DRHOOK- Frowny face: Botox is deadly spores in disguise

the handsome doctor John Hong of Charlottesville

Botox for the face is the number-one non-surgical cosmetic procedure. It's like "Take that frown and turn it upside down" because it paralyzes the muscles– although depending on where the Botox is used, both happy and frustrated faces can be erased. 

A recent a study indicates emotions might be blunted because of this Botox effect. I don't know how valid this study is, but I do know that it's hard to read the faces of some Desperate Housewives who look like South Park cartoon characters.

What is botulism?

Most folks know Botox is botulism toxin. A bacterium, Clostridum botulinum, produces a neurotoxin that prevents muscles from communicating with nerves. The end result: paralysis.

Botulism was first reported in 1820 in Germany as a result of, of all things, "sausage poisoning." Later, in Belgium, botulism was found to occur from ham contaminated with a spore-forming bacterium: hence the name botulus, after the Latin word for sausage. 

There are five ways to contract botulism: eating the toxin in contaminated food, ingestion of the spores (and then the toxins are released in the gut), entry through a wound, and through bioterrorism if aerosolized. 

The fifth way is bizarre: some people use unlicensed, highly concentrated botulinum toxin. (Sounds like a back alley job! Did they call it "Botoxic?")

There aren't a whole lot of cases of botulism in the USA: maybe 110 a year, mostly in infants who ingest the spores.

Depending on the strain of Clostridum botulinum, contaminated food might or might not appear spoiled. The spores are pretty heat-resistant and prefer to be away from oxygen. Home-canned foods are usually the source of food botulism outbreaks. (Of all places, Alaska has the most botulism from food due to fermented fish. Holy mackerel, Batman!)

Users of injected drugs, such as heroin, can get botulism (along with HIV, hepatitis B and/or C, and staph). Sinus infection with botulinum can occur in folks who snort cocaine. 

Botulism can be deadly. The face rapidly becomes paralyzed, and vision becomes blurry. Both sides of the body start to become weak while feeling/sensation remains intact. The poisoned person is conscious of all of this, without fever, blood pressure changes, or change in heart rate. No fun!

Paralysis from botulinum occurs about 12-36 hours after ingesting the toxin. Initially, it can cause dry mouth, sore throat, nausea, vomiting, abdominal pain, and diarrhea. This diarrhea, though, turns to constipation as well as the inability to pee because all the smooth muscles become paralyzed. The diaphragm is a muscle, too, and when it's paralyzed, it can making breathing very difficult or stop altogether.

Babies one week to 12 months old suffer from botulism if their intestines become colonized by this bacterium. Symptoms are always harder to read in kids, but they might present with constipation. Then weakness occurs with increasing limpness, feeding difficulties, and drooling. Though the baby is irritable, crying becomes weaker and weaker. 

Diagnosis is tough to make and can take a long time. Treatment involves observation to see if the patient will need to be put on a respirator to breathe. Some antitoxins are derived from horse serum, so side effects can make the patient feel like a very sick Mr. Ed. 

And if all this isn't enough, do you know how long a person ends up in the hospital? One to three months! 

Botox correctly administered by doctors has been proven to be safe. I just find it interesting how people use it for aesthetics. If looks could kill–


Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.


1 comment

Does Dr. Hong ever give himself migraines?!