Botox: poison and current for the face skin

The Science Department took a decision to review the four popular procedures used to rejuvenate the facial skin: Botox, hyaluronic acid, cell technologies, and darsonvalization. Scientific background, indications, and contraindications are reviewed in publication of "Gazeta.Ru".

There are many products which are currently used for rejuvenation of the face and body skin on the esthetic medicine market. Not taking a responsibility to recommend something, "Gazeta.Ru" reviews the four popular procedures and describes mechanisms which these procedures are based on.

Botox: the consequences of its application

Botox today is known to everybody as a magic medium that allows women (and men also) to get rid of facial wrinkles. However, not everybody knows that an active substance of this medicine is botulinum toxin, the lethally dangerous neurotoxin produced by bacterium Clostridium botulinum. This toxin causes botulism, the dangerous disease affecting the nervous system. The most terrible thing is that this disease affects motoneurons of the spinal cord connected to breathing muscles and one can die from acute breath failure. The disease is developed when botulinum toxin enters the human body with food.

The disease was noticed already in 18 century when people eat sausages. At present, the most common source of contamination is home-made canned food since the optimal conditions for these bacteria depend on the lack of oxygen. Botulinum toxin is an excellent example of Paracelsus words: "Poison is in everything and no thing is without poison. The dosage makes it either a poison or a remedy." The mechanism of action is the same for both poison and medicine: botulinum toxin blocks nerve-muscle transmission, i.e., the signal transmission from neurons to the muscle owing to which the muscle contracts.

In the nerve-muscle synapse that is a contact site between nerve and muscle cells, a signal is transmitted by means of acetylcholine, a neuromediator, which being contained in vesicles passes through the narrow space between both cells. Thus, botulinum toxin blocks releasing acetylcholine from the nerve cell. That is it! The muscle receives no signal from the nerves and stays relaxed. Such a muscle paralysis, which is deathly dangerous for the whole body, can be useful sometimes when applied in a certain skin region and in a small dosage. Botulinum toxin has been used as a medicine since 1989 to treat some diseases accompanied by muscle spasms, hypertonus, and convulsions.

The use of Botox in cosmetology

Botox relaxes mimic muscles and, thus, removes the age-related wrinkles which arise since these muscles contract too frequently.

Contractions of mimic muscles cause skin folds in the forehead, between eyebrows, in the eye corners, etc., and with age these folds become permanent. Botox injections into mimic muscles block their contraction caused by neural impulses. The muscles are relaxed, the skin becomes smooth, and patients look younger.

However, Botox acts for a limited amount of time: after some time the blocked nerve-muscle connections are restored. In the study with participation of a large number of patients, American cosmetologists found out that Botox action lasts for 3–5 months in women and for 4–6 months in men.

Thus, one can not get rid of wrinkles by such a procedure once and forever: Botox injections have to be repeated.

Botox effect is temporary

Although physicians say that during Botox action, patients sometimes lose a habit to contract the forehead or to narrow one's eyes so that the wrinkles may never come back.

By using Botox, one can also achieve another cosmetic effect, the facial lifting. If an experienced physician makes the Botox injections into certain facial muscles, then this procedure can result in elevating of lips and eyes corners as well as eyebrows, and, therefore, can lead to facial lifting. However, this effect will not last forever but for 4–6 months.

The temporary character of Botox effect is used by physicians-neurologists who use surgery to treat migraine in some patients, as it was described by "Gazeta.Ru". At first, the physicians inject Botox into certain muscles as a test on migraine. Then muscles are relaxed and stop squeezing the trifacial nerve. If the temporary therapeutical effect is observed, it means that the cause of migraine is obvious and in this case the physician can plan a surgical operation.

The efficiency of Botox in cosmetology depends on patient's age. Cosmetologists consider that Botox is absolutely unnecessary to apply before 25 years whereas at 30–40 years it displays the maximal effect, at 50–60 years the result is weaker, and after 60 years it does not already make sense to apply Botox. The reason is that the tonus of mimic muscles is decreased with age as well as their role in appearance of wrinkles.

Contraindications to Botox injections

Botox is contraindicated for highly myopic patients (above 6 diopters) since myopia is caused by weakening of eye muscles and Botox injections can make them even weaker. 

Botox is contraindicated for patients with weak facial muscles, which is displayed in swellings and ruptures under the lower eye lids. There are also patients with allergy on Botox.

Is there an alternative to Botox? 

Yes, there is! This is the SPRS therapy, the technology that allows one not only to remove small and average wrinkles but also to increase the thickness, tension, and elasticity of the skin. This procedure not only results in visual correction of the age-related skin changes, but also removes the cause of skin aging owing to enlargement of the skin fibroblasts population which decreases in number with age.

The SPRS therapy is based on application of autologous (i.e., patient's own) skin cells, fibroblasts. Fibroblasts are the main skin cells responsible for production of skin "youth" components: collagen, elastin, and hyaluronic acid. With age, the amount of fibroblasts in skin is decreased, as well as their biosynthetic activity and collagen content. Thus, American scientists have shown that in the skin of old people, the number of fibroblasts and their biosynthetic activity is decreased by 40% and 75%, respectively, as compared with the skin of young people.

The visual appearance of these processes is wrinkle formation and the decrease of skin thickness and elasticity. Briefly, the SPRS therapy can be described as follows: patient's skin sample of 4 mm in size is used to obtain a cell suspension containing cultivated autologous fibroblasts at the specialized laboratory of the Human Stem Cell Institute. The course of the skin therapy consists of 2 procedures separated with a one-month interval. The obtained cell suspension (the SPRS preparation) is delivered to the cosmetological clinic immediately before each procedure.

The cells are injected according to the special procedure intracutaneously (into the papillary layer of the derma) by tunnel mode using special mesotherapeutic needles which allow one to evenly distribute (with the adequate cell density) new functionally active fibroblasts throughout the skin region that requires correction. This completely excludes patient's body immune response since only patient's own cells are used for the procedure.

The autologous fibroblasts injected into the skin efficiently correct the age-related skin changes since, being transplanted into the skin, they intensively produce collagen, elastin, and the other important skin "youth" components. As a result, the skin microstructure is restored and the skin density and elasticity is increased whereas the amount and depth of wrinkles is decreased. Thus, as opposed to Botox injections, the SPRS therapy is an absolutely safe cosmetological method having no side effects owing to application of patient's own cells which perfectly survive in patient's skin. This promotes the long-term clinical effect that is maintained for several years.

• Hyaluronic acid: for those who take risk
• What is the SPRS therapy and how does it fight skin aging?
• How many the SPRS procedures should one take to achieve the optimal result? How often

must they be repeated?

• What is the cost of the SPRS therapy course?