How does Botox (botulinum toxin) work?
There are eight different types of botulinum toxin produced by C. botulinum; A, B, C1, C2, D, E, F, and G. All work by blocking the release of acetylcholine, one of the most significant neurotransmitters in our body. Acetylcholine activates muscles, so blocking it causes muscle relaxation and paralysis. Injections enable the botulinum toxin to be targeted directly into specific muscles. There it has a direct effect on acetylcholine in the nerve synapses, preventing signals that would normally cause the muscle to contract.
Type A is the most potent and longest lasting, followed by types B and F. Currently, preparations containing Type A and B are commercially available and include:
- OnabotulinumtoxinA (Botox, Botox Cosmetic)
- AbobotulinumtoxinA (Dysport)
- IncobotulinumtoxinA (Xeomin)
- LetibotulinumtoxinA-wlbg (Letybo)
- PrabotulinumtoxinA-xvfs (Jeuveau)
- RimabotulinumtoxinB (Myobloc).
All have different potencies and are not interchangeable; care needs to be taken so that the correct dosage stated is used for that product. Each manufacturer uses assay methods specific to their company, so even though dosages may be quoted in similar sounding units, potency varies several-fold between the different products. Approved indications also vary.
Effects are usually seen within 24-72 hours and peak around ten days. Effects last about two to four months or until new nerve terminals sprout and form new synaptic contacts.
Read next
Related medical questions
- How many units of Botox are used for migraines?
- How much does Botox cost?
- How does Botox work for migraines?
- How long does Botox last for migraines?
- What is a Botox lip flip?
- Dysport vs Botox: What's the difference?
- What is botulinum toxin used to treat?
- What are the side effects of beta blockers?
- What are the side effects of the flu vaccine?
- Why does throwing up relieve migraines?
- Do daith or tragus piercings help with migraines?
- Can depression cause headaches?
- What causes optical migraines?
- Headache or Migraine: Which one is it?
- How does Aimovig work to prevent migraines?
- What is a migraine aura?
- How long do venlafaxine withdrawal symptoms last?
- What are the new drugs for the treatment of migraines?
- Can ibuprofen cause constipation?
- Can you take ibuprofen with Excedrin Migraine?
- How do Ubrelvy, Qulipta and Nurtec compare for migraines?
- Is gabapentin addictive?
- How often can you take Excedrin Migraine?
- Should gabapentin be taken with food?
- Can you take Excedrin Migraine while pregnant?
- How long do you stay on Topamax for migraines?
- How long does it take for Topamax to start working?
- Does Qulipta cause weight loss?
- Ubrelvy vs Imitrex (sumatriptan): How do they compare?
- Is Ubrelvy better than triptans?
Drug information
- Botox Information for Consumers
- Botox prescribing info & package insert (for Health Professionals)
- Side Effects of Botox (detailed)
Related support groups
- Botox (25 questions, 157 members)
- Migraine (287 questions, 1,620 members)
- Hyperhidrosis (141 questions, 365 members)
- Migraine Prevention (123 questions, 335 members)
- Migraine Prophylaxis (70 questions, 82 members)
- Overactive Bladder (34 questions, 178 members)
- Urinary Incontinence (28 questions, 128 members)
- Chronic Migraine (20 questions, 66 members)
- Facial Wrinkles (9 questions, 36 members)
- Cervical Dystonia (7 questions, 65 members)
- Dystonia (5 questions, 60 members)