How does Botox work?

Many people are curious about: How does Botox work? Botox works by blocking the signal between nerves and the underlying muscles, causing the muscles to temporarily relax. This prevents the skin from contracting and reduces wrinkles such as frown lines or crow's feet. The treatment consists of small, virtually painless injections in specific areas. The effect begins after a few days and lasts an average of 3-5 months.

How does Botox work?

In 2025, more than 600,000 Botox treatments will be performed in the UK. It's therefore a very popular treatment.

Botox is a brand name for botulinum toxin. Other well-known brands include Azzalure and Bocouture. Botulinum toxin is injected with a small prick and works very locally. Because the botulinum toxin penetrates the nerve cells locally, the signal from the nerve to the muscle is blocked. This prevents muscle contraction and prevents, for example, the frown line from tightening. The connection between the nerve and the muscle is made by SNARE proteins. These SNARE proteins form the synapse (contact point) between the nerve and muscle cells. Essentially, these SNAREs are destroyed, preventing the signal from being transmitted. The SNAREs are replaced by new SNARE proteins by the body in about 12 weeks. Therefore, a botulinum toxin treatment is effective for approximately 3-4 months. So, when the nerves near your frown lines receive a signal to frown, the signal is not transmitted to your frown muscles.

Generally, doctors and clinics divide cosmetic botulinum toxin wrinkle treatments into three zones: frown lines, crow's feet, and forehead lines. These are so-called "mimic lines." Wrinkles that become active when you use your facial expressions.

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Inventor of botulinum toxin

Alan B. Scott is the American ophthalmologist who first experimented with botulinum toxin in the 1970s. He was looking for a nonsurgical solution for patients with strabismus and blepharospasm (irregular contraction of the eyelids).

He figured that injecting botulinum toxin into a muscle would relax it. And it worked! Since then, clinical research has been conducted on the mechanism of action and safety profile of botulinum toxin. More than 35 indications are now treated with botulinum toxin in the medical world. From uncontrollable bladder to strabismus, from dystonia (spasms) to migraines, and from excessive sweating (hyperhidrosis) to wrinkle treatments, botulinum toxin is considered the effective treatment method. Botulinum toxin has now been used in medicine for over 40 years.

Muscles involved in frown line treatment

To activate frown lines, three muscles are involved. This requires at least a few injection points.

The Corrugator Supercilii is responsible for the vertical frown lines between the eyebrows. These are often the most bothersome lines, as they can make you look angry. Usually, the Procerus muscle is also treated. This is the large, fan-shaped muscle between the eyebrows. It causes horizontal lines in the frown area and can also pull down the medial (inner) part of the eyebrows.

For treating frown lines, the Depressor Supercilii muscles are also relevant. Some doctors consider these muscles to be part of the Procerus. This muscle pulls the eyebrow down medially (toward the center of the face) and supports the Procerus in forming the horizontal frown lines. Sometimes, it’s necessary to compensate for or lift the eyebrows slightly. In that case, the Orbicularis Oculi is treated under the eyebrow at the lateral side (outer part of the face).

To treat frown lines, the recommended dosage is 20–30 units when using Botox or Bocouture. One vial contains 100 units, which must be diluted with 2 ML of saline solution (NaCl). Azzalure, however, has a treatment guideline of 50 Speywood units for frown lines, since it uses a different unit calculation method.

All in all, it is a precise procedure, highly dependent on the severity of the client’s frown lines. Ultimately, the doctor’s skill often determines the treatment result.

Crow's feet muscles

For crow's feet, the orbicularis oculi muscle is treated. This is often done with a few injections on the side and diagonally below the eye. Pharmaceutical companies Allergan (botulinum toxin brand Botox) and Merz (botulinum toxin Bocouture) recommend approximately 12 units per side, and pharmaceutical company Galderma (botulinum toxin Azzalure) recommends 20-30 units. Here too, the recommended number of units depends on the strength of the muscles causing the crow's feet.

Forehead wrinkle muscles

The last of the three zones/regions is forehead wrinkles. The muscle treated for this is the frontalis muscle. Multiple injections are often strategically distributed throughout the muscle to prevent contraction in the right areas. Galderma recommends 40-60 units of Azzalure distributed over the frontalis muscle. Allergan and Merz recommend approximately 20 units of their respective botulinum toxin brands, Botox and Bocouture.

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Muscle cosmetic botulinum toxin treatment per zone

Our muscles form a complex system. Most clinics use the well-known 3-zone division for cosmetic botulinum toxin treatments. This distinguishes between horizontal forehead lines, frown lines (including brow lift), and crow's feet. There is a fixed price for one zone, a fixed price for two zones, and a fixed price for three zones. Read all about Botox pricing here.

Click here to read all about the different brands of botulinum toxin. And click here to read all about the recommended dosage of botulinum toxin per zone or region.

The information on Injectablesbooking.co.uk has been compiled with care. Injectablesbooking.co.uk is not liable for any information that proves to be incorrect. The goal is to provide everyone with transparent information about injectables. This allows you to easily and safely search, compare, and book your next Botox or filler treatment on Injectablesbooking.co.uk.

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