by Jared Guichard, MD

What is A Neuromodulator?

October 8, 2021 | Injectables & Fillers

Today we’re discussing types of neuromodulators. Many clients have no idea what I am talking about when I say Neuromodulators.  But when I say “Botox” then most have a superficial understanding of what these medications are and how we use them.  “Neuromodulator” may seem like an intimidating word, but the truth is, we speak about neuromodulators all of the time without realizing! For example, dopamine and serotonin—the chemicals released by our brains to make us feel love and happiness—are both considered neuromodulators. Likewise, histamine—the chemical which causes our eyes and throats to itch come pollen season—is also a neuromodulator. Put simply, a neuromodulator is any substance which alters the activity of neurotransmitters. Neurotransmitters are the signals sent by our brain to various nerves throughout the body.

Now that you know what a neuromodulator is, you’re probably wondering what they have to do with aesthetics, right? Well, everyone’s favorite injectable—Botox—is a type of neuromodulator but so is, Xeomin, Dysport, and Jeuveau. In this article, we’ll be diving deeper into Botox and Xeomin, two types of neuromodulators. Neuromodulators such as these are considered inhibitory in nature, since they operate by blocking signals delivered to your muscles.  Consider them as you would interference on your cable TV, which prevents the picture from showing. (Except, in this case, the interruption is beneficial instead of annoying!)  When these medications are injected into a muscle they reduce the strength of its contraction by preventing a chemical called Acetylcholine from being released from a neuron to activate the muscle.  This is how these medications reduce the aging process in the face by reduction the strength of the muscles of expression to prevent them from creating deep lines and wrinkles.  There are no better mediations that can prevent aging like neuromodulators.

We’ll discuss their make-up, their efficacy, and their safety. By the end of this article not only will you have a deeper understanding of how neuromodulators work, you’ll likely be an expert!

Botox

The generic name for Botox is actually botulinum toxin. The “toxic” aspect of botulinum is only present at extremely high doses—ten or twelve times the amount injected intramuscularly for cosmetic purposes. Botulinum toxin type A, or Botox, is a protein created by certain types of bacteria. This protein acts in the manner described above and prevents certain neurotransmitters from passing between nerves and muscle receptors, causing a weakening of the muscle. In this way, Botox prevents the formation of wrinkles by relaxing the muscles which contract to cause them. These are called dynamic wrinkles and Botox is very skilled at eliminating these. Static wrinkles, or wrinkles which are present even when the face is at rest, can be eliminated using a combination of long-term Botox use and dermal fillers.

While ophthalmologists had been using the substance to treat eye muscle disorders prior, the cosmetic benefits of botulinum toxin were first researched in the late 80s. Jean and Alastair Carruthers, an ophthalmologist and dermatologist married couple from Vancouver, conducted a study in 1987 to determine whether botulinum toxin could be used to treat people with “eyebrow furrows.” Since then, botulinum toxin has been used to treat a host of muscular disorders and chronic conditions, such as migraine headaches. In 2002, only ten years after the findings of the Carruthers study were published, the Food and Drug Administration (FDA) approved botulinum toxin type A for cosmetic use.

There are several types of botulinum toxin, aptly given the names “type A” through “type G.” Only types A and B are used for cosmetic or medical purposes. Type A can be used to treat crossed eyes, uncontrollable blinking, esophageal spasms, and to decrease sweating, in addition to its cosmetic purposes. Type B, however, is only used to treat certain muscular diseases.

Are Neuromodulators Like Botox Safe?

Botox is incredibly safe. Though formulated using a toxin, Botox is no more harmful than saline. The toxin used for cosmetic purposes is purified by several processes.  After it’s injected, the body begins to break down the substance. Within three to four months, the substance will have been swept out of the affected muscle, processed by the liver, and on its way out of the kidneys. Therefore, anyone who says Botox stays in the body for years and affects people’s health later down the line is likely ill-informed.

Botox, like any other injectable, must be placed by a professional. The stiff, unyielding appearance of Botox recipients perpetrated by the media is often the result of poor placement or overapplication of the substance. Botox can be applied quite subtly to smooth the skin and give a long-term appearance of youthfulness. Always consult an experienced professional when seeking to have Botox applied.

neuromodulator

Xeomin

On the surface, there may seem to be little difference between Xeomin and Botox. Both are brand name versions of the botulinum toxin type A. Both are used for cosmetic purposes. Both substances begin as powder, to be dissolved into a solution, and must be reinjected at four to six month intervals. Therefore, what’s the true difference? Well, the difference lies in how these two substances are formulated and who they are best suited for.

Unlike Botox, Xeomin contains the “naked” form of botulinum toxin. Remember how we mentioned botulinum toxin is a type of protein? Well, Botox is formulated with non-toxin accessory proteins. These accessory proteins help stabilize the neurotoxin in shifting temperatures, pHs, and protect against degradation. Xeomin, on the other hand, does not contain any accessory proteins. The company which manufactures the drug takes special care to remove these proteins during the creation process. Instead, Xeomin is formulated using a composition which is inherently stable.

This lack of additives helps prevent the formation of antibody resistance. Sometimes, the body responds to the injection of botulinum toxin by creating antibodies which decrease the effectiveness of the substance. This can happen when someone has been receiving injections of Botox for a long period of time. As a work around, Xeomin offers botulinum toxin type A without proteins which may trigger the production of these antibodies. Thus, Xeomin is a wonderful option for those who have found Botox is no longer working optimally or who wish to avoid developing a negative antibody response to neuromodulators at all.

Using Neuromodulators to Treat Your Unique Needs

JAG Medical Cosmetics offers both Botox and Xeomin for the purpose of treating: wrinkles between the eyes and forehead, lines around the mouth, crow’s feet, gummy smiles, lip flips, nasal lines, neck lines, and more. Of course we’re happy to answer any questions you may have about our services and availability of offerings. Feel free to reach out!

If today’s article has you interested in what neuromodulators can do for you, don’t hesitate to schedule a consultation. We’ll speak about the options available, your concerns, and make a plan for how to proceed. We look forward to hearing from you!

About the author, Jared Guichard, MD

Dr. Jared Guichard is owner and medical director of JAG Medical Spa. With over 10 years’ experience in anti-aging medicine, he is committed to providing clients with the best in Aesthetics care and Anti-Aging treatments. He has a passion for all areas of medicine and continues to practice as a medical doctor in local hospitals in the Charleston area.

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