Wednesday, May 29, 2019

The Medical Uses of Botox

The Medical Uses of Botox

Botox may be best known for its cosmetic applications, but there are actually quite a few ways Botox can be used to treat both moderate and severe medical conditions. Doctors have only just begun to scratch the surface of what Botox is capable of treating, and patients are benefiting from these discoveries.

So what are the medical uses of Botox? Botox has been found to treat a number of conditions related to muscular and nerve issues, such as Bell’s Palsy, enlarged prostate, gastroparesis, excessive sweating, teeth grinding, rosacea, migraine headaches, eye disorders, depression, and more.

What is Botox?

Botox, scientifically known as botulinum toxin A, is a neurotoxin derived from the bacterium Clostridium botulinum. This neurotoxin and its deadly effects were first observed in the early 19th century, and scientists have since isolated the neurotoxin and its paralysis-inducing properties for both cosmetic and medical applications.

Botox is primarily used to paralyze muscles and nerves in the body by blocking the neurotransmitters coming from the brain. This paralysis can lead to serious consequences when misused, but doctors continue to discover an increasing number of ways it can help patients with various conditions.

The Medical Benefits of Botox

The first medical application of botulinum toxin A was created to treat strabismus, or crossed eyes condition, with a non-invasive and painless treatment. It would only be nearly two decades later when doctors would begin using Botox for cosmetic treatments.

The cosmetic application of the neurotoxin was only observed after successful trials on monkeys and later people with strabismus. Researchers noticed that the injections also led to fewer lines in the glabella, or the area between the eyes.

While the cosmetic market for Botox has exploded since the 90s, doctors have also experimented with its important role in various muscular and nerve conditions. As of today, Botox can help treat:

  • Bell’s Palsy
  • Enlarged prostate
  • Gastroparesis
  • Excessive sweating (Hyperhidrosis)
  • Teeth grinding (Bruxism)
  • Rosacea
  • Muscle spasticity
  • Urinary incontinence (Overactive bladder)
  • Migraine headaches
  • Depression
  • Chronic neck pain
  • Cerebral palsy
  • Cervical dystonia
  • Eye disorders

How Is Botox Applied?

Unlike cosmetic applications of Botox, patients who receive Botox as a medical treatment are usually recommended to the treatment by their general doctor. This treatment is generally done in a doctor’s office or medical clinic.

During the session, the doctor injects the necessary amount of Botox into the muscle tissue. Patients should feel little to no pain; this depends on the area of the injection site, their general pain threshold, and whether any topical anesthetic is applied to the skin.

While there will be some immediate results after the injection, it typically takes 2-3 days before the full effects of the treatment can be observed. The body needs time to fully absorb the Botox as it blocks the signals between the nerves and the muscles.

Possible Botox Side Effects

While certain Botox treatments may have more specific side effects, there are a few possible low-pain side effects with Botox. These may potentially include:

  • Muscle soreness
  • Headache
  • Dizziness
  • Fever
  • Nausea

These side effects are generally short-lived and should disappear a few hours after the treatment.

Medical Conditions Botox Can Treat

Condition What Is It Causes How Does Botox Help Average Units Required
Bell’s Palsy Facial muscle weakness Unknown Relaxes automatic facial muscle movements 10-80 units
Enlarged prostate Difficulty urinating due to blocked urethra Growth of prostate cells in urethra Kills prostate cell growth 100 – 200, depending on prostate size
Gastroparesis Inability to empty stomach of food Various causes Relaxes ring of muscles in the stomach 200 units
Hyperhidrosis Excessive sweating Overactive nerves Paralyzes the nerves responsible for sweating 50 units
Teeth grinding Chewing and grinding teeth while asleep Stress, anxiety, and other various causes Relaxes the jaw chewing muscles 20 units
Rosacea Facial flushing and reddening Genetics and environmental stimuli Numbs the blood vessels responsible for facial flushing 100 units
Muscle spasticity Involuntary and sudden muscle movement Imbalance of neurotransmitters Relaxes the muscles, easing muscle stiffness 300-400 units
Urinary incontinence Overactive bladder, loss of bladder control A side effect of various conditions leading to loss of bladder control Paralyzes the bladder muscle, preventing involuntary contraction 100-300 units
Migraine headaches Throbbing or pulsing headache that can last for days Various genetic and environmental factors Paralyzes the nerve endings leading to pain in the head 155 units
Depression Serious psychological and medical condition involving negative feelings and loss of interest Chemical imbalance in the brain Erases glabellar lines, leading to more positive disposition and behavior 29-39 units
Chronic neck pain Long-term pain or discomfort in the neck Strains, sprains, and musculoskeletal conditions of the spine Relaxes chronically contracted neck and spine muscles 100 units
Cerebral palsy Difficulties with body movements, postures, and muscle control Brain damage before or soon after birth Relaxes stiff muscles, giving the patient greater control 30 units/kg
Cervical dystonia Involuntary neck contractions Unknown, common amongst women in their 30s Paralyzes the nerves in the neck that lead to involuntary muscle movement 200 units
Eye disorders Spasms and involuntary movements of the eyes, such as crossed eyes One or more of the eye muscles receiving involuntary signals from the brain Relaxes the eye muscles

Bell’s Palsy

What is it? – Bell’s palsy or facial palsy is the sudden weakness of the facial muscles. Individuals who get Bell’s palsy experience facial drooping on half of the face, making their smiles and entire face tilted. This leads to drooling pain in the ear and jaw, headaches, and increased sensitivity on the affected side.

What causes it? – The cause of Bell’s palsy or facial palsy largely unknown. It can occur to anyone at any time, although it is more commonly observed in patients who suffer diabetes, an upper respiratory infection, or are in their third trimester of pregnancy.

While temporary in most patients, Bell’s Palsy has been observed to be permanent with some.

How does Botox help treat Bell’s Palsy? – As Bell’s Palsy is a condition of the facial muscles, Botox is the perfect medication for intervention in patients experiencing long-term or permanent facial paralysis.

Botox helps to relax the automatic muscle movements and the unwanted tension underneath the face, as these muscles become hyperactive during facial nerve paralysis. This helps faces return to a normal look, with results per treatment lasting up to 4 months.

Enlarged Prostate

What is it? – Enlarged prostate, also known as benign prostatic hyperplasia or BPH, is one of the most common diseases in older men. Over half of men over the age of 60 and about 80% of men aged 80 and older experience BPH.

