Botox goes mainstream

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Ten years after it was first approved, Botox injections are used regularly for medical and mostly cosmetic treatments

Unless you examine their hands and the corners of their eyes, it’s difficult to judge the age of Shauna MacIver and Bhavlene Panesar. The two St. Albert doctors pride themselves on their youthful appearance.

But it’s not Mother Nature at work here.

Many call it a fountain of youth, though the news on Botox was not always positive. After too many reports of teenagers injecting their skin to keep gummy smiles and first wrinkles in check, doctors have grown more conscious of age limits, and refer to the toxin’s medical effects over its cosmetic use.

Driving down St. Albert Trial, street signs and park benches tell a mixed story. Some advertisements refer to Botox as relief from sweat stains, while others offer it as an easy solution to unwanted facial lines.

Ten years ago, when Botox was first approved for medical purposes, only a few doctors in the Edmonton area used it. Now even St. Albert has three medical clinics and a few beauty spas providing the treatment.

MacIver and Panesar own Solace Medical Clinic, a medical, laser and skin clinic.

“It is probably popular with hyperhidrosis (excessive sweating) and people can avoid medication this way. And it’s popular for cosmetic reasons because it’s a less invasive procedure than a surgery,” said Panesar.

The drug does help with physical problems. Botox can be used with children as young as 12 years old to help with crossed eyes and twitching of the eyelid. Youth over 18 can receive it as a treatment against migraines and neck stiffness.

It also aids clenched jaws and overactive bladders, speech impediment and even the effects of surgery to loosen muscles, allowing them to heal faster without stiffening.

Used against excessive sweating, treatments are necessary every nine to 12 months. For migraine prevention and cosmetic injections, patients usually have to return every four to six months to assure a lasting effect.

It’s not cheap. MacIver and Panesar charge $10 a unit, and treatments run anywhere from 20 units and up.

Yet there were almost 200 million cosmetic injections done worldwide since the drug was first approved for cosmetic and medical use, said Becky Wilkins, a registered nurse and clinical director for External Affairs, a clinical spa that provides medical and cosmetic work in St. Albert and Edmonton.

“It’s becoming more mainstream, not just Hollywood anymore. The education available is phenomenal and the price has come down over the years, so you have more clinics that do the injections,” she said.

A team of three physicians and four full-time nurses runs External Affairs. Wilkins said there is maybe one patient in a thousand approaching her for the medical use of Botox. The clinic sees about one hundred people a month. Most of them are women between the ages of 30 and 40.

“People don’t want a frozen or fake look. What has changed over the years is that women want a more refreshed and youthful look and the biggest thing is that they don’t want to look so tired,” she said.

First developed in the 1970s, Botox was discovered by a doctor named Alan Scott. Scott was looking to cure crossed eyes when he received a trial amount of botulinum toxin, a poison produced by the bacteria that causes botulism, a disease that paralyzes muscles.

Botox is the protein extracted from the bacteria. It temporarily relaxes the muscle and reduces its activity, which also aids in the reduction of crow’s feet, furrowed brows and lines around the mouth.

Today, doctors try to avoid using Botox in correlation with the word toxin.

“Under the proper medical treatment it is a safe drug,” said Dr. Barry Lycka, an Edmonton-based dermatologist who has treated patients with Botox since 1995.

Problems occur when doctors and nurses lack proper training on how and when to use Botox on a patient. Most commonly, injections can leave behind some light bruising. In the worst case, however, it can lead to allergic reactions or partial paralysis and trouble with swallowing, breathing or eyesight.

“One has to get it into exactly the right muscle in order to avoid drooping of the eyebrows and other muscles,” he said.

“If you inject too much you get people looking abnormal. You look at the people in TV and they don’t really move a muscle or frown and it makes a person just look bizarre.”

Unlike the United States, Canada has a regulatory body that watches over proper treatment methods. Lycka said Health Canada generally reacts only after mistreatment takes place and doctors are seldom monitored in their clinics.

“Doctors to a large part have been self-policing. It’s a bit of an art, not a science. You can’t use the same amount of Botox on everybody, it’s always a bit different,” he said.

“I use a small amount to begin with and then build it up.”

Lycka does not use Botox on teenagers. Like most doctors, the age of his patients ranges from their early twenties to late eighties. Many of the younger people come for medical treatments, he said.

Wilkins said many of her St. Albert patients use the sister clinic in Edmonton to avoid being seen by friends, family or co-workers. The team at her clinic stresses a natural look, one that is not obvious to others. The trick, she said, is to use just enough Botox to make someone look rested, not lifted.

She cautions that not every clinic consults properly with its patients, giving them time to consider their decision and trying out a little Botox at first to test the result. As with any medical treatments, patients are advised to check the Allergan Canada Botox website to look for certified physicians and study the treatment, possible risks and side-effects well ahead of time.

Wilkins has also turned people away who went from one clinic to another with unrealistic expectations.

“What we really encourage is for people to do their own research, look at pictures of natural results, spend time with a professional. There are injectors who are quite happy to just take your money,” she said.

“The huge cheeks, that’s filler. It’s not Botox that does the plastic, puffed-up look. They key is to soften the muscle but not to lose the expression.”

Wilkins said she consults with patients, often to discuss the reasons for the treatment. Using Botox only to please someone else concerns her, she said. Nor will it stop the aging process or the daily stresses that cause worry lines and wrinkles.

It can, however, give people a more relaxed look – and a positive start to the day, she said.

“You should never feel like you have to. There are lots of lovely women that do well without Botox and are bundles of energy and they donate their time to charity,” she said.

“And then there are people who need a little boost.”

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