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Mechanism of Action

Botox contains a protein complex purified from the bacterium Clostridium botulinum. A component of this complex, Botulinum Toxin Type A is the important active ingredient. Type A is one of the seven distinct botulinum toxins produced by different strains of the bacterium.Botox decreases muscle activity by blocking overactive nerve impulses that trigger

excessive muscle contractions or glandular activity.

Phase I – Nerve-Muscle Communication is Blocked

Botox blocks the transmission of overactive nerve impulses to the targeted muscle by selectively preventing the release of the neurotransmitter acetylcholine (ACh) at the neuromuscular junction, temporarily preventing muscle contraction.This is primarily a local effect. Botox is also injected into the skin to treat the symptoms of severe underarm sweating (severe primary axillary hyperhidrosis) when medicines used on the skin (topical) do not work well enough in people 18 years and older. Botox Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe.

frown lines between the eyebrows (glabellar lines) in people 18 to 65 years of age for a short period of time (temporary).


A) Binding:

The heavy chain portion of the active ingredient in Botox (onabotulinumtoxinA) neurotoxin binds to the cell membrane of the motor nerve via an unidentified high affinity “acceptor”molecule. This high affinity binding action allows for efficient uptake of Botox by the motor nerve and facilitates selective,targeted treatment at the injection site.



B) Internalizing:

After binding, the Botox protein molecule passes through the cell membrane of the motor nerve and into its cytoplasm via a process called endocytosis. It is here that the enzymatic component (light chain) of the Botox protein molecule is activated.


C) Blocking:

Inside the motor nerve, the light chain of the Botox (onabotulinumtoxinA) protein molecule cleaves apart a protein (called SNAP25) that enables vesicles which store the neurotransmitter acetylcholine to attach to the cell membrane. Cleaving SNAP25 prevents these vesicles from fusing with the membrane and prevents the release of acetylcholine into the neuromuscular junction (the space between the motor nerve and the muscle). Thus, nerve impulses that control muscle contractions are blocked decreasing muscle activity.

Phase II – Nerve-Muscle Communication is Restored

The effect of Botox is generally temporary. Previous nerve impulse activity and associated muscle contractions resume over the course of a few to several months, depending on the individual patient and the indication for which they are being treated.


A) Nerve Sprouting:

New nerve endings sprout and connect to the muscle after the original nerve ending is blocked, renewing the ability of the nerve to cause muscle contractions.



B) Original Nerve Connection Re established:

Eventually, the new nerve sprouts retract and the original nerve ending regains its function, suggesting that treatment with Botox (onabotulinumtoxinA) neurotoxin does not permanently alter the neuromuscular junction.





  • Frown lines
  • Horizontal forehead wrinkles
  • Crows feet
  • Excessive sweating (hyper hydrosis)


  • Nasolabial folds & perioral lines
  • Neck lines( Nfertiti lift, Platysmal bands)
  • Poppy chin
  • Mental crease
  • Facial Asymmetry


  • Migraine (blepherospasm)
  • Bunny lines
  • Repeated nasal flare

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