All you need to know about Botox from Dr Pallavi Kashyap

Botox is used medically to treat certain muscular conditions, and cosmetically to remove wrinkles by temporarily paralyzing muscles. It is made from a neurotoxin called botulinum toxin that is produced by the bacterium Clostridium botulinum.

Although Botox is a powerful poison, when used correctly, it has a number of applications.

Dr. Pallavi Kashyap

Medishala talked to Dr.Pallavi Kashyap an expert Dermatologist at Skin Radiance Clinic about Botox injections and here is what she has to say:

What is Botox?

Botox injections have a range of medical uses. Clostridium botulinum, the bacterium from which Botox is derived, is found in many natural settings, including soil, lakes, and forests.

The bacterium can also be found in the intestinal tracts of mammals and fish and in the gills and organs of crabs and other shellfish. Such naturally occurring instances of Clostridium botulinum bacteria and spores are generally harmless. Problems only arise when the spores transform into vegetative cells and the cell population increases. At a certain point, the bacteria begin producing botulinum toxin, the deadly neurotoxin responsible for botulism.

Neurotoxins target the nervous system, disrupting the signaling processes that allow neurons to communicate effectively.


Image illustrating effect of Botox on nerve cell
Source: Google Images

Injected botulinum toxin prevents the release of acetylcholine, preventing contraction of the muscle cells. Botulinum toxin causes a reduction in abnormal muscle contraction, allowing the muscles to become less stiff.


Before(left) and after(right) Botox
Source: Google Images

Botox is most commonly used for cosmetic purposes to improve the appearance of fine lines and wrinkles.

Botulinum toxin is predominantly used as a treatment to reduce the appearance of facial wrinkles and fine lines.

Source: Google Images

Beyond aesthetic applications, Botox is used to treat a variety of medical conditions, including eye squints, migraines, excess sweating, and leaky bladders.

Botulinum toxin is currently approved for the following therapeutic applications:

  • Blepharospasm (spasm of the eyelids).
  • Idiopathic rotational cervical dystonia (severe neck and shoulder muscle spasms).
  • Chronic migraine.
  • Severe primary axillary hyperhidrosis (excessive sweating).
  • Strabismus (crossed eyes).
  • Detrusor (bladder wall muscle) overactivity – causing urinary incontinence.
  • Overactive bladder.
  • Canthal lines (crow’s feet).


Botulinum toxin is administered by diluting the powder in saline and injecting it directly into neuromuscular tissue. It takes 24-72 hours for botulinum toxin to take effect. In very rare circumstances, it may take as long as 5 days for the full effect of botulinum toxin to be observed.

Risks and side effects

Possible side effects of a Botox injection include migraines, nausea, double vision, and general malaise.

Injections with botulinum toxin are generally well tolerated and there are few side effects. In rare cases, an individual may have a genetic predisposition that results in a mild, transient unusual response to the drug.

Along with its intended effects, botulinum toxin may cause some unwanted effects. These can include:

  • Mild pain, local edema or erythema (reddening of the skin) at the injection site.
  • Numbness.
  • Headache.
  • Malaise – feeling generally unwell.
  • Mild nausea.
  • Temporary unwanted weakness/paralysis of nearby muscles.
  • Temporary upper lid or brow ptosis (drooping).
  • Weakness of the lower eyelid or lateral rectus (a muscle controlling eye movement).
  • Dysphagia – trouble swallowing.
  • Flu-like illness.
  • Gallbladder dysfunction.
  • Diplopia (double vision).
  • Bleeding.
  • Blurred vision.
  • Decreased eyesight.
  • Dry mouth.
  • Swelling.

Who is not eligible for the treatment?

Source: Google Images

Botulinum toxin should not be used in pregnant or lactating women, or by people who have had a previous allergic reaction to the drug or any of its ingredients. Not all migraine sufferers automatically qualify for Botox treatment. If you respond well to other migraine treatments or medications, you’re unlikely to be referred for Botox treatments.



What is the price of the treatment in India?

Source: Google Images

The cost of Botox injections varies from one practitioner to another, from one place to another and also depends upon the part of the body to be treated. Most people are pleasantly surprised when they hear the cost. The crow’s feet would cost about Rs.6000 a session. Given that it needs to be repeated in 6 months that translates to Rs.1000 a month. The upper face including the frown complex, crow’s feet and forehead would cost Rs.15, 000 to Rs.18, 000 per session. Drooping smile would cost Rs. 7,000, lip lines Rs. 7,000, Nefertiti Lift (for wrinkles on neck) Rs. 10,000 – Rs. 12, 500, Brow Lift Rs. 7,000, Gummy smiles Rs. 10,000 and cheeks and jawline lift Rs. 10,000 – Rs. 21,000.



Are the results of the treatment permanent?

The effects of BOTOX are not permanent. But Botox gives long time result if you choose professional for injecting. A treatment is required every 3-4 months although some patients have reported longer wait times after repeated treatments.


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