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Wrinkles are a natural part of the skin aging process; however, all do not welcome their appearance. Botulinum Toxin-Type A (BOTOX®) is a substance that can help minimize the appearance or formation of wrinkles. When injected, BOTOX works to temporarily partially or completely relax the muscle movements underneath the skin which helps soften wrinkles. The risks associated with BOTOX injections are minor, and treatments usually last from three to six months.
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Your skin is composed of three layers, the epidermis, dermis, and subcutaneous tissue. The epidermis is the outermost layer of your skin. It protects your inner layers of skin from the environment. The epidermis is made up of protein containing cells called keratinocytes. The keratinocytes form at the bottom layer of the epidermis and move upward to the outer layer. They eventually wear off and are replaced by the next layer of cells.
The dermis is your second layer of skin. It is made up of connective tissue and provides structure. It is composed of collagen and various elements that give your skin strength and elasticity. The dermis contains hair cells, sweat glands, and sebaceous glands that secrete oils to hydrate the skin. The dermal-epidermal junction contains rete ridges. The rete ridges are projections that increase the surface area of the epidermis, allowing more nutrients to reach it through the blood vessels.
Subcutaneous tissue composes your inner most layer of skin. Subcutaneous tissue contains fat cells. The fat cells insulate your body and make your skin appear plump or full. Below the subcutaneous tissue are fat tissues, your muscles, and your bones.
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Wrinkles appear primarily because of age-related skin changes. The loss of elasticity is accelerated by environmental factors such as sun exposure and smoking. Facial muscle movements, such as scowling or laughing, cause the skin to develop creases. The aging process causes skin to become less elastic, dryer, and thinner. Finally, gravity takes its toll causing skin to sag and loosen. The changes that take place in each skin layer are described below.
As skin ages, it becomes more difficult for it to repair itself. Epidermal cells are created more slowly, and the number of new cells decreases. The outer skin layer loses its ability to hold moisture and becomes dryer.
Aging causes significant changes in the dermal and subcutaneous skin layers. The dermal layer loses collagen and becomes thinner. Its structural and elastic supports break down. The number of sweat glands decreases and the sebaceous glands enlarge producing less oil and contributing to dry skin. The rete ridges in the dermal-epidermal junction become flatter. This leads to a reduction in blood flow that is necessary for the skin to remain healthy and repair itself. The fat cells in the subcutaneous tissue get smaller with age causing volume loss making it more difficult for them to pad damaged skin areas. Volume loss combined with gravity and loss of elasticity results in excessive skin.
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Wrinkles first appear as fine lines on the skin. Over time, they develop into continually deeper creases. On the face, wrinkles tend to develop on the forehead, between the eyebrows, around the mouth, and at the outside corner of the eyes.
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Your doctor will examine your skin and discuss your concerns with you. It is important to tell your doctor which areas of your skin are most bothersome to you and the desired effect that you wish to achieve. Your doctor will ask you to make over-exaggerated facial expressions to see the extent of your facial lines. Your doctor will also take before and after photographs to monitor your results.
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You can receive BOTOX injections in your doctor’s office. Your doctor will inject BOTOX into several areas of your face. The BOTOX will considerably limit, but not paralyze the affected facial muscles. You should avoid lying down for several hours after the procedure.
You should be able to see results in 2 to 7 days with results of muscle relaxation maximized at 2 weeks. Some people may need a few series of BOTOX treatments to achieve their desired effect. With long-term muscle relaxation, the decrease in repetitive motion of the skin, wrinkles start to soften and even possibly disappear. BOTOX treatments usually last from 3 to 6 months, after which time the facial muscles resume normal functioning which may result in reformation of wrinkles.
BOTOX will make your facial lines appear less deep; however, it will not erase them. Some people elect to receive additional procedures that complement BOTOX. Such treatments use injections of filler substances to pad or plump up the relaxed wrinkles, making them appear even less apparent.
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Wrinkles are a natural part of the skin aging process. However, you can help prevent the acceleration of wrinkles by avoiding sun exposure and not smoking. A good moisturizer and/or exfoliator may help minimize the appearance of fine lines and give your skin a youthful glow.
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Wrinkles become more pronounced with age. As you age, you are more likely to develop wrinkles because of the natural changes that take place in the skin. Sun exposure and smoking can accelerate the wrinkle process.
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The risks associated with BOTOX injections are minor. You may experience headache, pain, or flu-like symptoms. BOTOX injections can cause a drooping eyelid in a small percentage of people, which should be reported to your doctor. Additionally, difficulty breathing or rashes should also be reported to your doctor.
BOTOX is not recommended for women who are pregnant. It is also not recommended for people that are allergic to eggs. An egg substance is used to formulate BOTOX.
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Competitor products are in development to rival BOTOX (ie. Reloxin/Dysport). They should be on the market in the United States in the near future.
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