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FAQ – Anti-Wrinkle Injections for Chronic Migraine

Types of Anti-Wrinkle Injections

There are several different types of Botulinum Toxins (A, B, C, E, F).The Botulinum Toxin used for cosmetic purposes is the Type A Botulinum or BTX-A.

Botulinum Toxin of type A is marketed under the names of Anti-Wrinkle Injections, Anti-Wrinkle Injections-Cosmetic (USA) and Vistabel® (Europe) by Allergan Laboratories and under the name of Dysport® by the Ipsen-Biotech Laboratory.

Anti-Wrinkle Injections and Dysport® are the specialities used in medical indications (ophthalmology, neurology, and otorhinolaryngology). Vistabel® and Anti-Wrinkle Injections-Cosmetic are the specialities of the Allergan laboratory which obtained the marketing authorization (A.M.M and FDA approvals) for wrinkle correction, but their action is exactly identical to that of Anti-Wrinkle Injections.

Anti-Wrinkle Injections is one of the many trade names for the neurotoxic protein, called botulinum toxin that is produced by the bacterium clostridium botulinum.   In large doses, the protein causes botulism, a rare paralytic illness often linked to food poisoning, however, the protein is used in cosmetic medicine to treat moderate to severe brow furrow (glabellar lines), uncontrolled blinking, lazy eye, wrinkles and upper facial creases. These procedures use a small amount of diluted Botulinum Toxin that enables controlled weakening of muscles.

Botulinum Toxin is sold commercially under the brand names Anti-Wrinkle Injections, BTXA, Dysport, Myobloc, Neurobloc, Xeomin, Anti-Wrinkle Injections Cosmetic, and Vistabel.
Anti-Wrinkle Injections is widely used for non-cosmetic medical procedures.

In addition to cosmetic use, Anti-Wrinkle Injections is used to treat: cervical dystonia, writer’s cramp, excessive sweating, achalasia (an esophagus problem), chronic pain, neuropathy, and migraine headaches.

For people with overactive bladders, Anti-Wrinkle Injections can improve their quality of life, say researchers from King’s College London School of Medicine, London, England. Anti-Wrinkle Injections administered to the bladder is as good as prescribed medications for tackling urinary urgency and twice as effective in eliminating symptoms completely.

Men with enlarged prostates benefit from Anti-Wrinkle Injections directly into the prostate, a study at University Medical College, Taiwan found.

It is aso, a possible treatment for some cases of depression. Some studies have indicated that Anti-Wrinkle Injections used for aesthetic purposes can help people with mental illness. A study published in Dermatologic Surgery found that treating clinically depressed patients with Anti-Wrinkle Injections on the frown lines of their faces actually got rid of their depression.

Anti-wrinkle injection – Anti-Wrinkle Injections works by blocking the signals from the nerves to the injected muscles. The muscles can no longer contract strongly, which causes the wrinkles to relax and soften. It is most often used on forehead lines, laughter lines and frown lines.

Anti-wrinkle injection – Botulinum Toxin is a naturally occurring substance. It can be used as an effective and powerful medication.

Anti-Wrinkle Injections works to relax the contraction of muscles by blocking nerve impulses. The result is muscles that can no longer contract, and so the wrinkles relax and soften. It usually takes two to ten days to see cosmetic improvement and the effects tend to last from four to six months.

Most patients require further treatments to remove wrinkles and lines as they begin to reappear, but after each injection the wrinkles return less severe, as the muscles are trained to relax.

Researchers discovered in the 1950s that injecting overactive muscles with minute quantities of Botulinum Toxin type A, would result in decreased muscle activity by blocking the release of acetylcholine from the neuron by preventing the vesicle where the acetylcholine is stored from binding to the membrane where the neurotransmitter can be released. This will effectively weaken the muscle for a period of three to six months.

Anti-wrinkle injection treatment areas may include: frown lines between the eyebrows and on the bridge of the nose, squint lines (Crow’s-feet) at the corners of the eyes and forehead creases. Not all facial wrinkles benefit from anti-wrinkle injections. Anti-wrinkle injection won’t reverse wrinkles caused by sun damage. Also, it’s less desirable to treat the lines around your mouth because muscles in this area are needed for eating and talking.

The skin type, skin thickness and degree of wrinkling all play a role in determining whether these injections are effective or not.

Patients should only get anti-wrinkle injections in a clinic by a doctor. They should never share a tube of anti-wrinkle injection. Anti-wrinkle injections should be performed by doctors who are experts in skin care and facial anatomy.

A typical visit usually takes 30 minutes, with a slightly longer visit in the case of a first-time patient as lengthier discussion is needed to explain the procedure and its possible side effects.

If dynamic wrinkles make you look older than you are, cosmetic ‘denervation’ can smooth these out and give you a more youthful and pleasing appearance, however, this treatment cannot improve wrinkles due to aging and sun-damaged skin, since they are unrelated to upper facial muscle contractions. Muscle relaxing injections will not improve sagging skin or replace the need for a facelift or brow lift.

