Anti-aging facial with Botulinum Toxin A –
What is Botulinum toxin A?
Botulinum toxin (BoNT) is a biological product, a toxin, or toxin extracted from a bacterium called botulinum toxin. Clostridium Botulinum There are seven different serotypes, with type A being the strain that produces the largest molecular size Neurotoxin.1-3 and works well Therefore, it is more commonly used in medicine than other species.
Botulinum toxin production methods vary by brand, depending on the bacterial strain used by each manufacturer.4 Including the production process of each manufacturer is different. As a result, the efficiency, safety, and action of each brand are different. therefore, the active dosages for therapeutic use cannot be compared. Therefore, the amount of anti-aging agents of each brand is recommended to be used in different dosages.
use Botulinum toxin type A to reducethiswrinkles on the face
The use of Botulinum toxin type A (BoNT/A) for cosmetic purposes is injection. Intramuscular injection is injected into a muscle that is too contracted. It is the most commonly used injection in clinical practice. It is used to treat crow’s feet, between the eyebrows, and the forehead. The dosage depends on the number of wrinkles and the severity of the muscle spasms. The drug will begin to work within 2-7 days.5 Dates vary by brand.
resistance BoNT / A
Because BoNT/A is a neurotoxin protein, which is a complex protein. It is obtained by extracting proteins from bacteria. which if in the production process cannot remove all contaminants Once it enters the body, it can stimulate the immune system to produce antibodies. May cause drug resistance In some people, it may trigger an immune response to BoNT/A, thereby reducing the response to the drug’s action.
The cause of this BoNT/A immunity depends on heredity. It also depends on the manufacture and formulation of BoNT/A. Therefore, the prevention of BoNT/A resistance depends on the choice of brand of drug.6-9
Causes of BoNT/A resistance10
- Use drugs that have a non-standard manufacturing process.
- Injecting too many doses at a time or injection too often
- each person’s genetics
- Injected by an inexperienced doctor or the injection is wrong, requiring more frequent injections.
Things to know before injecting
Before deciding to inject BoNT/A, the most important thing is Make sure that the medication you are injecting is of the highest quality. It has been in use for a long time. And it meets the standards of drug safety agencies both nationally and internationally, such as the United States Food and Drug Administration (USFDA) and the European Medicines Agency EMA.
2-3 days before BoNT/A injection should refrain from scrubbing and scrubbing the face. to reduce the risk of bruising irritation and reduce the side effects that will follow It’s also a good idea to stop taking vitamin A acids that cause sensitive skin. and stop NSAIDs and fish oil painkillers for 1 week and if pregnant Injections are not recommended.11
Q When should I start injections?
A Can be injected when wrinkles begin Should not wait for long wrinkles to form a permanent deep groove.
Q If I stop injecting, will the wrinkles come back more than before?
A Wrinkles will gradually return according to the condition of the patient.
Q If injecting often, will there really be drug resistance?
A Actually, the injection period should be at least 3 months.4 And choose quality products because the poor quality BoNT/A may contain contaminants. This will stimulate the immune system more easily.
Q What is the difference between BoNT/A from each country? Which brand should I choose?
A different in the selected bacterial species and different production processes Therefore, choose a reliable country of origin. It is a long-established brand due to more scientific evidence of long-term safety. Thailand has both legal and illegal imports of BoNT/A. Many are sold on the internet. Some are counterfeit drugs. Until causing a disadvantage to the patient so much that there is life. It is therefore very important to choose a reliable product. both in terms of safety and efficacy including later drug resistance
Q How should I choose a doctor who injects?
A In addition to choosing a reliable drug brand. Choosing a doctor is also very important. Should be a doctor with knowledge, expertise and experience. To avoid unwanted side effects such as drooping upper eyelid, double vision strabismus, distorted mouth, and even breathing stops. and die12, 13
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2. Sakaguchi G, Ohishi I, Kozai S, Purification and oral toxicities of Clostridium botulinum progenitor toxins. In: Lewis GEJ, ed. biomedical Aspects of Botulism. New York; Academic Press, 1981;64:1589-94.
3. Inoue K, Fujinaga Y, Watanabe T, et al. Molecular composition of Clostridium botulinum type A progenitor toxins. Infect Immun 1996;64:1589-94.
4. Product information. Allergan Ltd. Revised 03/2020.
5. Brashear A, Watts MW, Marchetti A, et al. Duration of effect of Botulinum toxin type A in adult patients with cervical dystonia: a retrospective chart review. Clin Ther 2000;22: 1516-24.
6. Brin MF, Comella CL, Jankovic J, et al. Long-term treatment with Botulinum toxin type A in cervical dystonia has low immunogenicity by mouse protection assay. Mov Disord 2008;23: 1353-60.
7. Yablon SA, Brashear A, Gordon MF, et al. Formation of neutralizing antibodies in patients receiving Botulinum toxin type A for treatment of post-stroke spasticity: a pooled-data analysis of three clinical trials. Clin Ther 2007; 29:683-90
8. Zuber M, Sebald M, Bathien N, et al. Botulinum antibodies in dystonic patients treated with Botulinum toxin type A: frequency and significance. Neurology 1993; 43: 1715-8.
9. Myobloc® Prescribing information. Solstice Neurosciences, Inc. South San Francisco, CA, 2004.
10. Bangkok Biz News 2021, ‘Bo…be safe’, drug-resistant, beautiful, not risky-handsome, not fooled, accessed 25 August 2021,
11. Faculty of Medicine Siriraj Hospital 2013, good or bad when using “Botox”, accessed 25 August 2021,
12. Cote TR, Mohan AK, Polder JA, Walton MK, Bruan MM. Botulinum toxin type A injection: adverse events reported to the US Food and Drug Administration in therapeutic and cosmetic cases. JAAD 2005;53:407-15.
13. Gershon SK, Wise RP, Bruan MM. Adverse events reported with cosmetic use of Botulinum toxin A. Pharmacoepidemiol Drug Safety 2001;10(Suppl):S135-6.
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