.

Botox, is a purified form of one of the most potent toxins known to man. In high doses it can cause the clinical disease botulism. However, in carefully administered low doses, it is very useful for treating hyperkinetic facial lines.

The structure and function of botulinum toxin was originally determined at Fort Derrick, Maryland from work which began during World War II in an attempt to understand and develop antitoxins to potential agents of biological warfare.

"Structurally, the toxin is composed of a heavy chain and a light chain, joined together by two disulfide bonds. The active neurotoxin is
formed by 'nicking' of one of these disulfide bonds," Dr. Lowe explained. “Of clinical relevance is that botulinum toxin type A has been shown not to cross the blood-brain barrier and has no systemic risk at the amounts used.”

Local injections of botox have been used successfully to treat strabismus, blepharospasm and other hyperkinetic movement disorders. The active toxins work by causing a reversible muscle paralysis by blocking acetylcholine release at the neuromuscular function.

The "ideal" patients for this treatment have upper facial expression lines, like forehead lines, frown lines and crows feet which are caused by the use of small muscles in the face.Botox was injected using an electromyography (PMG) instrument connected to the delivery needle.

"The injections are in an upward and lateral direction from the middle inter-eyebrow area. These instruments are a very effective means of assuring the botox is delivered accurately into the body of the muscles," explained Dr. Lowe.

Patients injected with the drug had significant improvement in facial lines. Some patients improved for up to one year after treatments. Side effects are rare, and can be minimalized by the upward and lateral technique. Additionally, botox decreases the patient's ability to frown or squint, which prevents the progressive worsening of these lines over time. Therefore, the method can be considered both corrective and preventive.

"Botulinum toxin type A appears to be safe and effective for the treatment of glabellar frown lines. Botox may be combined with collagen and skin rejuvenation lasers. Studies are currently underway for treating other hyperkinetic facial lines," Dr. Lowe said.

The American Academy of Dermatology is the largest medical society representing physicians who specialize in treating hair, skin and nail conditions.

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