The early clinical studies indicate that the duration of the treatment benefits is increased over time, so that you should require fewer injections in the future. The duration of the effect varies from patient to patient and may be less effective for those over 65 years of age.

Since anti-wrinkle injections don’t work for all wrinkles, a consultation with Dr Ayham Al-Ayoubi is essential, however, those below should not have Anti-Wrinkle Injections:

  • Clients who are pregnant or trying for pregnancy, breastfeeding
  • Patients with certain neuromuscular conditions (e.g. myasthenia gravis)
  • Those with infections at the treatment site
  • Patients taking aminoglycoside antibiotics or captopri preparation / typical procedure

Anti-wrinkle injections are injected with a fine needle into specific muscles with only minor discomfort. A topical ice pad should be applied to the skin to decrease the sensation of the injection. It generally takes between two to fourteen days to take full effect and it is best to avoid alcohol and exposure to excessive sunlight at least five days prior to treatment. Aspirin should be stopped two weeks before treatment in order to reduce bruising.

A few simple measures may optimize the safety and improve the results of treatment. To minimize the risk of later bruising, it is recommended that patients discontinue any non-essential medications or dietary supplements that can cause thinning of the blood:

Aspirin (2 weeks prior)

Non-steroidal anti-inflammatory medications (ibuprofen, naproxen, etc)

Fish oil supplements

Vitamin E

Gingko and ginseng

Red wine

You may have headaches for a few hours after the treatment. Take care, though, not to rub or massage the treated areas. This can cause the toxin to migrate to a different area of your face. If this occurs, temporary facial weakness or drooping is possible.

Recommendation is to schedule treatments about every 6 months to help maintain a consistent appearance in the first year. From then on treatment can be delayed by a few months each time as wrinkles have become less apparent.

 

The drug has been used in medicine for almost 30 years. There are approximately 1800 published studies about it, making it one of the best-researched medicines ever. Dosages used to treat children with cerebral palsy may range from 100 to 400 units, whilst typical dosage for cosmetic use is 20-50 units.

The cosmetic effect of Anti-Wrinkle Injections on wrinkles was originally documented by a Plastic Surgeon from Sacramento, California, Dr. Richard Clark, and published in the journal Plastic and Reconstructive Surgery in 1989.

Canadian husband and wife ophthalmologist and dermatologist physicians, JD and JA Carruthers, were the first to publish a study on Anti-Wrinkle Injections for the treatment of glabellar frown lines in 1992. Similar effects had reportedly been observed by a number of independent groups (Brin, and the Columbia University group).

After formal trials, on April 12, 2002, the FDA announced regulatory approval of Botulinum Toxin type A (Anti-Wrinkle Injections Cosmetic) to temporarily improve the appearance of moderate-to-severe frown lines between the eyebrows (glabellar lines). Subsequently, cosmetic use of Botulinum Toxin type A has become widespread, with many people viewing it as less intrusive and/or artificial than other types of plastic surgery

Also Botulinum toxin type A ( Anti-Wrinkle Injections) was approved for the treatment of excessive sweating in the United Kingdom in July 2001.

The safety of Anti-Wrinkle Injections is clear , however, some patients may experience side effects; the most common being, temporary bruising at the site of injection, headaches, which resolve in 24-48 hours, Inappropriate facial expression, such as drooping eyelid, uneven smile, or loss of the ability to close the eyes. This will wear off in around two- six weeks.

Other adverse events from cosmetic use include headaches, dysphagia, flu-like syndromes, blurred vision, double vision, dry mouth, fatigue, allergic reactions and swelling or redness at the injection site.

Individuals who are pregnant, have egg allergies or a neuromuscular disorder are advised to avoid Anti-Wrinkle Injections.

Patients rarley develop eyelid drooping. This development is usually caused by migration of the anti-wrinkle injection and for this reason, you shouldn’t rub the treated area for twelve hours after injection or lay down for three to four hours.

How does Anti-Wrinkle Injections work to treat Migraines?

There are many different types of headaches. A migraine is a type of headache where the person often has an intense throbbing headache and additional symptoms such as nausea, vomiting or increased sensitivity to bright light, noise or smell.

There are two recognised forms of migraine. A migraine is often described as a classic migraine with ‘aura’ if the person gets some form of visual distortions prior to the headache. These visual distortions are often in the form of zigzag or flashing patterns across their vision. Non-classic or common migraines do not have this aura.

Migraines are thought to be caused by changes in the chemicals of the brain, in particular serotonin. Serotonin levels are believed to decrease during a migraine, which can cause the blood vessels in the brain to spasm and then dilate, causing the headache. Other triggers can be: hormonal changes, certain food items, environmental situations, emotions, stress and physical triggers (for example muscular tension or poor sleep).

Acute migraines are usually treated using painkillers and anti-sickness medications. For people whose migraines do not respond to over-the-counter medications, stronger painkillers may be prescribed by a doctor. If a person suffers from regular debilitating migraines they may need to be prescribed preventative (prophylactic) medications, which they take to stop them getting migraines. There are various drugs currently prescribed for migraine prophylaxis, including beta-blockers and certain antidepressants or anticonvulsants.