Roughly half of all men who experience BPH develop symptoms such as urinary tract infections, frequent urination, and severe kidney and bladder damage.

What causes it? – BPH is the growth of noncancerous prostate cells that hinder the passage of urine from the bladder to the urethra. As this growth becomes bigger, the urethra passage becomes narrower, forcing the bladder to push harder to expel urine and semen.

Due to this increased pressure, the muscles in the bladder eventually become stronger and more sensitive, leading to more frequent urination. As the growth continues to expand, the bladder muscles experience more difficulty expelling the urine, until it can no longer completely empty the bladder.

How does Botox help treat enlarged prostate? – Some doctors now treat enlarged prostate with Botox, which has been found to drastically improve the quality of life of patients with enlarged prostate (effects lasting up to a year after Botox treatment).

Through a process known as apoptosis, Botox reduces the enlarged prostate gland by killing the prostate cells slowly. This allows the urine to pass more freely from the bladder through the urethra.

Gastroparesis

What is it? – Gastroparesis is a digestive medical condition that prohibits the stomach from digesting and expelling food completely. This is problematic as food that sits in the stomach for an extended period of time can lead to bacteria growth, harden into solid masses (known as bezoars), make blood sugar levels difficult to maintain.

What causes it? – In many cases, doctors are unsure about the main cause of gastroparesis in a patient. However, several conditions are commonly recorded with gastroparesis. These include:

  • Untreated diabetes
  • Multiple sclerosis
  • Parkinson’s disease
  • Taking antidepressants
  • Some uncommon conditions, including scleroderma and amyloidosis

How does Botox help treat gastroparesis? – Part of the problem of gastroparesis involves spasms coming from a ring of muscles in the stomach known as the pyloric sphincter.

Also known as the pylorus, this ring of muscles is involved with food passage from the stomach to the small intestine. A patient suffering gastroparesis experiences muscle spasms in the pylorus, which make it more difficult to empty the stomach.

Botox injected into the pylorus relaxes these muscles, allowing the food transfer to occur without difficulty. A single treatment of Botox can improve gastroparesis symptoms for up to 6 months.

Hyperhidrosis (Excessive Sweating)

What is it? – Hyperhidrosis is the condition of excessive sweating in the underarms and other areas in the body (commonly in the face, hands, and feet). Also known as sudorrhea or polyhidrosis, hyperhidrosis affects roughly 3% of Americans.

While hyperhidrosis is not a life-threatening condition, it can drastically decrease one’s quality of life, often leading to discomfort, psychological trauma, and social embarrassment.  

What causes it? – There are two kinds of hyperhidrosis: Primary idiopathic hyperhidrosis, which has no single obvious cause, and secondary hyperhidrosis, in which the excessive sweating is a side effect of another condition, such as gout, tumor, hyperthyroidism, or obesity.

How does Botox help treat hyperhidrosis? – Sweating is the body’s natural response to the outside temperature. When it feels a higher temperature, it sends signals to the sweat glands to begin sweating. However, some people have more active nerves, naturally or as a side effect of another condition, leading to excessive sweat production.

Botox injected in the areas of excessive sweating paralyzes the nerves responsible for beginning sweat production. Results are so effective that after the Botox has fully paralyzed the nerves, patients can experience complete dryness for several months.

Teeth Grinding

What is it? Teeth grinding, also known as bruxism, affects approximately 10% of American adults. This condition is the excessive grinding of teeth while sleeping at night, leading to moderate to severe jaw and tooth damage, causing headaches and aching jaws.

Patients who leave their teeth grinding untreated may end up needing serious dental work, such as implants, root canals, or partial or complete dentures.

What causes it? – Bruxism is generally caused by anxiety or stress, so the first therapies should be concerned with the patient’s psychological and mental well-being. However, continuous cases of bruxism can be caused by sleep apnea, or problems with the teeth, such as crooked teeth, missing teeth, and abnormal bite.

How does Botox help treat teeth grinding? – Patients suffering stubborn bruxism have difficulty treating it, as there are no recognized trusted treatments to cure bruxism. Generally, patients are advised to wear mouthguards at night until the bruxism passes (if it ever does).

However, some doctors are turning to Botox to treat teeth grinding. When injected directly into the jaw’s chewing muscles, Botox has been found to dramatically reduce nighttime teeth clenching and grinding in patients with bruxism. By relaxing the jaw’s chewing muscles, patients are far less likely to unconsciously chew and grind in their sleep.

Rosacea

What is it? – Rosacea is a facial skin condition that is often confused with skin allergies and eczema. This condition leads to excessive redness on the face, as well as blood vessels becoming visible and distinct. In severe cases, individuals with rosacea may experience pus-filled bumps on their face.

What causes it? – While doctors are unsure of the exact cause for rosacea, it is theorized that its due to a combination of environmental stimuli and genes. And while rosacea can develop in any demographic, it is most commonly observed in fair-skinned, middle-aged women.

For those who have rosacea or a history of rosacea, there are various factors that can worsen or trigger rosacea symptoms. These include stress, alcohol, cosmetics, spicy food, extreme temperatures, and too much sunlight.

How does Botox help treat rosacea? – The blood vessels in individuals with rosacea generally become dilated when they are triggered, leading to the extreme redness and flushing on the face. Botox helps to treat rosacea by paralyzing these blood vessels, prohibiting them from dilating.

With Botox injected into the upper layers of the facial skin, it can interact directly with the blood vessels that cause facial flushing. Once paralyzed by the Botox, the blood flow surges on the face lose their excess visibility. Like with other Botox treatments, these results can last for months before patients need another session.

Muscle Spasticity

What is it? – Muscle spasticity or spasticity is a disorder of muscle control in the body. While most people can generally stiffen, tighten, and contract their muscles without difficulty, individuals suffering spasticity have an inability to control their muscles with ease.

In some cases, individuals have zero control over their muscles; in other cases, control is sporadic, coming and going in random intervals. Sometimes their reflexes may be stronger or last longer than they intended.

What causes it? – Spasticity is a condition related to the relationship between the muscles and the central nervous system. Individuals with spasticity have an unusual imbalance of the neurotransmitters that allow communication between the muscles and the brain.

Similar imbalance can be observed in individuals suffering brain injuries, multiple sclerosis, and cerebral palsy.

How does Botox help treat muscle spasticity? – While Botox doesn’t help the direct relationship between the central nervous system and the muscles, it can assist the brain in getting its signals through to an unresponsive muscle set.

