Botox is a form of botulinum toxin (pronounced “botch-uh-line-um”), a protein produced by the bacterium Clostridium botulinum. If ingested, the toxin causes botulism (“botch-uh-liz-um”), a potentially fatal paralytic illness. C. botulinum thrives in neutral pH, low-oxygen environments, and is sometimes found in tainted canned foods. The first recorded case of botulism occurred in 1735 Europe, presumably caused by poorly prepared sausage (“botulism” actually comes from the Latin for sausage, botulus).
In humans, botulinum toxin prevents the intended effects of neurotransmitter’s – powerful chemical signals used by the nervous system. The toxin specifically blocks acetylcholine, the neurotransmitter that activates our muscles. This acetylcholine inhibition causes paralysis throughout the body, and – in 24 to 72 hours – can reach the lungs and suffocate the bacterium’s host. Because of these deadly effects, botulinum toxin is widely considered the most deadly neurotoxin ever discovered: if properly distributed, less than half a pound could kill every person on earth!
Luckily, strict FDA regulations on canned foods and advances in medical care make botulism increasingly rare and increasingly less fatal. Infants, however, are especially susceptible to botulism because their stomachs lack digestive bacteria found in adults; even if they don’t ingest the bacterium itself, they can develop botulism from eating bacterial spores. These spores are always present in honey, making it very dangerous for young children to eat.
Botox (or Dysport) is the brand name of modified type A botulinum toxin, and was first used for cosmetic purposes around 1989. Because of it’s paralytic effects, when minute doses of Botox are injected into facial muscles, it causes them to relax and smoothens out wrinkles. Botox is often criticized for its side effects: occasionally, patients develop ptosis – a drooping of the eyelid – and the toxin can sometimes spread from the targeted area and paralyze parts of the face.
There is significant debate over Botox’s safety, as it’s caused over a dozen deaths since its first use. However, none of these deaths were due to the tiny doses of toxin used to reduce wrinkles. Botox is actually used to treat a wide range of medical conditions including excessive sweating, chronic headaches, and motor spasms; the toxin was originally used in 1980 to treat strabismus (crossed eyes). The majority of these recorded deaths occurred in children suffering from cerebral palsy, injected to inhibit leg spasms. Sadly, the combination of large treatment dose and small body size can result in accidental overdose, causing botulism and death.
Honestly, research on Botox’s dangers is inconsistent and sometimes presented in misleading ways. Some consider cosmetic procedures unethical; groups describing Botox’s risks tend to either fiercely oppose or fiercely support its use. For those who are less invested in this debate, there’s still something to be learned from this ongoing argument: when strong opinions mix with scientific study, it makes the truth a lot harder to find.