Who shouldn’t get Botox®?

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While Botox® has proven to be a safe and useful drug for both cosmetic and non-cosmetic uses, as with all drugs, there are a few conditions in which Botox® should not be used, or used with caution.  A few of the more common ones include:

  1. Pregnancy and breastfeeding: the reason for this being a contraindication is more due to inadequate study of the outcomes of using Botox® in pregnancy and breastfeeding, rather than that there have been any cases of fetal deformity or abnormality that have been linked to Botox® use in pregnancy.  Having said that, this DOES NOT mean it is safe to use Botox® in pregnancy and almost all aesthetic practitioners will advise you to wait until you have delivered and finished breastfeeding to continue your Botox® treatments.  The good news is that during pregnancy women retain more water than they ordinarily do, and so many wrinkles and fine lines appear softened during pregnancy!  That combined with your glowing pregnancy skin should be enough to tide you over until it is safe to have Botox® again.  We also think that being able to frown may be essential in communicating with the father of your child during your pregnancy, so maybe laying off the Botox® will help get your points across too!
  1. Allergy or hypersensitivity: If you have had Botox® in the past and at the time of injection experienced symptoms of allergy or hypersensitivity you should approach Botox® treatments with caution.  Having a full blown anaphylactic attack is an absolute contraindication to ever even considering using Botox® again (anaphylaxis is an extreme allergic reaction causing swelling of the airway and requiring resuscitation).  Hypersensitivity such as extreme swelling and redness (soft tissue oedema), an itchy rash or hives (urticaria) and shortness of breath (dyspnoea) are also reasons to avoid Botox®.  Many of these reactions are thought to be due to the stabilising agents and preservatives contained within the Botox® preparation and not to the toxin itself, however these kinds of reactions can be life-threatening and should be treated seriously.
  1. Infection at the injection site: This essentially means that your doctor should not inject into a pimple, pustule or abscess, and that if the skin in the area of intended injection looks red, swollen or suspicious it would be prudent to delay the injections by a few days or a week until the infection has cleared. In many cases your doctor can place the injection slightly differently so that it will still target the correct muscle but will avoid the potential risks of injecting into a pimple, however if the infection is more widespread your doctor may prescribe some antibiotics and ask you to return once you have completed the course for your Botox®.  The reason for this contraindication is that passing a needle through infected tissue into non-infected tissue has the risk of spreading the infection into deeper tissues causing extensive damage.  Another point to consider in such cases is that if your Botox® is injected into a pocket of infection it may have no effect at all and will simply drain as the infection drains.
  1. Neuromuscular disorders: Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junctional disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) should be monitored particularly closely when given Botox®. These patients (and if you have never heard of these diseases it is highly unlikely that you suffer from one of them) may be at increased risk of having severe difficulty swallowing or breathing even from the low doses of Botox® typically used in cosmetic injections.

When you visit your doctor for Botox® you will note that they usually ask you to fill in an extensive medical history form that you may find daunting or unnecessary.  The reasons for this are more for the doctor’s knowledge and safety in the event of an unrelated incident.  For example if you are diabetic and you collapse in your doctor’s office prior to the administration of your Botox® it is important that your doctor knows about your diabetes so that he or she can check your sugar and give you appropriate treatment, and the same goes for heart disease or asthma or a whole host of other diseases.  Likewise your doctor needs to know what medication you take because blood thinning medications increase your chances of bruising after an injection, and muscle relaxants may react with your Botox® causing excessive weakness.

When using or considering Botox® it is important that you feel that the lines of communication with your doctor are open, and that you have asked your doctor to explain any questions you may have surrounding your treatment.  Most importantly you need to understand that all doctors are obliged to exercise confidentiality in all aspects of your treatment meaning that they cannot discuss your treatment and medical history (or share your before and after photos unless you have signed consent for them to do so) with anyone unless it is in a professional capacity.  What this means is that if you are dishonest with your doctor the only person you are potentially harming is yourself.

If you would like to know more about Botox give us a call on (021) 6833048 or send us an email on capetownaesthetics@gmail.com


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