Botox injected in the areas with muscles suffering spasticity can help to relax the muscles, making it easier for the individual to normally move and contract these muscles without difficulty.

Urinary Incontinence

What is it? – Urinary incontinence, also known as overactive bladder, is the loss of bladder control in an individual, leading to unexpected urine leakage during sudden moments of physical pressure (such as during a sneeze or a cough) or having a sudden intense need to urinate.

There are five types of urinary incontinence, each describing the exact urinary symptoms; these include stress incontinence, urge incontinence, overflow incontinence, functional incontinence, and mixed incontinence.

What causes it? – Urinary incontinence is generally not considered a disease on its own. Rather, it is usually observed as a symptom of other underlying diseases, physical conditions, or unhealthy habits. Doctors can help patients understand their exact cause for their urinary incontinence.

Causes can be anywhere from the type of food or drink an individual consumes, to pregnancy, to prostate cancer or neurological disorders.

How does Botox help treat urinary incontinence? – Botox can treat urinary incontinence by taking away the bladder’s unwanted contractions. The Botox should be injected straight into the bladder, where it blocks the neurotransmitters operating between the bladder muscle and the bladder.

This prevents the bladder from contracting on its own, allowing patients to have greater control over their bladder. Results can last up to six months before patients must undergo another treatment.

Migraine Headaches

What is it? – A migraine is a severe pulsing or throbbing sensation that is generally felt on one side of the head. Unlike average headaches, migraines can last for several pains or hours, inflicting pain that can prevent an individual from participating in daily activities.

This pain is usually experienced with other symptoms, such as extreme visual and auditory sensitivity, vomiting, and nausea.

What causes it? – While the exact cause of a migraine hasn’t been identified, doctors believe that environmental and genetic factors contribute to the probability and frequency of migraines. Some triggers of migraines include:

  • Fasting
  • Processed foods and food additives
  • Alcohol and caffeine
  • Excessive sensory stimuli
  • Inconsistent sleeping patterns
  • Intense physical activities
  • Severe weather changes

How does Botox help treat migraine headaches? – While most medical uses for Botox are off-label, Botox for migraines is actually FDA-approved. This is most recommended for patients who experience headaches for 15 days or more every month.

For treatment, Botox is injected around the nerve endings in the head that lead to migraines. The neurotoxin then paralyzes these nerve endings, blocking communication between the chemicals and the brain’s headache pain networks. Patients can experience relief from headaches for up to 10-12 weeks after a single treatment.

Depression

What is it? – Depression, or major depressive disorder, is a serious medical and psychological condition that leads to negative feelings about the self, including the self’s actions, feelings, and behaviors.

Depression leads to an overall feeling of numbness, with depressed individuals experiencing loss of appetite, feelings of worthlessness and guilty, increased fatigue, insomnia, loss of interest in all activities, and thoughts of suicide.

What causes it? – While some mistakenly believe that depression is just a regular case of negative emotions, depression is actually partly caused by a chemical imbalance in the brain. This and genetic vulnerability combined with various external stressors – medical problems, medications, stressful events – create depression.

How does Botox help treat depression? – Several studies over the course of the last two decades have found Botox to be very effective at treating depression, alone or if paired with antidepressant medication. The treatment involves injecting the glabellar frown lines – the lines between the eyes, above the nose – with Botox, clearing them up.

Researchers suggest that the cause for the effectiveness of this treatment is due to a mechanism known as “facial feedback”. We are influenced by our facial expressions, and the angrier, sadder, and more negative we feel, the more pronounced our glabellar frown lines become.

By injecting those lines with Botox, they gradually disappear. And as we notice the disappearance of those lines between our eyes, over time our levels of depression naturally improve.

Chronic Neck Pain

What is it? – Chronic neck pain is long-term discomfort or pain in and around the neck area. Individuals with chronic neck pain experience stiff neck, sharp and stabbing sensations in a single spot along the neck or upper spine, and tenderness and soreness in the neck area.

What causes it? – The most common causes for chronic neck pain are sprains and strains, however these can heal relatively quickly, a few weeks at the longest. Common causes for these include sports injuries, sleeping in uncomfortable positions, repetitive neck movements, bad posture, and whiplash from motor vehicle accidents.

More serious causes of chronic neck pain include cervical herniated discs, cervical degenerative disc disease, cervical osteoarthritis, cervical foraminal stenosis, and other spine and cervical disc-related conditions.

How does Botox help treat chronic neck pain? – Some cases of neck pain are caused by muscles that are chronically contracted or tense. Doctors begin by identifying the tense muscles, and then injecting Botox in the surrounding areas to target them. The Botox causes the muscles to relax, helping to ease the chronic neck pain.

Patients generally accompany Botox injections for chronic neck pain with various forms of physical therapy.

Cerebral Palsy

What is it? – Cerebral palsy is a disorder characterized by the individual’s issues with posture, muscle tone, and general body movement. Individuals suffering from cerebral palsy show first symptoms in their infancy, displaying signs of involuntary movements, abnormal reflexes and posture, and unusual muscle movement.

What causes it? – Cerebral palsy is caused by damage to the brain while it is in an immature and developmental state, generally while still in the womb.

How does Botox help treat cerebral palsy? – Individuals and especially children suffering from cerebral palsy struggle with muscle spasticity caused by involuntary muscle stiffness. Botox helps to ease muscle spasticity of cerebral palsy by easing the patient’s muscle stiffness.

Immediate benefits of Botox include fewer spastic movements, an easier time walking, less overall body pain, and greater range of motion.

Cervical Dystonia

What is it? – Cervical dystonia, also known as spasmodic torticollis, is the painful and involuntary contraction of the neck muscles. Individuals with cervical dystonia experience their head twisting from one side to another, or forward and backward, without warning, making everyday life very difficult to navigate.

What causes it? – As cervical dystonia is both a rare and unique condition, its cause is mostly unknown. While some individuals with cervical dystonia have a genetic familial history of the disease, others have no genetic connection to it at all.

People who are likely to develop cervical dystonia are women in their 30s, particularly those who have a family history of the condition.

How does Botox help treat cervical dystonia? – The involuntary neck muscle contractions individuals with cervical dystonia experience are a result of signals from the brain automatically forcing them to spasm or bend.

In cases of cervical dystonia, Botox is injected into the neck area, where the patient most commonly experiences the involuntary contraction. The Botox paralyzes the muscles and nerve endings in this area, leading to a dramatic reduction of involuntary contractions for up to 3 months every session.

