All You Need to Know About Botox

Perhaps you have been considering Botox for some time and would like to know if it's safe, what the benefits are and how much it costs. More importantly, is it right for you? These are questions more than 7 million Americans who received Botox in 2017 had. The truth is that the effects of Botox can be very subtle.A  dermatologist says “My patients know they’re going to leave with a natural look." 

A good dermatologist takes the time to see how your face moves—and injects accordingly. In fact, the Dr. says “I’m observing the way you speak, laugh, frown—we go through all your emotions, so I know which muscles to inject and how much. And you should never feel pressured to get more than you’re comfortable with.” Another dermatologist confirms: “Over-treatment and improper placement are the two biggest causes of ‘bad Botox.’”
Of course, it is recommended that you start slow. A great place to start is to see an experienced dermatologist. But, if this is your first time you're considering Botox, you likely have more questions. So, before your first appointment, read on for everything you should know:
What is Botox? 
Botox is made from a protein called botulinum toxin which freezes your muscles. Dr. says “In simple terms, Botox binds to the receptors on the muscles, so that they don’t receive the signal to contract.” And as Dr.  puts it, “Botox essentially acts as a mute button between the nerve and muscle.”
This so-called mute button means you won't be able to make the movements associated with wrinkles between your eyebrows, crow's feet, and forehead lines. These three areas for cosmetic treatment are approved by the FDA. Dr. says “Botox won’t help with static wrinkles, the wrinkles that are there when you aren’t making an expression. The goal is to prevent dynamic wrinkles from becoming permanent static wrinkles.”
What are the benefits of Botox beyond reducing wrinkles?
Botox is also used to treat non-cosmetic issues like excessive sweating or eyelid twitching. Dr. says “Botox blocks the signal of the nerve telling the sweat gland to secrete sweat and relaxes the muscles around the eyes to help with twitching eyelids.”
But how did doctors come about this knowledge? Dr. notes that they did so through therapeutic observations. In addition to this, the muscle-relaxing effects also help to treat chronic migraines, overactive bladder, strabismus (crossed eyes), and maybe also depression. In fact, treatments that prevent frowning correlate with reduced negative mood, according to a study published.
Is Botox expensive, and how long does it last?
Prices vary depending on your provider. A Dr. charges patients around $150-$400 per area, such as the forehead, or around the eyes. As for what you can claim from your insurance? Botox isn't typically covered for cosmetic procedures. 
Once you've had your Botox procedure, it usually takes about five to 14 days to fully activate, and the results last anywhere from three to four months. 
Does Botox hurt?
Botox is an injection, so expect to feel a few quick pricks. If you really can't stand needles, ask your dermatologist to use numbing cream. Overall, the process is short and sweet and you can move on with your day, with just a little, mild redness. 

Is Botox safe? What are the side effects?

According to the FDA, there is a chance that the toxin can move beyond the site of injection, causing muscle weakness, double vision, urinary incontinence, and even difficulty breathing, swallowing or speaking. If any of these symptoms occur, seek medical attention ASAP, particularly in relation to swallowing and breathing difficulties which can be life-threatening. 
Still, severe side effects have never been definitively linked to dermatological use, where the doses are low. According to research conducted in this area, research shows adverse effects are more likely in therapeutic cases, where doses are much higher, and other diseases are also at play. 
According to Dr., “Botox is safe and efficacious as long as you’re in the hands of someone who’s licensed and trained.” Of course, as with any other drug, side effects are possible, albeit minor ones. Dr. says “Side effects are uncommon but include a headache, bruising, and a drooping brow or eyelid.” So, if you're one of the few people stuck with one of the latter, according to Dr., your doctor can prescribe eye drops to stimulate the eyelid muscle and raise the lid. “Or, if the brow is drooped, you can inject Botox into the muscles that pull the brow down to get some brow elevation.” This is a rare occurrence, but to be on the safe side, you can reduce your risk by seeing an experienced provider. 
So, the bottom line is that Botox is a popular treatment that comes with limited side effects when performed by an experienced dermatologist. It is not a painful treatment, and in total lasts for up to four months, however, in terms of cosmetic purposes, it is pricey.

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Botox jabs effective, safe in reducing chronic migraine

Besides removing those wrinkles and enhancing your beauty, botox has also been proven to be effective and safe in treating chronic migraine that affects your daily activities, says a new study.

Chronic migraine is defined as at least 15 headache attacks per month for more than three months, with migraine symptoms on at least eight days every month.

The study showed that botox or botulinum toxin injections is superior to inactive placebo for preventive treatment of migraine and that it significantly reduced the frequency of chronic migraine attacks.

Botox prevents migraine headaches before they start, but takes time to work. It is injected around the pain fibres involved in the production of headaches. 

"Botulinum toxin is a safe and well-tolerated treatment that should be proposed to patients with migraine," said the researchers.

For the study, the team included nearly 3,650 patients, among which 1,550 had chronic migraine. The remaining patients had less-frequent episodic migraine headaches.

The results found that three months after injection, patients treated with botulinum toxin had an average of 1.6 fewer migraine attacks per month, compared to those treated with inactive placebo.

The improvement was apparent within two months of botulinum toxin treatment. They are repeatedly injected every three months to sustain the effects of treatment.

Although botulinum toxin had a higher rate of adverse effects compared to placebo, but none of these were serious.

Importantly, there was a significant improvement in quality of life in patients treated with botulinum toxin which was directly linked to a reduction in depressive symptoms. 

"It can be explained by the reduced impact of headaches and migraine-related disability, thus reducing symptoms of depression and anxiety," said a Professor.

Although botulinum toxin injection for chronic migraine is  government approved, there are still conflicting data regarding its effectiveness, the study said.

