How does Botox (botulinum toxin) work?
There are eight different types of botulinum toxin produced by C. botulinum; A, B, C1, C2, D, E, F, and G. All work by blocking the release of acetylcholine, one of the most significant neurotransmitters in our body. Acetylcholine activates muscles, so blocking it causes muscle relaxation and paralysis. Injections enable the botulinum toxin to be targeted directly into specific muscles. There it has a direct effect on acetylcholine in the nerve synapses, preventing signals that would normally cause the muscle to contract.
Type A is the most potent and longest lasting, followed by types B and F. Currently, preparations containing Type A and B are commercially available and include:
- OnabotulinumtoxinA (Botox, Botox Cosmetic)
- AbobotulinumtoxinA (Dysport)
- IncobotulinumtoxinA (Xeomin)
- LetibotulinumtoxinA-wlbg (Letybo)
- PrabotulinumtoxinA-xvfs (Jeuveau)
- RimabotulinumtoxinB (Myobloc).
All have different potencies and are not interchangeable; care needs to be taken so that the correct dosage stated is used for that product. Each manufacturer uses assay methods specific to their company, so even though dosages may be quoted in similar sounding units, potency varies several-fold between the different products. Approved indications also vary.
Effects are usually seen within 24-72 hours and peak around ten days. Effects last about two to four months or until new nerve terminals sprout and form new synaptic contacts.
Read next
Where do they inject Botox for migraines?
Botox is injected into 7 specific muscle areas around your head and neck to help prevent migraine headaches before they start. Areas include your forehead, bridge of the nose, temples, neck, back of the head, and just above the shoulder blades in your upper back. Continue reading
Does Botox for migraines also help with wrinkles?
Botox Cosmetic is used for aesthetic purposes for wrinkles and Botox is used as a therapeutic treatment for different medical conditions, including migraine headache prevention. Botox Cosmetic and Botox come as separate products but are both prescription medicines that contain the active ingredient onabotulinumtoxinA. Continue reading
What is Daxxify, the recent FDA-alternative to Botox?
Daxxify (daxibotulinumtoxinA-lanm) is the first Botox alternative that is free of human albumin or animal-based components, and it was FDA-approved in September 2022. It is also the longest-lasting of all the cosmetic injectable wrinkle treatments, lasting for 6 months in most people and 9 months in some. Continue reading
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Drug information
- Botox Information for Consumers
- Botox prescribing info & package insert (for Health Professionals)
- Side Effects of Botox (detailed)
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