Botulinum Toxin Injection
A botulinum toxin injection is the injection of a preparation containing type A botulinum toxin, a component produced by the bacterium Clostridium botulinum, and it is used to treat various conditions. In treating expression lines, botulinum toxin is injected into the muscles that create the wrinkles to suppress their contraction. In treating localized hyperhidrosis, on the other hand, intradermal injection into the armpits or forehead suppresses the working of the sweat glands. Botulinum toxin is also used to treat keloids and hypertrophic scars, showing an effect on redness, itching, and pain. Furthermore, it is sometimes used for rosacea, addressing the excessive reactivity of the blood vessels and sebum secretion in the hope of improving redness.
About the Botulinum Toxin Preparations We Use
BOTOX® was originally the product name of the U.S. company Allergan, but the name has spread and is used almost like a generic term. Our clinic uses Allergan’s BOTOX VISTA® and Medytox’s CORETOX®.
BOTOX VISTA® (made by Allergan)
BOTOX VISTA® is a botulinum toxin preparation approved by the Ministry of Health, Labour and Welfare in Japan. It is widely used around the world and has an extensive track record of safety and efficacy.
CORETOX® (made by Medytox)
CORETOX® is a botulinum toxin preparation made by the Korean company Medytox. It is a high-purity preparation that does not contain complexing proteins, and there is a possibility that antibodies are less likely to form with repeated use.
*CORETOX® is a drug not approved in Japan. Under the doctor’s judgment, we import it through a domestic pharmaceutical wholesaler.
Purposes of Botulinum Toxin Injection
Expression lines
Botulinum toxin inhibits the release of a substance called acetylcholine from the motor nerves, blocking nerve transmission to the muscle fibers. When botulinum toxin is injected, the movement of the facial muscles that move the face is suppressed, so the muscles relax and the formation of wrinkles can be prevented.
The effect usually begins to appear two to three days after the procedure, reaches its maximum in two to four weeks, lasts about four to six months, and then gradually fades.
Note that fine wrinkles unrelated to expression, the so-called crepe-like wrinkles, are caused by photoaging from ultraviolet light, so botulinum toxin has little treatment effect on them.
Learn more about expression lines
Jaw widening and clenching
Injecting botulinum toxin into the masseter muscle relaxes the muscle’s tension. In addition to an expected effect of making the face line look slimmer, it is also effective in reducing jaw fatigue and discomfort from teeth grinding and clenching.
Hypertrophic scars and keloids
Botulinum toxin can show an effect on hypertrophic scars and keloids, which are excessive raising of a scar. The proposed mechanisms by which it acts on keloids are an action that suppresses fibrosis and a reduction in tension on the wound due to decreased muscle tone.
Learn more about hypertrophic scars and keloids
Hyperhidrosis (primary axillary hyperhidrosis, forehead sweating)
By suppressing the release of acetylcholine, a neurotransmitter secreted from the ends of the sympathetic nerves, botulinum toxin blocks the signal that stimulates the sweat glands and suppresses sweat secretion. For the armpits, the effect lasts four to nine months, so those who are only bothered in summer can sometimes get by with one injection a year. GlaxoSmithKline’s botulinum toxin is covered by insurance only for severe primary axillary hyperhidrosis.
For forehead sweating, micro-injection therapy injects very small amounts into the very superficial layers of the skin. The effect lasts about three to six months.
Learn more about hyperhidrosis
Micro-injection Therapy
A treatment in which botulinum toxin is injected in small amounts into the superficial layers of the skin. Whereas an ordinary botulinum toxin injection acts on the muscles, Microbotox acts on the sweat glands, sebaceous glands, and the nerves near the skin surface.
Expected effects
- Improvement of enlarged pores and oily shine from sebum
- Relief of facial hyperhidrosis symptoms
- Redness and flushing associated with facial redness and rosacea
- Improvement of fine wrinkles
Efficacy
It usually appears in two to fourteen days and lasts about three to six months.
Side effects
Pain at the time of injection, bruising, redness, swelling, asymmetry, insufficient effect, heaviness of the forehead, difficulty raising the eyebrows, an unnatural facial expression, muscle weakness if it affects a muscle near the injection site, becoming bothered by sweat from other areas because sweating at the injection site is suppressed, and allergy (extremely rare).
Learn more about facial redness (rosacea)
Those Who Cannot Receive Botulinum Toxin Treatment
- Those who are pregnant or possibly pregnant
- Those who are breastfeeding
- Those who have had an allergic reaction to a botulinum toxin preparation
- Those with a neuromuscular junction disorder such as myasthenia gravis
Note Regarding Unapproved Medications
CORETOX® is an unapproved drug that has not received approval under Japan’s Pharmaceuticals and Medical Devices Act. Under the doctor’s responsibility, we import it through a domestic pharmaceutical wholesaler. Note that approved drugs such as BOTOX VISTA® are available in Japan.