Botulinum is commonly used by doctors to reduce the appearance of wrinkles.

Wrinkles in the skin are caused by regular folding and ruffling which eventually leaves resting creases in the skin. This ruffling is due to the muscles below the skin shortening/contracting.

The idea behind Botulinum is that if you prevent these muscles shortening this prevents the skin ruffling and the creases relax out like a shirt hung on the line and the skin becomes smooth.

After a few treatments the body gets used to not moving those muscles so much and you need less and less Botulinum to maintain the effects of smooth skin.

So how does it relax the muscles? Muscles shorten when they receive a signal from a motor nerve. The connection between the nerve and the muscle is called the neuromuscular junction. A transmitter called acetylcholine is released from the end of the nerve and travels across the gap and binds to receptors on muscle which leads to the signal being transferred.

Botulinum prevents the release of this transmitter from the nerve. The transmitter is stored in containers in the nerve called vesicles, these containers are released with the help of proteins called SNARE proteins which are a bit like tug boats pulling the containers out of port to sea. Botox inactivates the SNARE proteins particularly SNAP-25. This means the transmitter cannot be released and the muscle cannot shorten.

These effects last for about 3months as it takes this amount of time for the SNARE proteins to regenerate and the muscle strength returns to normal.

Dr Steve Young
Aesthetic Practitioner and Anaesthetist
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