Using Neurotoxins Safely In Practice
While almost every procedure that most of us perform is perfectly safe, there is always a small population that faces the very real potential to be at risk. This is a completely reasonable thing to expect – every treatment and every medication comes with a potential adverse effect for some people. Issues like this are common and we at TSLMS are here to help our busy members sort out fact from fiction and keep the idea of a panic at bay. Afterall, there is no reason to panic – but there is a reason to take note and understand the risks that go along with treating with neurotoxins.
What are Neurotoxins
Normally we would all consider neurotoxins bad; like really bad. Why? Well, as explained it is because of the damage that these substances can do to the human body and the human brain and nervous system:
Neurotoxins are toxins that are destructive to nerve tissue (causing neurotoxicity). Neurotoxins are an extensive class of exogenous chemical neurological insults. That can adversely affect function in both developing and mature nervous tissue. The term can also be used to classify endogenous compounds which when abnormally contacted, can prove neurologically toxic.Though neurotoxins are often neurologically destructive, their ability to specifically target neural components is important in the study of nervous systems.Common examples of neurotoxins include lead, ethanol (drinking alcohol), manganese glutamate, nitric oxide, botulinum toxin (e.g. Botox), tetanus toxin, and tetrodotoxin. Some substances such as nitric oxide and glutamate are in fact essential for proper function of the body and only exert neurotoxic effects at excessive concentrations. (Source).
What are the Risks of Neurotoxins
According to MedicalNews.net, “Depending on a neurotoxin’s chemical profile, it will cause damage to certain parts or particular cellular elements of the nervous system. Non-polar substances are more soluble in lipids and can therefore access the nervous tissue more easily than polar compounds, which are less soluble in lipids. The body’s response to neurotoxins is influenced by factors such as the neurotransmitter affected, cellular membrane integrity and the presence of detoxifying mechanisms.” This sounds very scary, and it can be. The following is a definition of what this can mean:
Neurotoxins inhibit neuron control over ion concentrations across the cell membrane,or communication between neurons across a synapse. Local pathology of neurotoxin exposure often includes neuron excitotoxicity or apoptosis but can also include glial cell damage. Macroscopic manifestations of neurotoxin exposure can include widespread central nervous system damage such as intellectual disability, persistent memory impairments, epilepsy, and dementia. Additionally, neurotoxin-mediated peripheral nervous system damage such as neuropathy or myopathy is common. Support has been shown for a number of treatments aimed at attenuating neurotoxin-mediated injury, such as antioxidant and antitoxin] administration. (Source).
As pointed out in an article published by the National Institutes of Health, “More serious complications are associated with higher doses, improper injection techniques, and occur in patients with underlying comorbidities.”
So now that we have addressed the risks and concerns, we should turn our attention to why and how we use neurotoxins for the betterment of the aesthetic and cosmetic sciences.
Safe Uses for Neurotoxins
The most well known and used neurotoxin in our field is botulism. While many people know this best by the brand name Botox, there is so much more to it than that. As noted by the National Institutes of Health:
Clostridium botulinum is a Gram-positive bacterium first identified more than 100 years ago. It produces a neurotoxin that has been studied extensively since its discovery. Today, seven antigenically different serotypes have been identified, two of which are used clinically: serotypes A and B. Serotype A (BTX-A) appears to be the most potent subtype among them.
In 1980, Scott published the landmark paper describing the clinical use of botulinum toxin type A for the treatment of strabismus. In 1987, Carruthers and Carruthers noticed that patients treated with botulinum toxin for blepharospasm experienced improvement in glabellar lines.Since then, BTX-A has been approved by the United States Food and Drug Administration (FDA) for a variety of cosmetic and non cosmetic applications, including strabismus, blepharospasm, cervical dystonia, hyperhidrosis, glabellar rhytides, and, most recently, urinary incontinence from detrusor overactivity.
Botulinum toxin’s most common cosmetic application is in the treatment of upper facial rhytides and dynamic lines, namely glabellar lines, horizontal forehead wrinkles, and crow’s feet. In the lower face, the use of botulinum toxin was initially controversial because results were considered unpredictable. While the demarcation between the upper and lower face is somewhat arbitrary, the utility of botulinum toxin in the lower face is becoming increasingly apparent. However, the medical literature on the use of botulinum toxin in the lower face and neck is sparse with most publications limited to clinician experiences only.
And, while long-term effects of botulinum toxin can have some consequences, this neurotoxin has, without question, made an extraordinary impact on our field – helping people find, recapture, and hold on to youth. The long-term consequences, it turns out are not only negative – there are some positive as well. For instance, your face learns to not frown and your skin will inevitably look younger and brighter than if you had never used it.
