What the medicine is

The medicine used for anti-wrinkle treatment is botulinum toxin type A. It is a prescription-only medicine in the UK, which means it can only be supplied after a qualified prescriber has assessed you in person and decided that it is appropriate for you.

Several licensed brands of botulinum toxin type A are available in the UK. They are not interchangeable unit for unit, and the choice of product and dose is a clinical decision made by your prescriber.

How it works

Botulinum toxin type A temporarily blocks the chemical signal between a nerve and the muscle it controls. The injected muscle contracts less strongly for a period of time, and movement gradually returns as the effect wears off, typically over around three months, although this varies between individuals.

Licensed uses

For cosmetic use, products are licensed for the temporary improvement of certain facial lines, such as frown lines between the eyebrows, and in some cases crow's feet and forehead lines. Use in other areas may be outside the product licence ("off-label"). If this applies to you, your prescriber will explain it at your consultation before you decide anything.

By law, this medicine cannot be given to anyone under 18 for cosmetic purposes.

How it is prescribed at Avismo

Karen, our V300 independent nurse prescriber, carries out every prescription consultation face to face. She takes a full medical history, assesses how your muscles move, and explains the risks, the alternatives and the option of not having treatment. If it is appropriate, she prescribes it for you specifically, and treatment takes place at a separate appointment on a different day, with Karen or with Lorna, our HCPC-registered operating department practitioner.

Who should not have this medicine

Under 18s, as treatment for cosmetic purposes is not permitted by law
Pregnancy, breastfeeding or trying to conceive
Neuromuscular conditions such as myasthenia gravis
Known allergy to any component of the prescribed medicine
Active skin infection or inflammation at the treatment site
Some medicines, including certain antibiotics, can interact, so please bring a full medication list

Medicines that can interact

Tell your prescriber about every medicine you take, including those bought without a prescription. In particular, certain antibiotics (aminoglycosides), other medicines that affect nerve or muscle function, and medicines that thin the blood can interact or increase the chance of bruising.

Possible side effects

Like all medicines, botulinum toxin type A can cause side effects, although not everybody gets them. Common effects include:

Small raised bumps at the injection points, which usually settle within an hour
Pinpoint bruising
A mild headache for a day or two, particularly after forehead treatment

The main uncommon risk is a temporary drooping of an eyelid or eyebrow (ptosis), or some asymmetry, caused by the medicine affecting a nearby muscle. These resolve as the effect wears off, and careful dosing and placement make them less likely. Very rarely, effects can spread more widely and cause difficulty swallowing, speaking or breathing, which needs urgent medical attention. Karen covers all of this with you at your consultation before you consent.

After treatment

Stay upright for four hours after treatment
Avoid rubbing or massaging the treated area for the rest of the day
No strenuous exercise, saunas, steam rooms or facials for 24 hours
Avoid alcohol for 24 hours
Expect little change on day one. Movement softens over the following days and settles by around two weeks
Contact the clinic straight away if you have any concerns

Reporting side effects

If you have any side effect, contact the clinic on 07958 129660. You can also report side effects directly to the MHRA through the Yellow Card scheme at yellowcard.mhra.gov.uk. If you have difficulty swallowing, speaking or breathing, call 999.

Back to anti-wrinkle injections

Anti-wrinkle treatment: patient information