Eye Disorders

What is it? – Eye disorders such as blepharospasm (eyelid spasms), diplopia (blurred vision), and strabismus (crossed eyes) lead to various symptoms involving involuntary eye movements.

What causes it? – Eye disorders are generally caused by one or more of the six muscles in the eyes experiencing spasms or involuntary movement.

How does Botox help treat eye disorders? – The first medical application of Botox to be tested on humans and approved by the FDA was actually for strabismus, or crossed eyes, back in the late 70s.

Botox injected near the eye area, generally in the glabellar lines, helps to relax the muscles that control the eye movement, helping individuals suffering from various eye muscle disorders.

Botox Beyond Cosmetics

The versatility of botox proves that it goes beyond erasing fine lines and smoothing out wrinkles. When applied by a knowledgeable professional, patients can harness the power of this super toxin to control and treat both major and minor inconveniences, one injection at a time.

Is botox the right medical treatment for you? Talk to us today, and learn how botox can help make your life better.

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Thursday, May 23, 2019

Hair Botox: Regain Your Healthy Hair

A head full of healthy hair is a definite sign of beauty, but healthy hair fades in most people by their 30s or 20s at the earliest. Hair that was once naturally long, shiny, and luxurious can become dull, broken, and thin. This is why more women are turning to Botox for its hair-rejuvenating effects.

So what does Botox do to your hair? Whether you opt for Botox for hair treatments or Botox scalp injections, Botox treatments for the hair can revitalize unhealthy hair and help revive its fuller look. The way this works depends on the type of Botox for hair treatment you choose.

How do you know which Botox hair treatment you need, or whether Botox is the right treatment for your hair? Understand first exactly what leads to damaged hair, other existing treatments on the market, and why Botox is the choice millions make every year.

Your Hair: Natural Changes, Damages, and Aging

Hairs are made of a type of protein known as keratin. These strands of keratin grow out of hair follicles or specialized cells in the scalp. Hair follicles act as the soil for our hair, providing the necessary nutrients and lubrication for the hair to grow and look healthy.

While hair follicles exist all around the body, they are most numerous and active on the scalp (which has roughly 100,000 hair follicles). These follicles work in cycles – hair growth, hair rest, and hair renewal. We lose around 50 to 200 strands of hair per day, ending a full hair strand cycle that takes three years to complete.

With no external factors considered, general hair loss is caused by the process slowing down as we age. The growth phases shorten while the rest phases lengthen. This is known as pattern baldness, which affects more men than women. When women do experience pattern baldness, it usually only affects about half of their hair.

How You Damage Your Hair Every Day

With that said, there are plenty of ways that we damage our hair every day without realizing it, adding to the unhealthy, dull look we seek to treat. Here are some of the ways you damage your hair:

  • Stress: Stress can lead to both breakage of hair and hair loss. Too much stress leads to hair follicles becoming dormant, meaning that any hair that is in the growth phase will break off mid-growth.
  • Heat: Too much heat applied directly to your hair can lead to long-term damage to the hair cuticle. This is most commonly seen in misuse of hair heating tools, such as curling irons, flat irons, and hair dryers. However, your hair can also experience heat damage from too much exposure to the sun.
  • Over-Washing: Some people produce more natural oil (sebum) on their skin and in their hair, tempting them to wash more than necessary. Washing your hair several times per day can exhaust your hair follicles, leading to slower growth and hair loss.
  • Pulled Hair: For those who like to tie their hair back with hair ties or bands, this can be very damaging to the hair cuticles. Tying the hair back applies unnecessary stress to the hair and the scalp, more than it can handle.
  • Lack of Maintenance: While it may seem counterintuitive to cut your hair when you are trying to achieve fuller and longer hair, it’s actually better to opt for a regular trim. Hair trims are necessary to free your hair of any split ends, which generally lead to hair breakage.
  • Over-Styling: Too much work and styling on your hair causes hair cuticle to break down, leading to long-term hair damage. This includes sessions of coloring, straightening, relaxers, perms, and more. It is recommended that you give your hair at least 8 weeks of rest between professional hair styling sessions.
  • Harsh Drying: Most people dry their hair after a shower by vigorously rubbing a towel over their hair, but this damages your hair in two ways: 1) The motion is usually too rough; and 2) Your hair is extra vulnerable when it is wet. For best drying practices, just wrap your hair in a towel and leave it there for a few minutes to absorb the remaining water.

As we damage our hair and become older, we experience loss of volume, more frequent hair breakage, slower growth, increasing dryness, rougher texture and dullness (due to less protein production), and general thinning.

Botox can help to ease these symptoms and in the best cases, even reverse them. But is Botox the best treatment for you?

Non-Botox Hair Treatments on the Market

Hair treatments offered by hair salons and spas generally consist of keratin treatments. Keratin treatments are known to increase the shine and smoothness of your hair, with some products also claiming to increase fullness and general hair health.

But hair keratin treatments can be confusing for those who are new to the market. With various products and named techniques offered by most salons, how do you know where to start with keratin treatments?

The truth is that there are only really two types of hair keratin treatments: the traditional Brazilian blowout, which works to straighten the hair and soften the texture, and various smoothing treatments, which aim to add shine to the hair and remove any frizz, without changing the hair’s natural texture.

What Is A Keratin Treatment? How Does It Work?

Keratin is the protein that makes up hair strands, and all keratin hair-smoothing treatments have this as their primary ingredient. However, what distinguishes the various smoothing products is the other ingredients involved in the process, with keratin playing a minor role with most treatments.

Traditional treatments involving keratin use a solution that releases the formaldehyde gas, which flattens the hair by applying a kind of coat of armor over the hair which can last an average of three months.

Smoothing treatments work without the use of formaldehyde. Rather than sitting on the surface of your hair, smoothing products permeate the hair cuticle, creating a result that lasts stronger than formaldehyde without providing as powerful an effect.

Why Keratin Treatments Are Dangerous

The danger of keratin treatments is the chemicals used in the hair-straightening products. Most chemicals involved with keratin treatments are not FDA-approved, and one of the most dangerous chemicals that keratin hair treatment patients regularly expose themselves to is formaldehyde, the same chemical used by morticians to prepare corpses for funerals.

Pregnant women are strictly advised to avoid keratin treatments due to formaldehyde exposure. Formaldehyde can lead to a host of side effects, including asthma, allergies skin irritation, and various long-term cancerous conditions.

