Kenneth Beer, M.D. is a board-certified dermatologist and dermatopathologist in Palm Beach, Fla., and the director of, an online skincare company. He is also the director of The Cosmetic Bootcamp, which trains physicians in best practices for cosmetic medicine. Dr. Beer is an instructor in dermatology at the University of Miami, and he is an A.B. Duke Scholar at Duke University. He obtained his medical degree from the University of Pennsylvania School of Medicine, and received his dermatology and dermatophathology training at the University of Chicago. Visit Dr. Beer's office at

Botox: What You Need to Know

Monday, 26 September 2011 11:59 AM

Botox is no longer the only game in town when it comes to wrinkle treatment.
For the past few years another product called Dysport has been competing to ease the lines on your face. Most recently, there is another product that was approved known as Xeomin. Although it is not yet available for injection, Xeomin is interesting because unlike Botox or Dysport, there are no proteins attached to the molecule that is the active ingredient. This may help the product obtain faster results.
Patients frequently come to my office asking what types of wrinkles are the best candidates for treatment with Botox, Dysport, or Xeomin. My response is that these drugs are great for relaxing wrinkles that are caused by muscles. What they are not good for is etched-in lines or creases from loss of soft tissue, such as those that run from the nose to the corner of the mouth.
My most frequent injection sites for these products include frown lines and the lines around the sides of the eyes and forehead.
In addition, I often use the injections to relax the stringy muscles of the neck, improve forehead wrinkles, and contour the jawline by relaxing the muscle that causes clenching. Occasionally, I will use one of these treatments to relax the fine lines around the lips, but I typically find that my CO2 Ultrapulse laser works better for this.
Besides wrinkle treatment, Botox is also used to stop excessive sweating in the armpits, palms, and feet.
The list of medical uses for Botox is actually longer than that for cosmetic ones. Botox can be used to treat everything from migraine headaches to urinary bladder spasms. Muscle spasms of all types may be treated with Botox and some physicians use it for treating the pain of shingles.
Headaches are among the most frequent non-cosmetic uses for this product and many of my patients who come in for cosmetic treatments find that their chronic headaches disappear as a welcome added benefit.
People who are needle shy might be interested to know that topical gels containing Botox are being tested for approval by the FDA and the early data looks promising. It is likely that a form of Botox that will not require a needle will be approved in the near future.
Sometimes patients will ask whether they should attend a “Botox party” where injections are being done. Aside from the fact that most of these are illegal and that it is a bad idea to have medical procedures performed in a non-medical environment, I think it is just stupid.
The people who are doing the injecting at these “parties” are unlikely to be reputable, may or may not have a license, be trained, or be using the actual product.
Many of the people who attend these events complain that their injections don’t last more than a few weeks. The reason is that the person who injected them diluted the product so that the patient got very little active ingredient. So, although they may have spent less than if they had gone to a reputable physician, they certainly did not get a deal.
If you are considering getting wrinkle treatment, seek the care of a dermatologist or plastic surgeon with the experience and knowledge to help achieve a good outcome.

© HealthDay

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Monday, 26 September 2011 11:59 AM
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