Introduction to Botox
Botulinum toxin type A (Botox®) interferes with acetylcholine release from nerve terminals causing temporary paralysis of the injected muscles. The pioneering work of Scott1 over 25 years ago was for strabismus. In 1989 it was approved for blepharospasm, hemifacial spasm, torticollis, and strabismus. Since then it has been approved for cosmetic treatment of the glabellar furrows and axillary hyperhydrosis. Botox has become the number one cosmetic procedure and is widely used to treat rhytids of the glabella, forehead, eyelids; nasal; cervical; and perioral areas. Offlabel oculofacial uses include: hyperkinetic wrinkles of the face; hyperlacrimation; eyelid retraction; spastic entropion; blepharoptosis; migraine/stress headaches; and improving symmetry for facial palsy.