While some salons may claim that their keratin hair treatment products are “formaldehyde-free”, this claim is misleading. This is because of the nature of formaldehyde: even if it is not a present ingredient in the product, it can be created as a gas when other chemicals in the product are exposed to heat.

Many keratin treatment products have actually been identified by the Occupational Safety and Health Administration of the US (OSHA) as containing formaldehyde levels significantly higher than the permitted limit.

Downsides of Keratin Treatments

Aside from the dangerous addition of formaldehyde in the keratin treatment process, there are also a few other consequences from these hair treatments. These include:

  • Hair Loss: Keratin treatments generally involve flat irons applied to the hair at temperatures equal to or higher than 450 degrees Fahrenheit. This causes severe heat damage to the hair that damages its natural internal keratin. Too many keratin treatments per year lead to excessive hair loss and hair breakage.
  • No Showers: After a traditional keratin treatment, it is strongly advised that you avoid any excessive contact with your hair for three days. This includes showering and tying your hair back.
  • Inconsistent Results: If you decide to push through with a hair keratin treatment, there is still no guarantee that you will receive the results you expect. Results vary from person to person when it comes to keratin treatments due to several factors, including the state of your hair, the flat-iron’s temperature, how skillfully it was applied, and many more.

Botox Hair Treatments

So what is the difference between a Brazilian Blowout and hair Botox? While a Brazilian Blowout or traditional hair keratin treatment requires heating the treatment product into the hair, hair Botox involves no keratin at all, making it a much safer and oftentimes more effective hair treatment alternative.

There are two kinds of hair treatments involved when people refer to hair Botox: the Botox for hair treatment, and Botox scalp injections.

Botox for Hair Treatments

When people refer to hair Botox, “Botox for hair” treatments are generally the treatment that is being specified. Botox for hair treatments surprisingly don’t actually involve any botulinum toxin product at all. Instead, they incorporate AnimoMar C, a protein found in some species of fish, which produces similar relaxing effects to the hair that Botox is known for.

Unlike keratin treatments, the protein involved in Botox for hair treatments is absorbed into the hair, rather than just coating over the outer layer of the hair. This allows it to produce faster and more distinct results than traditional Brazilian Blowouts, with none of the chemicals or other negative side effects.

Frequently Asked Questions

What does Botox do to your hair?

Botox for hair is a topical treatment, meaning it is applied on the hair directly (which is why some people can do it themselves at home). This treatment manages frizzy hair, helping to straighten hair while returning a more youthful shine to it.

The micro-keratin formula produced by AnimoMarC penetrates the hair and fills in thin and broken areas. This produces a fuller and more lustrous look.

How long does Botox last in your hair?

While a keratin treatment will last just 2-3 months, a hair Botox treatment can last over 4 months. This is because the ingredients in hair Botox are absorbed into the hair, producing longer-lasting results. To keep results lasting as long as possible, make sure to use shampoo with little to no sulfate.

How much does hair Botox cost?

A single Botox for hair treatment can cost anywhere from $150 to $300, depending on your location and the experience of your salon. While this costs more than an average keratin treatment, remember that Botox results last much longer as well.

What can I expect from the results?

Generally, you can expect these results from hair Botox:

  • Healthy hair fibers
  • Less frizz in your hair
  • No split ends
  • Shinier and softer hair
  • Nourished and healthier overall look to your hair

Can hair Botox be applied at home?

Yes. While it would be better to have a professional apply your hair Botox, the treatment can be done at home. Make sure to have a good understanding of the different hair Botox brands, so you know the proper application and any exact requirements necessary for treatment.

Application steps generally include:

  • The initial wash
  • Blow-dry the hair
  • Mix just 5 cc of your chosen hair Botox product with about 50 mL of water
  • Create sections in the hair and massage the product into each section thoroughly
  • After treating the hair, apply heat to it
  • Wash the hair without shampoo, removing most of the product
  • Dry the hair with a blow-dryer

How is it applied?

A Botox for hair treatment is quick, painless, and easy. A treatment begins with shampooing the hair to engage the scalp’s hair cuticles. This also helps prepare the hair for conditioning. After thorough shampooing, Botox is applied to the hair and is massaged deep into the strands and the scalp.

The duration of your session will depend on the length and fullness of your hair, but it will generally last anywhere from 20 to 90 minutes.

What are Botox for hair side effects?

As with any kind of hair treatment, there is a small risk of an allergic reaction for some people. If you believe that you might be allergic to the product, do your best to avoid any skin contact with the product.

Is Botox for hair safe?

With no dangerous chemicals such as formaldehyde used in hair Botox products, you can rest assured knowing that it is safe to apply in your hair. The only risk is a possible allergic reaction, which can be negated by ensuring little to no skin contact with the product.

Botox Scalp Injections

Unlike Botox for hair, Botox scalp injections involve actual Botox. Botox is injected straight into the patient’s scalp, with the goal being to relax the muscles at the top of the head. With relaxed muscles, the scalp becomes a more conducive environment for hair growth and rejuvenation given the increased nutrient delivery and enhanced blood flow in the area.

There is some evidence that Botox scalp injections can stimulate hair growth, but most studies have found that scalp injections are only effective if the nearby hair follicles are still functional.

Hair Botox Aftercare Tips

While hair Botox is an effective treatment method on its own, there are certain ways you can help improve results, making your hair look healthier for a longer time from a single treatment. Here are some tips for hair Botox aftercare:

Wash gently after treatment

While you don’t necessarily have to avoid the shower for 3 days like with keratin hair treatments, it would help to wash gently for 48-72 hours after your treatment for the best absorption rate. Try to wash less frequently than usual for the next few days; if you feel that your hair is becoming greasy, apply dry shampoo to it.

Find the right shampoo

Regular shampoo won’t cut it after a hair Botox treatment, because they contain sulfate and some chemicals that can be counterproductive to the absorption process.

Check for shampoos, conditioners, and moisturizers that advertise no chemicals or sulfate. Coconut, macadamia oil, and argan oil are great ingredients for your hair products.

Wear a hair mask

A weekly hair mask after a hair Botox treatment can do wonders for the efficacy of your results. You will want to find a hair mask that is sulfate and parabens free; a homemade hair mask would work fine as well. Try creating your own hair mask out of coconut oil, for example.