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There's a Link Between Chronic Migraines And This Common Jaw Disorder

People who get chronic migraines might not think there's anything worse than the debilitating attacks – but it turns out that many of the afflicted could be experiencing a double whammy.

New research has found a link between chronic migraines and a common jaw condition called temporomandibular disorder (TMD), and scientists think the disorder could increase the severity and frequency of migraine attacks.

"Our study shows that patients with chronic migraine, meaning attacks occurring on more than 15 days per month, are three times as likely to report more severe symptoms of TMD than patients with episodic migraine,"  says one of the researchers.

The temporomandibular joint  connects the jaw to the skull on either side of the face, and up to 30 % of the adult population are thought to experience some degree of pain related to the joint's movement and function, collectively called TMD.

Symptoms falling under the TMD umbrella include joint pain, reduced jaw movement, clicking or popping of the joint, and also muscle pain and fatigue, extending as far as the neck.

While TMD is thought to be primarily related to stress and muscle overload, researchers have also previously looked at associations between the temporomandibular joint and migraines.

Now, for the first time, the team have investigated the link between TMD and chronic migraines.

As opposed to patients who get episodic migraines (occurring less than 15 times monthly), chronic migraineurs experience attacks at least every other day over a three-month period.
 
The researchers studied 84 women in their early to mid-thirties – 21 being chronic migraine patients, 31 experiencing episodic migraines, and 32 with no history of migraine.

Among the cohort, TMD symptoms were observed in just over half (54 percent) of the control participants, but in episodic and chronic migraineurs, this figure jumped to 80 percent and 100 percent respectively.

According to the team, the ties between migraines and TMD could relate to nerve endings called nociceptors that process pain in response to dangerous or noxious stimuli.

"The repetition of migraine attacks may increase sensitivity to pain," leader explains.

"On the other hand, TMD can be considered a potential perpetuating factor for migraine because it acts as a constant nociceptive input that contributes to maintaining central sensitisation and abnormal pain processes."

But while migraine patients are more likely to have signs and symptoms of TMD – at least, going off this study's relatively small Brazil-based sample, that is – the TMD condition itself doesn't seem to predict who gets migraines, but the team thinks it may increase the frequency and severity of attacks.

"We do know migraine isn't caused by TMD," researcher says.

"Migraine is a neurological disease with multifactorial causes, whereas TMD, like cervicalgia – neck pain – and other musculoskeletal disorders, is a series of factors that intensify the sensitivity of migraine sufferers."

To fully understand the causal mechanism at play here will fall to future research, but for now, the researchers say their work will help clinicians treat patients with migraines, in terms of looking out for any signs of TMD that could worsen their migraine pain.

In the meantime, if you're one of those affected by these terrible attacks, scientists say you may want to take a look at your diet: and we really hope you don't like chocolate or wine.

We may not have all the answers on how to beat migraines just yet, but there's lot of simple things you can try. 

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Chronic migraine cases are amplified by jawbone disorder

In a new study, a group of researchers have found that the more frequent the migraine attacks, the more severe will be the so-called temporomandibular disorder. 

The temporomandibular joint acts like a sliding hinge connecting the jawbone to the skull, therefore the disorder's symptoms includes difficulty chewing and joint tension.

The first author of the study said, “Our study shows that patients with chronic migraine, meaning attacks occurring on more than 15 days per month, are three times as likely to report more severe symptoms of TMD than patients with episodic migraine.” 

Previous studies already indicated that migraine is somehow associated with pain in the chewing muscles. 

However, this research was the first to consider the frequency of migraine attacks when analyzing its connection with TMD: eighty-four women in their early to mid-thirties were assessed, being that 21 were chronic migraine patients, 32 had episodic migraine, while 32 with no history of migraine were included as controls. 

Signs and symptoms of TMD were observed in 54 percent of the control participants without migraine, 80 percent of participants with episodic migraine, and 100 percent of those with chronic migraine.

For researcher, central sensitization may explain the association between the frequency of migraine attacks and the severity of TMD.

Researcher noted, “The repetition of migraine attacks may increase sensitivity to pain. Our hypothesis is that migraine acts as a factor that predisposes patients to TMD. On the other hand, TMD can be considered a potential perpetuating factor for migraine because it acts as a constant nociceptive input that contributes to maintaining central sensitization and abnormal pain processes.” 

Nociceptive pain is caused by a painful stimulus on special nerve endings called nociceptors.

Migraine and TMD have very similar pathological mechanisms. Migraine affects 15 percent of the general population, and progression to the chronic form is expected in about 2.5 percent of migraine sufferers. 

On the other hand TMD is stress-related as much as it has to do with muscle overload. Patients display joint symptoms -- such as joint pain, reduced jaw movement, clicking or popping of the temporomandibular joint, but also develop a muscular condition, including muscle pain and fatigue, and/or radiating face and neck pain.

TMD and migraine are comorbidities. However, while people who suffer from migraine are predisposed to have TMD, people with TMD will not necessarily have migraine.

“Migraine patients are more likely to have signs and symptoms of TMD, but the reverse is not true. There are cases of patients with severe TMD who don't present with migraine,” shared the lead researcher for the study and principal investigator for the Project.

The researchers believe that TMD may increase the frequency and severity of migraine attacks, even though it does not directly cause migraine.

“We do know migraine isn't caused by TMD. Migraine is a neurological disease with multifactorial causes, whereas TMD, like cervicalgia -- neck pain -- and other musculoskeletal disorders, is a series of factors that intensify the sensitivity of migraine sufferers. Having TMD may worsen one's migraine attacks in terms of both severity and frequency,” noted author. 

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