Muscle relaxants for lines especially of the upper face has been made easier with botulinum toxin A. The use of botulinum toxin A - Dysport and Botox - to treat severe muscle spasm has been around for a few decades. By chance in the early 1990s, it was noticed that when a patient was treated for a severe muscle spasm about the eye, furrows in the forehead disappeared. Further study went on.
As time has gone by more uses were found. The dose of the toxin for expression lines is many times less than that used for major muscle problems.
The only significant problem that had been encountered in the past with this agent had been a tendency for a few patients to develop immunity to it. This does not seem to be such a problem when used in the doses required for expression lines.
How Does It Work
The active ingredient blocks the nerve endings that supply the muscles. By binding to the nerve endings, none of the active nerve conduction chemical is released to cause the muscle to contract.
Over time (usually about three months) new endings are grown by the nerve to allow it to resume its action. This means that the effect will reverse – useful if the patient is not keen on the result.
Eventually the body will break down the original blocking agent. The original nerve ending will resume working and the new nerve sproutings will be absorbed.
Over time in some people the duration of benefit seems to extend. This does not occur though with everyone. It could be that the wasting away of the unused muscle could account for the increased delay in recovery or that some people produce the new nerve endings more slowly.
Botulinum toxin A is registered for use in treating the frown lines between the eyebrows both in the Dysport version we use and the other commonly promoted Botox.
Other expression line treatments are not covered by this registration, but are widely used. It has also been registered for treating excessive sweating.
What Lines Can Be Treated
Expression lines caused by muscles that are purely for expression and not serving other useful functions, such as closing the mouth or the eye etc, are the best treated. There are a number about the upper face that are related to this, such as the frown lines between the eyebrows, the worry lines across the forehead, the smile lines lateral to the eyes and the fine lines that occur associated with this under the eyes.
The heavy crease above the chin below the lower lip can be reduced by an appropriately aimed injection.
It is also useful in reducing the down-turning of the corners of the mouth, the band lines of the fine neck muscles and in the more central lip areas to reduce fine lines – but here care must be taken to avoid patient drooling and also affecting careers such as flautists who will not be able to pout their lips to blow correctly.
The bulk of the muscles at the angle of the jaw can also be treated to lessen excessive squareness or fullness here.
Can Anything Else Be Treated
Excessive sweating in the armpits, hands and feet has been successfully treated by a series of injections in these areas. Larger amounts are required for this. Migraines have been prevented for a time in people receiving treatment for frown and worry lines.
Page Note:You will need to pay for this medicine and the doctor’s consultation. Dysport treatment lasts about four months and after this time further courses of treatment may be necessary. Discuss with your specialist if Dysport is right for you. Dysport is a Prescription Medicine containing 500 units of Clostridium botulinum Type A toxin–haemagglutinin complex for injection. It is used for the treatment of severe frown lines. It should be administered only by trained medical professionals. Talk to your specialist about the benefits/risks of this procedure in cosmetic medicine.
Cautions: Presence of infection at site of injection and glaucoma. Dysport should only be used with caution under close supervision in patients with subclinical or clinical evidence of marked defective neuromuscular transmission. Teratology and other reproductive studies have not been performed and Dysport's safety in pregnancy and lactation has not been established. Possible side effects include headaches, pain, burning or redness at injection site, local muscle weakness including drooping eye lids, lack of feeling and nausea. If you have side effects or concerns speak to your doctor.
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