Did You Know?

Did you know that Dr. Miller is a certified skin expert for Answers.com? With more than 17 years of experience in the dermatology field, Dr. Miller has the answer to all your skincare questions, from how your diet affects acne to treatment options for actinic keratosis.

Read on for a sample question and Dr. Miller’s answer, or click here to view the full article on Answers.com.

Question: How does Botox work?

Answer: Botox and the other neurotoxins, Xeomin and Dysport, have become one of the most commonly performed cosmetic procedures in the United States. All three of these products are slightly different forms of the botulinum toxin. What makes them so effective to remove wrinkles?

How Are Wrinkles Formed?

Some wrinkles on the face are formed by repetitive movement of the skin to the point of forming a crease. Similar to folding a piece of paper over and over again, a crease forms in the skin eventually becoming permanently visible. The so-called "11's" of the forehead are formed in this way as are the wrinkles known as the "crow's feet" or "laugh lines". Other wrinkles are formed as a result of a loss of fat under the skin due to aging. These are the so-called "parentheses" and "marionette lines" on the lower face. They are not due to a repetitive movement of the skin.

What Does Botox Do?

Wrinkles caused by the repetitive movement of the skin are the wrinkles that Botox and the other neurotoxins Xeomin and Dysport can improve. When we make facial expressions, our nerves send a chemical signal to the muscles of facial expression telling those muscles to contract, or move. These muscles are attached to the skin and therefore those muscles will move the skin in a characteristic fashion, making a smile, frown or expression of surprise. These muscles have a receptor on them that accepts the signal that the nerves send out. When the signal from the nerve attaches to the muscle receptor, the muscles will contract. That chemical signal degrades within seconds so that the muscle doesn't continue to contract. The Botox, Xeomin and Dysport molecules look like the chemical signal from the nerves that tells the muscles to contract, and attaches to the muscle receptor. However, the neurotoxins do not make the muscle contract. Unlike the chemical signal that does signal the muscle to contract, the neurotoxins take months to degrade instead of seconds. Therefore, Botox, Xeomin and Dysport occupy the receptor on the muscle for several months so that the chemical signal that is still being sent out by the nerves, cannot attach to the muscle receptor telling the muscle to contract. This temporarily paralyses the muscles of facial expression so that the wrinkles called the "11's", or "crows feet" are not formed. After a several weeks of inactivity, any permanent crease or wrinkle formed by movement of the skin will efface since the skin renews itself.