The Simple Truths About Botox

Injection of Botox (botulinum toxin type A) has become one of the most common nonsurgical cosmetic procedures performed in the United States. Yet, amid its unflagging popularity, there remain many myths about the procedure, the most common being that people who get Botox are being injected with botulism (a bacterial form of food poisoning). It is this and other types of misinformation that can lead consumers in the wrong direction when deciding whether to use Botox.

Woman getting facial injections
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The History of Botox

Botox is the brand name of a type of toxin produced by a bacterium called Clostridium botulinum. The toxin has different medical purposes based on the specific type used, ranging from type A to type G.

Type A, the most potent, is marketed under the names Botox, Daxxify, Dysport, Jeuveau, and Xeomin. All have been approved by the Food and Drug Administration (FDA) specifically for the purpose of reducing facial wrinkles and horizontal forehead lines. Other FDA-approved uses include the treatment of migraines, strabismus (crossed eyes), blepharospasm, cervical dystonia (torticollis), and bladder problems. Another formulation using type B botulism toxin is marketed under the name Myobloc.

Botox has largely become the generic term for all these products, even among those receiving Dysport or Myobloc injections. Although the results can vary, all formulations work quite similarly.

How Botox Works

Despite what many will tell you, Botox doesn't actually remove wrinkles. In fact, you should be wary of any doctor, nurse, or aesthetician who claims that it does.

Instead, Botox works by temporarily disabling the facial muscles that cause wrinkles—specifically, those associated with crow's feet, the wrinkles at the corner of your eyes, and the frown lines between your eyes. Botox is able to do this by directly blocking the facial nerves that tell your muscles to contract.

Once injected, the muscle is basically paralyzed, leading to the reduction of so-called "dynamic wrinkles" (wrinkles that are only present when muscles contract). This is why Botox is so effective on the wrinkles around the mouth and cheeks (apparent when we smile) and at the corner of the eyes (apparent when we squint, frown, and grimace).

Not all wrinkles are treated equally. As we get older and lose elasticity in our skin, a permanent crease can sometimes develop even when the muscle is relaxed. While Botox cannot erase these deep creases, it may help to soften them.

Botox isn't reversible once it has been injected, but it does wear off. Its effects typically begin within 48 hours of injection and become noticeable within five to 10 days. However, the effects only last from between three to five months, at which point you would need another treatment to maintain the anti-wrinkle effects.

A Word From Verywell

Studies published in 2015 have shown that people who get Botox injections are generally satisfied with the results. However, it should never be considered a miracle treatment. While you can certainly expect some noticeable improvement, Botox can't turn back the clock 20 years.

In the end, it is always important to be realistic about what Botox can and cannot do. Moreover, the improper use of Botox can result in what many call a "frozen face," a condition which ends up highlighting the procedure rather than the wrinkles it is meant to conceal. Always check the credentials of the professional who plans to give you the shots and ask for references from current or former clients.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Board of Cosmetic Surgery. Learn more about Botox, Dysport & Xeomin.

  2. Walker TJ, Dayan SH. Comparison and overview of currently available neurotoxinsJ Clin Aesthet Dermatol. 2014;7(2):31–39.

  3. Rivers JK, Bertucci V, Mcgillivray W, et al. Subject satisfaction with onabotulinumtoxinA treatment of glabellar and lateral canthal lines using a new patient-reported outcome measure. Dermatol Surg. 2015;41(8):950-9. doi:10.1097/DSS.0000000000000424

By Heather L. Brannon, MD
Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years.