Throw out cotton pillows

Cotton is known to dehydrate the hair, so resting on a cotton pillowcase all night long is the worst thing you can do for your hair right after hair Botox treatment. Microfiber pillowcases are a great and inexpensive alternative.

Which Botox Hair Treatment Should I Get?

Most Botox hair treatments that you hear about are hair treatments that involve no Botox at all, but still boast results that last longer and show more prominently than more traditional forms of hair treatments on the market.

While Botox scalp injections are less popular, they have also shown interesting results and can help people who feel that other hair treatments don’t work on them. Contact us at My Ethos Spa to find out what hair treatment is best for your hair, and how you can begin your path to a fuller and more lustrous head of hair today.

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The Origin of Botox: How It All Started

Botox is the face of the non-surgical cosmetic treatment industry. An estimated 6 million people undergo Botox treatments annually, and the Botox industry reached sales of nearly $1 billion in the last financial quarter alone.

But this trend is relatively new – in 2001, annual Botox sales were just around $300 million (source). Understanding Botox’s quick rise means understanding how Botox all started.

So where does Botox come from? Botox, or botulinum toxin type A, is a neurotoxin produced by a rod-shaped microorganism known as C. botulinum or Clostridium botulinum. Clostridium botulinum is an anaerobic bacterium found in soil and bodies of water around the world, only growing in oxygen-free environments.

On this page we will explore how scientists turned one of the deadliest toxins in the world into a cosmetic treatment used by millions of people every year.

Understanding Botulism

Clostridium botulinum creates the botulinum neurotoxin, which is one of the most powerful known toxins. When this toxin enters a person’s body, they acquire the severe neuroparalytic disease known as botulism.

There are six kinds of Clostridium botulinum – A, B, C, D, E, and F – with each type producing a unique exotoxin but similar symptoms.

There are four categories of botulism as a disease:

  • Foodborne botulism: The most common type of botulism, this is caused by eating food that is contaminated with A, B, or E type botulinum neurotoxin (B and E are both odorless and tasteless, making contamination nearly impossible to detect).
  • Infant botulism: The most common type of botulism in North America, infant botulism occurs when an infant 12 months or younger is infected by viable spores which then produce the toxin in the infant’s intestinal tract. Infants this age can be infected by spores through contact with the outside environment or by eating honey.
  • Wound botulism: Mostly caused by drug use injections, wound botulism occurs when Clostridium botulinum spores infect an open wound, consequently growing the toxin inside the wound.
  • Adult infectious botulism: Similar to infant botulism, adult infectious botulism is the spore colonization of an adult’s intestinal tract. This is mostly seen in adults with previous surgery to their intestinal tract or experiencing changes with the intestinal flora.

Clostridium botulinum is widely present in nature, and can be found in soil (forest and cultivated), streams, coastal waters, lakes, and in the intestinal tracts of mammals and fish, as well as other parts of shellfish and crabs.

It should be noted that any type of low-acid food can create the environment for Clostridium botulinum spore and toxin growth. This includes many canned vegetables, fish, and meats, including peppers, olives, salmon, corn, ham, eggplant, beans, and more.

When dealing with botulism, the illness can often be difficult for doctors to diagnose, as the early symptoms are generally shared with more common diseases that physicians may be more familiar with. Early onset symptoms include constipation, vomiting, and nausea.

Early detection and administration of anti-toxins are essential towards successfully treating botulism.

Botox: The Napoleonic Wars, The Sausage Disease, and Bacteria Discovery

While Clostridium botulinum can be found in soil worldwide, it wasn’t until after the Napoleonic Wars of the early 1800s when it was first discovered. This discovery was largely due to two European biological scientists: Justinus Kerner and Émile Pierre-Marie van Ermengem, whose work towards discovering Clostridium botulinum occur seventy years apart.

The early 1800s were a difficult time for most of Europe, with many countries experiencing and afterward recovering from the Napoleonic Wars of 1803 to 1815.

Though it was common knowledge at the time that pork products could lead to a number of deadly illnesses, poverty forced people to eat pork sausages, despite lacking the resources for clean and proper preparation.

A country famous for its sausages, Germany experienced more pork-related deaths than other areas. Smoked blood sausages were the most common cause of the sausage disease, and so many people were falling ill to it that in 1811 the Department of Internal Affairs of the Kingdom of Württenberg attributed the poisoning to “prussic acid”.

Justinus Kerner, a German medical doctor and romantic poet, began to investigate the mysterious pork disease.

He studied those with symptoms of the disease and began testing sausages himself, discovering that the sausages could become poisonous even without exposure to air. Kerner theorized that if isolated properly, parts of the poison could be used to paralyze muscle twitches and spasms.

The disease was named botulism after Kerner’s studies, originating from the Latin word for sausage, “botulus”. (Some argue that it was named so because the bacteria could be seen to be rod or sausage-shaped.)

Roughly seventy years later, Belgian bacteriologist Émile Pierre-Marie van Ermengem was invited to study the smoked and pickled ham that had ruined a funeral dinner party in a Belgian town known as Ellezelles, causing thirty-seven people to fall sick and three to die within a week. Their symptoms included eyelid spasms, impaired vision, speech disorder, and more.

Kerner’s previous study and classification of botulism poisoning had made the medical community aware of its symptoms, and van Ermengem intended to understand exactly how the poisoning worked.

Van Ermengem soon identified the tiny rod-shaped bacteria which grew in oxygen-free petri dishes. He discovered valuable information about this bacteria: it created the toxin rather than was the toxin itself, some animals were immune to the toxin’s effects, and heating and salting could prevent the toxin from being created.

Van Ermengem named it Bacillus botulinus, which was later renamed Clostridium botulinum when it was placed in the Clostridium genus.

The Civil War, Food Canning, and 20th Century Botulism

Food canning started in the early 19th century in France, and found its way to the US by 1825. It was only after the Civil War that it gained popularity, after soldiers in the millions were forced to eat rations packed in cans.

Although they were reluctant to eat food packaged in unfamiliar conditions, the practice slowly grew in popularity as canners improved the public image of canned food. This was done with government regulations, scientific improvements, and better canning practices.

But spoilage was still an area of concern. Germ theory only became widespread in the late 19th century, and canners were forced to deal with microorganisms growing in their cans.

While most kinds of spoilage were relatively harmless and obvious (through smell or sight, and only causing short-term digestive issues), one lethal kind of bacteria was difficult to get around: Clostridium botulinum.

