As with any other drug, there are certain advantages, disadvantages, contraindications, precautions and side effects that must be considered with the use of BTX.
The following are advantages of BTX use:6,10
- Minimally invasive
- Psychological benefit to the patient
The following are disadvantages of BTX use:6
- Short-term solution
- Asymmetrical/unnatural appearance due to improper injection technique
- Cost
- Possibility of viral disease transmission due to human albumin
The following are contraindications/precautions for use of BTX:2,3,4,7
- Sensitivity to any botulinum toxin, human albumin, or saline solution
- Pregnant women and nursing mothers
- Children under 12 as it could impact nerve growth
- Neuromuscular disorders such as myasthenia gravis or muscular dystrophy
- Patients with impaired hemostasis or taking aspirin therapy
- Cardiovascular disorder
- Pre-existing infection at the injection site
- Skin infections such as eczema or psoriasis
- Those taking aminoglycoside antibiotics, quinine, chloroquine or calcium channel blockers as these may potentiate the effect of BTX therapy
- Emotionally disturbed individuals especially after the age of 65
The following are side effects of BTX use:2,3,4
- Systemic effects:
- Anxiety
- Dizziness
- Drowsiness
- Nausea
- Sweating
- Fever/chills
- Allergic reaction like rash or hives
- Headache
- Pharyngitis
- Dysphagia
- Facial pain
- Flu-like symptoms
- Hoarseness
- Local effects:
- Pain
- Redness
- Tingling
- Weakness
- Bruising
- Swelling
- Tenderness
- Bleeding
- Muscle atrophy, especially with long-term use
