Botulinum Toxin

April 2013ELIXIR

Consumer Guidewww.elixirnews.com

A magical injectionBotox is the name most people usewhen they think about the so-called‘magical’ injection that banisheswrinkles and frowns. Like‘Hoover’, now synonymous withvacuum cleaning, it has become aneveryday term to describe all formsof the botulinum toxin thattemporarily paralyses muscles.

But Botox is, in fact, a uniqueformulation, therefore it is abrand/patent owned by the USpharmaceutical company Allergan.It has a whopping 85% share of thismarket – but possibly for not muchlonger, as a major competitor isnow looming on the horizon.

The other products are: Dysportfrom Valeant Pharmaceuticals,Myobloc made by SolsticeNeurosciences and Xeomin fromMerz – which together have a 15%market share. But the newcompetition is coming from a rivalpharma giant, Johnson & Johnson,with the launch of its own ‘Botox’product.

A new competitorElixir, for one can’t wait to find outwhat they will call it, as everyonetrying to sell a new cosmeceuticalhas tried to ride on thatbandwagon! We will keep youposted on our website when moreinformation unfolds (or you could

join our newsletter to make sureyou don’t miss out on the latestnews)!

No two are the same!All of these products containvariations of the formula, so theyare not interchangeable if you arehaving them as a course oftreatments. So that is something tobe aware of and check when thedoctor is opening the sealed phial.

This toxin is manufactured in alaboratory using the microbe thatcauses botulism, a serious form offood poisoning. Which is anotherreason to exercise caution whenseeking treatment. And a red signalfor anyone who is pregnant orplanning to get pregnant – do not tohave this injection – because itmust migrate within the body andthe affect on a fetus or baby isunknown.

A tiny needle, of the type used forinjections is used, so pain isminimal

Other medical conditionsAs well as wrinkles, Botox hasreceived FDA (US healthwatchdog) approval for use in anumber of medical conditions,such as repetitive neck spasms(cervical dystonia), excessivesweating (hyperhidrosis),overactive bladder, facial twitchesand some eye problems. Botoxinjections may also help preventchronic migraines.

Consult doctor firstIf you are planning to have abotulinum toxin treatment –whether it’s for a cosmetic reasonor other - you should always speakto your medical doctor and seekadvice first.

However, we answer some simplequestions and answers on the fol-lowing pages, which are meant tobe helpful. These are not asubstitute for professional medicaladvice.

Not much pain but a lot of gain - I’veonly had it done only once - it takesjust a few seconds - but my wrinkleshave stayed away for years!

Botulinum Toxin

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Questions & Answers

Q. What is Botox used for?

A. It is a botulinum toxin treatment,given as an injection. It works byblocking certain signals from thenerves, mostly signals that causemuscles to contract.

The most common use of theseinjections is to temporarily relax thefacial muscles that underlie andcause wrinkles, such as:

� Frown lines: between theeyebrows� Crow's-feet: the lines that fan outfrom the corners of the eyes�Forehead furrows: the horizontallines that form when you raise youreyebrows

Botox is also approved for seriousmedical conditions, includingmigraine. In addition to thesecosmetic procedures, which improveyour appearance, botulinum toxininjections have also been used totreat conditions that affect how thebody functions.

Examples include:

� Cervical dystonia: In this painfulcondition, the neck muscles contractinvoluntarily, causing the head totwist or turn into a contortedposition.� Lazy eye: The most commoncause of lazy eye is an imbalance inthe muscles responsible forpositioning the eye. This can resultin crossed eyes.� Muscle contractions: Someneurological conditions, such ascerebral palsy, can cause limbs topull inwards. In some cases, these

contracted muscles can be relaxedwith injections.� Hyperhidrosis: In this condition,excessive sweating occurs evenwhen the temperature is not hot andthe affected individual is notexercising. In some people, thesweat literally drips off their hands.� Chronic migraine: In cases whena person experiences migraines morethan 15 days a month, botulinumtoxin injections may help reduceheadache frequency.� Bladder dysfunction: Injectionscan also help reduce urinaryincontinence caused by an overactivebladder.

BOTOX - BEFORE & AFTER

Untouched photos of a model taken at maximum frown before and after treatment - Photo: Botox/Allergan

Elixir has expert doctors who can answer yourquestions so if there is something that is not an-swered here please email us atexperts@elixirnews.com.