The major event that rocked the canning industry occurred in 1920, when a botulism outbreak caused by spoiled olives killed 18 people across the country. The problem was damaged cans: if cans acquired any dents or holes during the canning process, they could possibly become hosts to botulinum toxin growth.

Public trust in canned food dropped, and canners were forced to work with the government and scientists once more to improve their canning practices. With improved government regulations and stricter and more scientific canning processes, the public slowly accepted canned food into their kitchens again.

The Modern World and Botulism: Is It Still A Danger Today?

While the modern world hasn’t experienced the kind of botulism outbreak that ravaged Europe in the 1800s or the outbreak of 1920, there have been a few worldwide scares in the last few decades that led to can recalls in the tens of millions.

In 1982, a Belgian died of botulism after eating canned salmon imported from the US (the man’s wife also ate the salmon and fell ill, but later survived). Health agencies worldwide began tracking the US-packaged salmon cans, leading to a recall of 55 million cans of salmon.

It was found that a few of the cans contained a tiny defect – a small hole at the side of the can – which had been caused by a malfunctioning machine in the packaging process. This hole led to the growth of botulinum toxin in some cans.

This event was similar to a case in 1974, when 75 million cans of mushrooms were pulled from shelves after concerns of botulism.

The question remains: is foodborne botulism a danger today? For the most part, no. From 1926 to 1982, there were only eight reported deaths caused by foodborne botulism due to contaminated cans (an estimated 900 billion cans of food was consumed during this time).

First Applications of Botulinum Toxin: Biological Warfare In Chinese Prostitutes

Although Kerner’s theories for botulinum toxin application included the most popular applications of it today (partial facial muscle paralysis and sweat gland paralysis for hyperhidrosis), the first serious attempted development for botulinum toxin in human application was for biological warfare during World War I.

All tests failed during the first Great War, but this was later picked up by American laboratories during World War II. One attempt at botulinum biological warfare was developed by the US Office of Strategic Services, or the OSS.

The plan was to equip trusted Chinese prostitutes with gelatin capsules containing lethal doses of botulinum toxin. The prostitutes would hide the capsule in their hair or behind their ears, and slip it in the food or drink of high-ranking Japanese officers who hired them.

The plan went as far as the production and shipment of the pills to a Navy detachment in Chunking, China. Unfortunately, when the pills were tested on stray donkeys who were unaffected by the poison, the project was cancelled. It was later discovered that donkeys are actually immune to botulism, explaining their survival.

While botulinum toxin is still one of the most acutely toxic substances in the world (theoretically, just 4 kilos of it could kill all of humanity), studies and projects in biological warfare are now concerned with other substances.

This is because it was discovered that botulinum toxin is a poor candidate for biological weaponry, for the following reasons:

  • Mortality rates are inconsistent
  • There are many available antibiotics that can treat it
  • Standard water sanitation protocols can inactivate any dosage
  • It is not contagious, meaning it can only be used to target one person at a time

Botulinum Toxin as Human Treatment

In the 1960s, ophthalmologist Dr. Alan Scott of the San Francisco Smith-Kettlewell Eye Research Institute started research into new alternative treatments for strabismus, or crossed eyes. Strabismus is largely caused by hyperactive muscles in the eyes forcing them to look in separate directions.

Dr. Scott theorized that by dulling the nerves and muscles in the area, the faulty neurotransmissions could be blocked, thus curing crossed eyes. Scott and his partner Dr. Edward Schantz tested a number of substances on monkeys with strabismus, and finally found success when they injected them with botulinum toxin.

After nearly a decade of animal testing, Scott and Schantz were granted FDA permission for human trials. In 1978, they began injecting botulinum toxin to treat strabismus in humans.

The breakthrough strabismus treatment became widespread in North America in the 80s, and was later officially approved by the FDA for treating blepharospasm (eye spasm) and strabismus in 1989.

From Treating Eye Spasms to Erasing Facial Wrinkles

While testing on monkeys in the 70s, researchers observed that the botulinum toxin had another unintended effect: it dramatically reduced the lines and wrinkles in the glabella, or the area in the face above the nose and between the eyes. While doctors were aware of this side effect, this knowledge went largely ignored until 1987.

Dr. Alastair Carruthers and Dr. Jean Carruthers together ran a clinic in Vancouver, where they treated everything from skin cancer surgery to cosmetic procedures and blepharospasm. Though not yet approved by the FDA, by this time botulinum toxin had become a popular treatment for the eye spasm condition.

It was a blepharospasm patient of Dr. Jean Carruthers who opened her to the idea of botulinum toxin as a facial wrinkle treatment. In one session, as Carruthers was injecting the toxin in her patient, the patient demanded that she inject again in the forehead.

When asked why, the patient claimed that “when you inject in my forehead, my wrinkles go away.”

Dr. Alastair and Jean Carruthers discussed the patient’s observation and began seeing botulinum toxin as a treatment for frown lines in the forehead, known as “glabellar lines”. The fillers used for treatment at the time were painful for patients and its effects were short-lived.

The two doctors began testing on their receptionist and later their patients. They presented their success at various conferences in the early 90s, including the American Society for Dermatologic Surgery in 1991.

Unfortunately, their colleagues weren’t sold. They believed that it needed more clinical trials to prove any kind of lasting success. The Vancouver pair continued sharing their results over the next few years, and their conference audience slowly grew.

This led to a snowball effect in 1993. Doctors around the world began offering Botulinum toxin, now known popularly as “Botox”, as an off label treatment for glabellar lines, and later other wrinkles and lines on the face. As an off label treatment, it required no FDA approval for practice.

Though Botox began making a name for itself in the cosmetic treatment world in the 90s, it wasn’t until 2002 that the FDA officially approved it for glabellar lines, and later in 2013 for crow’s feet.

Today, Botox is used for a number of medical and therapeutic applications, including:

  • Blepharospasm
  • Hemifacial spasm
  • Chronic migraine
  • Severe shoulder and neck muscle spasms
  • Excessive sweating
  • Strabismus
  • Chronic migraine
  • Crow’s feet
  • Glabellar lines
  • Overactive bladder
  • Upper limb spasticity

Botulinum toxin can now also be found in several popular commercial forms, including:

  • Botox (OnabotulinumtoxinA)
  • Dysport (AbobotulinumtoxinA)
  • Bocouture (IncobotulinumtoxinA)
  • Myobloc (RimabotulinumtoxinB)

Botox: The Anti-Aging Solution From My Ethos Spa

At My Ethos Spa, we know everything there is to know about Botox, from its history to how it can help you today. Botox is your all-in-one anti-aging facial solution, working on everything from forehead lines to crow’s feet and more. Contact us today and find out how we can help you with your Botox needs.

