Medical Minute #2- Botox

(Brazil Offers Free Botox and Chemical Skin Peels to Its Poorest) Good or Bad Idea?

Want free Botox? You'll have to move to a favela to get it. The Associated Press reports from Rio de Janeiro that Brazilians who make less than $250 (or appoximately 555 Brazil reais) are now being offered free Botox injections, laser hair or acne removal treatments and chemical skin peels, all thanks to the Brazilian Society of Esthetic Medicine. (On the plus side, nutritional counseling is offered gratis as well.)

According to the organization's spokeswoman, Isabel Alvarez, some 10,000 brasileiros have already been treated. Alvarez explains to the AP that this program is a win-win situation for everyone, because doctors-in-training can get extra practice on cosmetic procedures while their nation's poorest people can enjoy treatments that they could otherwise never afford.

While that all sounds very well-intentioned, has anyone in Brazil examined why free Botox for low-income citizens might be a not-so-great or say, psychologically damaging, idea? And here's a thought for U.S. doctors--we're in a recession, and 20% of our country's population already lives in poverty. Why didn't we think of this first? (Kidding...sort of).

Readers, what do you think of Brazil's free Botox plan? Is it a symbol of how cosmetic procedures have run amok (particularly in Latin America? Or is it just a nice way of providing accessible treatments for those who want it?

Here is an Intro to Botox

BOTOX® (Botulinum Toxin Type A) Purified Neurotoxin Complex is a sterile, vacuum-dried purified botulinum toxin type A, produced from fermentation of Hall strain Clostridium botulinum type A grown in a medium containing casein hydrolysate, glucose and yeast extract. It is purified from the culture solution by dialysis and a series of acid precipitations to a complex consisting of the neurotoxin, and several accessory proteins. The complex is dissolved in sterile sodium chloride solution containing Albumin (Human) and is sterile filtered (0.2 microns) prior to filling and vacuum-drying.Botox works by temporarily paralyzing the muscles at the site of injection.

The History of Botox®

Botulinum toxins were first researched in the late 1960s to treat neurological disorders. otox was first approved by the FDA in 1989 to treat eye muscle disorders (blepharospasm, uncontrollable blinking, and strabismus, crossed eyes). In 2000, it was approved to treat cervical dystonia (a disorder that causes severe neck and shoulder contractions). As an unusual side effect of the eye disorder treatment, doctors observed that Botox® softened the frown lines between the eyebrow.


Side Effects of Botox
Anxiety; back pain; dizziness; drowsiness; dry eyes; dry mouth; eye irritation; facial pain; flu-like symptoms; headache; inability to focus eyes; increased cough; nausea; neck pain; pain, redness, swelling, or tenderness at the injection site; runny nose; sensitivity to light; sweating; upset stomach; weakness of the muscles at or near the injection site.

Seek medical attention right away if any of these SEVERE side effects occur when using Botox Cosmetic:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bleeding at the injection site; chest pain; difficulty swallowing; drooping of the upper eyelid; eyelid swelling; fever; irregular heartbeat; paralysis; pneumonia; seizures; shortness or breath; speech changes or problems; unusual weakness; vision changes.The reactions announced by the FDA Friday resembled botulism, a rare but potentially deadly paralyzing illness caused by botulinum toxin in tainted food, the agency said in what it called "an early communication about an ongoing safety review" of Botox, Botox Cosmetic and Myobloc, the three brands sold in the USA.

The products' labeling already warns of the "rare potential" for serious problems — such as difficulty swallowing and breathing — far from the site of the injection in patients with neuromuscular disorders. The label also describes the possibility of adverse side effects near the injection site, such as drooping eyelids after injections for frown lines.