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“If you have symptoms such as blurring vision orproblems breathing you should see a doctorstraight away”

Q. What are the risks?

A. Botox injections arerelatively safe whenperformed by anexperienced doctor.

The most common sideeffects include swellingor bruising at theinjection site, headache

or flu-like symptoms. Ifthe injections aren'tplaced correctly, themedication may spreadinto adjacent tissues andcause problems such as:

� Eyelid droop� Crooked eyebrows� Uneven smile

� Dry eye or excessivewatering

Although,very unlikely,there is a possibility thatthe effect of botulinumtoxin may spread to otherparts of the body andcause botulism-like signsand symptoms.

Call your doctor rightaway if you notice any ofthese effects hours toweeks after being inject-ed with a botulinumtoxin product:

� Muscle weakness allover the body� Vision problems

� Trouble speaking,breathing or swallowing� Loss of bladder control� Doctors generallyrecommend againstusing botulinum toxins(and most other drugs)when you're pregnant orbreast-feeding, since theeffects on the baby aren'tknown.

CHOOSING THE RIGHT DOCTOR IS CRITICAL

Pick a doctor withan eye for naturalbeauty - get recom-mendationsQ. How do I selecta good doctor?

A. Botulinum toxinmust be used onlyunder a doctor'scare. It can bedangerous if it's

administeredincorrectly. Ask fora referral from yourprimary care doctoror look for a doctorwho specialises inyour condition andwho has experiencein administeringBotox treatments.

He will have beenproperly trainedthrough Allergan. Askilled and properlycertified doctor canadvise you on theprocedure and canhelp determine if itsuits your needsand health.Word-of-mouthrecommendation isalso useful,especially in thearea of aesthetictreatments. Andchoose a doctorwho prefers thesubtle approach.This means amedical practitionerwho has anaesthetic eye forwhat suits you as anindividual – after allyou can always goback for more – andyou want to look

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Q. Is there anything I need to do before I have aninjection?

A. Your doctor will need to know if you've receivedany type of botulinum toxin injections within the pastfour months. If you take blood thinners, you may needto stop taking these for several days before, to reduceythe risk of bleeding or bruising. Your doctor alsoneeds to know if you take muscle relaxants, sleepingaids or allergy medications. Also tell your doctor is youhave had any facial fillers as these can be a problemand conflict with treatment.

Q. What can I expect if I decide to go for a wrinkletreatment?

A. Before the procedure:Although most peopletolerate the injection discomfort well, you may wantyour skin to be numb beforehand. Several options areavailable, including:

• Injections: Your doctor can inject a numbingmedication into your skin.• Cream (usually dental block anesthetic): Aprescription cream can be applied 60 to 90 minutesbefore the procedure.• Cold spray: A blast of very cold air is directed at theskin for about 10 seconds. The numbness only lasts afew seconds.• Antihistamines: These can help keep swelling to aminimum if you are an allergy sufferer• Arnica: A homeopathic remedy for bruising,available in tablet form can also reduce bruising.

Subtle enhancement is key to natural beautyDuring the procedure:Your doctor uses a thin needleto inject tiny amounts of botulinum toxin into your skinor muscles. The number of injections needed dependson many factors, including the extent of the area beingtreated. Botox injections should be performed in adoctor's office and by a doctor.

Don’t even think about having it at a Botox party,where alcohol is being consumed – medicalpractitioners who do this can now be struck-off themedical register and/or given a legal/professionalpenalty.

After the procedure:Expect to resume your normal daily activities right after the procedure. Take care,though, not to rub or massage the treated areas. A goodprofessional doctor will tell you this. This can cause thetoxin to migrate to a different area.The injectionsusually begin working a few days after treatment.Depending on the problem being treated, the effect maylast for three to 12 months. To maintain the effect,you'll need regular follow-up injections.And alwaysremember if you are not sure you are perfectly entitledto cancel the procedure. Beauty comes from within – sobeing wrinkle-free may not equate to happiness!

What your doctorneeds to know!

1. Are you taking anymedication, includingmuscle relaxants orsleeping pills?

2. Are you taking anyvitamins or other dietarysupplements?

3. Do you suffer fromallergies?

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