Neurotoxins
(Botox / Dysport / Xeomin / Jeuveau)
What are neurotoxins and how do they work?
(Botox/Dysport/Xeomin/Jeuveau)
Botulinum toxin A is a neurotoxin produced by the bacteria, Clostridium botulinum.1 This neurotoxin blocks the neurotransmitter acetylcholine which signals your muscles to contract.2 Preventing the muscle contractions causes relaxation of the muscle and relaxation of the overlying skin resulting in decreased lines and wrinkles. The most common brand of neurotoxin is Botox; often these terms are used interchangeably like Kleenex or Band-Aid.
What can they be used for?
Neurotoxins are most often used to paralyze the muscle to prevent wrinkles. There are also non-cosmetic uses like TMJ or hyperhidrosis.
- TMJ is generally caused by over developed chewing muscles which we can treat with a neurotoxin to reduce the strength of the muscle contraction overtime.3 Some patients feel pain relief in a few days. Others may take 3-4 treatments spaced out over a year to feel results.
- Hyperhidrosis can be treated by blocking the neurotransmitter that causes sweat glands to secrete sweat. Common treatment areas are the axilla (armpit), hands, and feet.
What to expect during the procedure?
How long does it last and is it reversible?
The effect of the neurotoxin is not reversible, but it does wear off in 3-4 months. We typically recommend repeating treatment close to the 3-month mark to provide a consistent appearance to help make your injectables undetectable.
Different types of neurotoxins:
There are a variety of botulinum toxins available, and each is slightly different. All treatments have been proven to be safe and effective in wrinkle reduction via muscle paralysis.1
Botox
OnabotulinumtoxinA
We can all agree that Botox has the most name recognition. It is the #1 selling neurotoxin on the market. Botox has been FDA approved for treating lines since 2002.
Dysport
AbobotulinumtoxinA
Dosing conversion is necessary when discussing the difference between Dysport and Botox. A 3:1 ratio is appropriate where three units of Dysport is equivalent to one unit of Botox. Some patients experience the onset of muscle paralysis in as little as 2-3 days.
Xeomin
IncobotulinumtoxinAA protein free botulinum toxin A. Some believe the absence of proteins is beneficial to reduce the risk of developing antibodies (immunity) however more research is needed to determine if this is clinically significant or merely anecdotal.
Jeuveau
PrabotulinumtoxinA-xvsf
A newer botulinum toxin type A which has been shown to demonstrate similar safety and efficacy when compared to Botox
References:
1. Walker TJ, Dayan SH. Comparison and overview of currently available neurotoxins. The Journal of clinical and aesthetic dermatology. 2014;7(2):31-39. Accessed August 18, 2022.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130383/
2. Dover JS, Monheit G, Greener M, Pickett A. Botulinum Toxin in Aesthetic Medicine: Myths and Realities. Dermatol Surg. 2018 Feb;44(2):249-260. doi: 10.1097 / DSS.0000000000001277. PMID: 29016535; PMCID: PMC5821482.
https://pubmed.ncbi.nlm.nih.gov/29016535/
3. Mor N, Tang C, Blitzer A. Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection. Toxins (Basel). 2015 Jul 24;7(8):2791-800. doi: 10.3390/toxins7082791. PMID: 26213970; PMCID: PMC4549724.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549724/