Is Botox Dangerous

Episode #216 / Jul 16, 2010
Botox is extremely effective at helping to remove and prevent lines and wrinkles. However, many people are concerned about it's safety. In this episode of DermTV, Dr. Schultz explains why Botox when administered by a professional is perfectly safe.
anthony on July 29, 2010 at 3:07am

I agree that Botox is usually safe.

But here are some very real side effects from the official Botox Website.

• Droopy eyelids -- in up to 3 percent of people

• Nausea -- up to 3 percent

• Muscle weakness -- up to 2 percent

• Facial pain -- up to 2 percent

• Indigestion or heartburn -- up to 1 percent

• Tooth problems -- up to 1 percent

• High blood pressure (hypertension) -- up to 1 percent

Neal Schultz, M.D. on August 5, 2010 at 3:49pm

@anthony: Thank you for posting those. I think they're very important for people who are considering Botox to see. However, I believe it's also very important to understand those statistics. So let's put them into perspective in two different ways. (As a side note, discussions such as this one is exactly why I started DermTV: to separate the facts from the noise/misinformation out there.)

First, and I sincerely don't mean to be flippant or insensitive here, but I'm not sure most people should live by avoiding activities/products/services/etc. which the use of has a 1% chance of going wrong. If that were the case, we'd never be able to leave our house each day. For example, even though the odds are that you'll get into a car accident at least once in your life, people, for the most part, don't avoid cars. However, this may be a bit simplistic. There are ways to increase and decrease your chance of getting into that accident, and there is the severity of the accident, both of which are caused to some extent by factors completely under your control (e.g., are you wearing a seat belt, is the driver drunk, etc.) So ultimately, you have to make a decision about whether the chance of risk for whatever you're doing is possible or probable, and whether you actually need/want to do it (whether that's getting into a car, Botox, or whatever).

With the above stated, let's now turn to the stats that Allergen, the manufacturers of Botox, published. The most important thing to understand about them is that those stats include everyone who administers Botox: not only dermatologists, but also dentists, family practitioners, etc. This means that not everyone who is administering Botox actually has the required experience with facial skin, facial muscles, and injecting techniques. It's almost like the car accident. Get in the car with the wrong person and you're much more likely to get into an accident. As a result, the stats are skewed by these inexperienced people and thus you can extrapolate that from a qualified administer the chances of any side effects are much lower. While I can't tell you whether I'm the norm or not, I can share my own experience with side effects. Since Botox was released, I've completed somewhere around 6,000 injections, from which I've only seen six cases of side effects. These included droopy eyelids four times and muscle weakness in the neck twice. That's 0.1% of side effects.

Ultimately, there's risk in everything you do. You just have to decide where you want to take them. If the published numbers above (taken into context with my discussion) make you uncomfortable receiving Botox then you certainly shouldn't receive the treatment. Regardless, however, when you consider Botox, remember that Botox is not a "point and shoot" treatment. It takes judgement, knowledge of muscle anatomy and facial aging, and injector technique for micro injections. Thus, above all else, make sure that whoever is injecting you is qualified. Injectee beware.