PHILIPPE ABIMELEC M.D
DERMATOLOGIST
Former Consultant at Saint-Louis Hospital
Hair and Nail Specialist
Fellow of the American Academy of Dermatology
129 rue Caulaincourt 75018 Paris
Phone: 00 33 (0)1 42 64 83 15 - Fax: 00 33(0)1 42 64 31 09
email: dermatologue@orange.fr

The Botulinum Toxin is produced by bacteria (Clostridum botulinum). It is a neurotoxin (a toxin blocking nervous conduction) causing (in very large quantities) a disease called botulism. Botulism is caused by the ingestion of rotten food where the proliferation of the bacteria has led to the formation of botulinum toxin in great quantities.

There are several types of Botulinum toxins (A, B, C, E, F).The Botulinum Toxin used in dermatology is the Type A Botulinum or BTX-A. Botulinum Toxin of type A is marketed under the names of Botox®, Botox-Cosmetic (USA) and Vistabel® (Europe) by Allergan Laboratories and under the name of Dysport® by the Ipsen-Biotech Laboratory. Botox® and Dysport® are the specialities used in medical indications (ophthalmology, neurology, and otorhinolaryngology). Vistabel® and Botox-Cosmetic are the specialities of the Allergan laboratory which obtained the marketing authorization (A.M.M and FDA approvals) for wrinkle correction but their action is exactly identical to that of Botox®.

The Botulinum Toxin blocks the nerve impulse between the nerve and the muscle. In fact, the nerve fabricates and carries a chemical substance (acetylcholine) which makes it possible for the muscle to contract. The Botulinum Toxin prevents release of acetylcholine and, thus, muscle contraction.

The medical potential of Botulinum Toxin was first identified by Scott in the 1980's for the treatment of strabismus. The utility of Botulinum Toxin was then demonstrated in ophthalmology to treat blepharospasm and nystagmus and in neurology for spasmodic torticollis. It started being used in dermatology in the 1990's to treat frown lines. Botox® is now recognized as an effective and safe treatment of so called expression lines (frown lines, Crow's feet and face lines) and excess perspiration or hyperhidrosis.