The post The Origin of Botox: How It All Started appeared first on Ethos Spa Skin and Laser Center.



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Monday, May 20, 2019

Does Botox In Your Armpits Stop Sweating?

The last decade has seen a huge rise in the number of people opting for Botox, but not in the way that you might expect. While Botox is most popular for reducing facial wrinkles and fine lines, many people also use Botox for excessive sweating, particularly in the armpits.

So does Botox in your armpits stop sweating? In short, yes. When injected in the underarm area, Botox has been found to be extremely successful with stopping sweat production in the armpits. This process works through nerve paralysis: the injected Botox paralyzes the nerves which are responsible for activating the sweat glands in the armpit, thus preventing sweat from occurring.

Sweat, the Body, and Botox

When your body temperature rises, your body begins to sweat to cool itself off. The nervous system is responsible for activating this process; when it feels a higher body temperature, it engages with the sweat glands to begin sweat production. However, some people have more active nerves than others, leading to overstimulated sweat glands that produce more sweat than necessary.

How does Botox prevent the armpits from producing sweat?

Botox in the armpits works in the same way that it does on the face, by paralyzing the nerves underneath the skin. After these nerves are paralyzed, they can no longer function for the next several months, preventing them from contracting (as they do in the face, causing wrinkles), or in this case, activating the armpit’s sweat glands.

Botox is a neurotoxin that has been used in cosmetic treatments since the late 80s. While it was first used to help frown lines disappear, Botox application has since matured and evolved into treating most signs of facial aging, from wrinkles to fine lines.

Doctors continued to experiment with Botox application due to high demand for the product. It was only in 2004 that Botox gained FDA-approval as a hyperhidrosis (excessive sweating) treatment.

Since then, doctors have found that Botox can also be injected in other areas of the body to dull overactive sweat production, such as the palms and the feet, however, these are only done as off-label procedures.

Off-Label Botox Procedures for Sweat

When a doctor refers to an off-label usage or procedure, they are referring to a medication or treatment that is used for an application that goes beyond its standard approval. Some patients may be wary of off-label practices, but Botox is still safe beyond the face and underarm area. The only matter is effectiveness.

Where else can Botox be injected to lessen your body sweat? Doctors have successfully treated sweatiness in foreheads, feet, and sweaty palms. However, Botox in these areas generally doesn’t last as long as Botox in the armpits, with forehead sweat reduction lasting an average of five months.

Is Botox in the Armpits Right for Me?

3% of the population experiences the excessive sweating condition known as hyperhidrosis.

However, anyone who feels that they sweat more than the average person can opt for a Botox procedure in the underarm area.

But some people might hesitate before considering Botox to solve an issue that might only be mildly irritating. Do you truly sweat more than the average person, or are you simply overthinking it?

How do you know if Botox in the armpits is right for you? According to Dr. Darren Ezer of the Toronto Sweat Clinic, it’s a matter of your quality of life. There are some questions you have to ask yourself, including:

  • Are you forced to leave social situations because of your underarm sweat or general body sweat?
  • Do you find yourself sweating through multiple shirts in a single day?
  • Do you sweat through your shirt even without physical exertion?
  • Do you find yourself with lower confidence, self-esteem, and productivity issues because of your body sweat?

Whether you have severe hyperhidrosis or just a case of above average sweaty armpits, it is important for you to consider Botox in the armpits if you struggle with any of the questions above.

Understanding the Botox Procedure for Sweaty Armpits

After consulting with their chosen doctor and arranging an appointment, there is little to no preparation involved in the days leading up to a patient’s Botox appointment. Here is everything a patient can expect from the Botox procedure:

  • Shaving the armpit area is optional, however, a hairless armpit might make the process easier for the dermatologist.
  • The patient is given a choice of a numbing cream to help dull the pain of the needle (if it is their first treatment, it’s better to choose to have the numbing cream applied).
  • A full bottle of Botox powder is mixed with saline; all of it is necessary for the treatment.
  • A small injection map will be drawn in the underarm. While some doctors will opt for a starch iodine test to find the specific sweat glands, most choose not to, as sweat glands are generally in the same area for most people.
  • Botox is injected into the armpit, giving the patient a feeling of deep pin pricks. Some patients who are experienced with facial Botox are surprised with the depth of Botox injections in the underarm. This is because the nerves around the armpit are deeper than those in the face, which are more superficial.
  • Some patients may experience light pain or bruising after the treatment; aside from this, patients may return to their normal daily activities, work, and exercise immediately after treatment.
  • After two weeks, the patient should consult with their doctor about a follow-up appointment. The doctor should check if any final touches are required to complete their treatment.

Here are some common questions regarding Botox after it is injected in the underarm area:

When Will I Experience Results?

The Botox will need some time to fully stifle the nerves in the underarm, but once this has occurred you can expect up to a 90% reduction in your armpit sweat about 2-7 days after the treatment.

For a totally dry underarm experience, wait up to two weeks.

How Long Will It Last?

The effectiveness of Botox varies. Some people may only experience dryness in the underarms for 4 months, while others have reported results lasting up to 14 months. The treatment is recommended roughly every 6 months for continued dryness.

Will It Stop Working?

As long as you have had a Botox armpit treatment in the last few months, then you should expect total dryness in your underarms. That is why this procedure is increasingly popular amongst celebrities, as they need to stay fresh and dry during events and awards shows that demand uncomfortable clothing and bright lights.

Will Botox Stop the Armpit Smell Too?

It’s a common misconception that sweat and smelly armpits are the same thing. Foul-smelling armpits are generally caused by a chemical or bacterial effect, not because of the sweat.

While the smell may slightly lessen as the underarm area becomes less damp, the body odor will still remain. You will still want to use your deodorant for body odor issues.

Can Men Use Botox For Armpit Sweat?

Of course. Botox for body sweat is not exclusive to women; many men are opting for Botox for body sweat issues these days.

Botox: Your Ultimate Body Sweat Solution

Anyone who experiences quality of life issues because of their excessive body sweat can benefit from Botox treatments.

While the injections may not always be covered by insurance, you will only need one or two injections per year to experience radical changes in your day-to-day living.

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