Anti-Wrinkle Injections is the term used for Botulinum Toxin A which is a prescription medicine that is injected to prevent headaches in adults with chronic migraines, who have Fift eenor more days each month with headaches lasting for four or more hours each day in people 18 years or older.

Botulinum Toxin type A, or Anti-Wrinkle Injections, as it is commonly known, is a purified neurotoxin derived from the bacterium clostridium botulinum. It works by paralysing the nerve supply to muscles, thereby restricting their movement.

Anti-Wrinkle Injections have been shown to be highly effective in preventing headaches, nausea and dizziness associated with chronic migraines that afflict hundreds of thousands of people every year.

Anti-Wrinkle Injections works by temporarily paralysing key muscles in the forehead and neck, blocking the nerve connections. As well as being a muscle relaxant. Anti-Wrinkle Injections may also be effective at blocking pain signals. Clinical trials indicate that on average, a Anti-Wrinkle Injections treatment will reduce the frequency of migraine by about fifty per cent. For people who are having migraines virtually every day, this can make an enormous difference to the quality of their lives.

To treat chronic migraines, Anti-Wrinkle Injections is injected every twelve to sixteen weeks to specific sites around the head, neck and upper back, to try to weaken and dull future headache symptoms.

What areas can be treated?

Any muscle activity on the body can be targeted with Anti-Wrinkle Injections, however, it is most commonly performed in the upper face.

The most common areas requested are: forehead lines, vertical frown lines between the eyebrows, and crows-feet or laughter lines radiating away from the eyes. Whilst it does work around the mouth, chin and neck area, the benefits must always outweigh any possible weakness of the mouth muscles. This of course will be discussed with Dr Ayham Al-Ayoubi prior to any treatment. Smile lines are usually best dealt with, either by injectable fillers, or CO2 Laser Resurfacing.

How is Anti-Wrinkle Injections administered?

Having Anti-Wrinkle Injections for migraine attacks is not the same as having them for wrinkles. The injections sites will be different to achieve a different result. The doctor will inject Anti-Wrinkle Injections into the forehead, neck and shoulders of the patient.

These are the main areas where tension builds up which can lead to a migraine. The reduction in muscle tension also produces less strain upon the nervous system which also helps migraine attacks.

Unlike many of the other conditions in which it is used, it is not thought to work by relaxing overactive muscles. Botulinum Toxin has been shown to reduce pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain and bladder pain.

Botulinum Toxin is believed to inhibit the release of peripheral nociceptive neurotransmitters, which may then have a knock-on effect on the central pain processing systems that generates migraine headaches.

Also, the reasons why Anti-Wrinkle Injections might aid migraines are not clear, and several theories have been put forward. Throughout time it has been suggested that:

  • Anti-Wrinkle Injections might relax muscles around the head and thereby reduce blood pressure within the brain
  • Anti-Wrinkle Injections might reduce the nerves’ ability to send pain signals during a migraine
  • Anti-Wrinkle Injections might prevent the nerves from sending signals that will lead to a migraine

Possible side effects

There are very few side effects to the Anti-Wrinkle Injections procedure. While allergy to any medicine is possible, it is indeed rare  with Anti-Wrinkle Injections.

Safety of Anti-Wrinkle Injections is clear, however, some patients may experience side effects.

The most common side effect of Anti-Wrinkle Injections is temporary, slight bruising that can sometimes occur, however, this can usually be covered with make-up.

Headaches, which resolve in 24-48 hours, can occur, but these are rare.

Inappropriate facial expression, such as drooping eyelid and very small amount of brow drooping can occur when injected in an area, this can usually be avoided by not treating the 1-cm area just above the eyebrows. Despite precautions in exceptionally rare circumstances this can still occur, however, due to the non-permanent nature of Anti-Wrinkle Injections this is always temporary.

Uneven smile, or loss of the ability to close the eyes. This will wear off in around two – six weeks.

Other adverse events from cosmetic use include headaches, dysphagia, flu-like syndromes, blurred vision, double vision, dry mouth, fatigue, allergic reactions and swelling or redness at the injection site.

Individuals who are pregnant, breastfeeding or have egg allergies or a neuromuscular disorder are advised not to have Anti-Wrinkle Injections treatments at all.

Rarely, patients may develop eyelid drooping. This usually resolves in three to four weeks. This development is usually caused by migration of the anti-wrinkle injection and for this reason, you shouldn’t rub the treated area for twelve hours after injection or lay down for three to four hours.

Patients can reduce the risk of bruising by avoiding aspirin or ibuprofen-type drugs, in the week prior to treatment (as these drugs thin the blood and are best avoided prior to any injectable treatment).

Also Botulinum Toxin type A (Anti-Wrinkle Injections) was approved for the treatment of excessive sweating in the United Kingdom in July 2001.

The drug has been used in medicine for almost 30 years. There are approximately 1800 published studies about it, making it one of the best-researched medicines ever. Dosages used to treat children with cerebral palsy may range from 100 to 400 units, whilst a typical dosage for cosmetic use is 20-50 units.

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