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Botox: They Say it's Safe, But Here
is Why You Need to Beware

In 2007, Botox topped the list of the most popular nonsurgical cosmetic procedures, with nearly 2.8 million treatments in the United States alone.


Nearly 3 million people received Botox treatments in 2007 to remove the wrinkles between their eyebrows.

Most widely known as a treatment to get rid of wrinkles or frown lines between your eyebrows, Botox is made from botulinum toxin type A, which is the same toxin that causes botulism food poisoning.

When injected into your forehead, Botox blocks nerve cells' release of a chemical called acetylcholine, which signals muscle contraction. As a result, the injections interfere with your muscles' ability to contract, causing existing frown lines to smooth out and disappear in about a week.

Botox is also approved to treat eye muscle disorders, excessive underarm sweating, and cervical dystonia, a neurological movement disorder that causes neck and shoulder spasms. It was actually after using Botox in the treatment of an eye disorder that its wrinkle-removing "side effect" was discovered.

New Warnings From the FDA

Though millions of Americans receive regular Botox injections, even going so far as to organize "Botox parties," new concerns have surfaced over its safety.

In February 2008, the U.S. Food and Drug Administration (FDA) warned that Botox and its competitor Myobloc have been linked to dangerous botulism symptoms, including a few deaths in children.

botox injection

In rare cases, the toxin in Botox may spread to other areas of your body, paralyzing muscles and causing trouble breathing and swallowing.

They warned that in "rare cases" the toxin can spread beyond the injection site, causing paralysis and weakness in muscles used for breathing and swallowing, a condition that can be deadly. The FDA is investigating several deaths, most of which involve children who were treated with Botox for cerebral palsy-related leg spasms.

The agency is also investigating reports of illnesses linked to Botox, including at least one woman who was hospitalized after receiving Botox injections for wrinkles.

According to the FDA, anyone who receives Botox should be aware of the symptoms of botulism, which include:

  • Difficulty swallowing and breathing

  • Slurred speech

  • Dry mouth

  • Drooping eyelids

  • Muscle weakness

  • Difficulty holding up your head

"I think people should be aware there's a potential for this to happen," said Dr. Russell Katz, FDA's neurology chief in CNN. "People should be on the lookout for it."

Public Citizen Also Urges Stricter Warnings

Consumer advocacy group Public Citizen has also asked the FDA to "immediately increase its warnings and directly warn patients and doctors about the use of botulinum toxin."

The request follows their analysis of FDA data that found between Nov. 1, 1997, and Dec. 31, 2006 there were 658 reported cases of people suffering adverse effects from injections of botulinum toxin.

Of these, 180 were associated with paralysis of respiratory muscles and difficulty swallowing, or pneumonia, 87 required hospitalization, and 16 people died.

"Nobody should be dying from injected botulinum toxin," said Dr. Sidney Wolfe, director of Public Citizen's Health Research Group. "Educating physicians and patients about what adverse symptoms to look for and when to seek immediate medical attention will save lives."

If you choose to receive Botox for cosmetic purposes, be sure you have chosen an experienced health care practitioner for the treatment. The FDA recommends that the lowest effective dose be used, and that you receive injections no more than once every three months.

Also, be on the lookout for the serious symptoms described above, along with some of the other common side effects, which include:

  • Headache

  • Respiratory infection

  • Flu syndrome

  • Nausea

  • Pain in the face

  • Drooping eyelids (which can result if too much is injected into the wrong facial area)

If you notice any of the above symptoms following a Botox treatment, you should see your health care provider immediately.

Recommended Reading

Why Your Face Ages, and How to Avoid Premature Aging

Aging Gracefully: Enjoy a Vital, Fulfilling Life Regardless of Age

Sources February 8, 2008

Public Citizen January 24, 2008

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