what is done to botox to make it „safe“ to inject into someone?

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I just learned that botox is so toxic that it makes sarin gas look breathable, in fact according to the wikipedia list of toxins ordered by toxicity it is the single most dangerous toxin to life as we know it in the universe so far.

What on earth is done to it so that it can be injected into someones cheeks?

In: 279

Nothing. It’s super dangerous.

But when done in carefully controlled, very small doses, it can be safe-ish.

Nothing is done to it!

It is injected in very small quantities, inside the face, specifically because it cause muscle paralysis. When the small face muscle can’t move anymore, then the skin doesn’t fold and wrinkle anymore.

Doctor do so in an extremely control way as to not damage anything and not paralyze anything needed to survive.

It’s a procedure that been perfected over time.

Edit to add: As people have mentionned below, it can also be used for tons of medically valid reasons and saves lives everyday, but my response was about cosmetics injections primarily.

They dilute it and put a small about in specific locations. They can’t really make is safer, as the thing that makes it deadly is what gives it the desired effect. They are just very careful how much they use and where it goes.

Nothing has been done to it. It does what it’s meant to do, paralyzes the nerves. But when injected cosmetically (or medically), it is done in extremely minute quantities and very precise so it’s localized.

Does it do any long term nerve damage if used continuously?

As others have said, the botulism toxin itself is not modified, and is used locally for specific effect.

What makes it safe-ish is that the source of botox introduced to the body during treatment is finite and localized.

Labs produce botox by cultivating *Clostridium botulinum* bacteria. The toxin is isolated and collected, but the bacteria themselves are discarded. Botox injections contain no bacteria.

When a person is infected with Clostridium botulinum, the bacteria can continue to produce botulism toxin. The body tolerates small, finite amounts of botox, but becomes overwhelmed if infection produces botulism toxin faster than the body can neutralize it, or if emough toxin was introduced at the time of infection. Instead of being localized to an injection site, botulism toxicity can affect the whole body.

Edit: The bacteria that creates the botulism toxin does so only under anaerobic conditions. Nevertheless, uncontrolled introduction of botulism toxin through either infection, injection, or ingestion creates risk of much greater amounts of toxin being introduced to the body, which are not necessarily confined to specific and safe locations.

It’s diluted, that’s all there is to it. The botox injected for cosmetic reasons is present in such small concentrations and amounts that it isn’t enough to kill a person.

Is this the old poisonous vs venomous discussion?

I feel like the other answers don’t get directly at the issue.

There’s an old adage that “the dose makes the poison”. Everything is toxic in sufficient quantity. You can poison yourself to death with water if you drink enough in a short period of time (there have been several examples of this).

The reason Botox treatment doesn’t kill you is because they don’t inject enough to kill you. It’s still toxic, it works by paralyzing the targeted muscles, but the dose is small enough that some muscle paralysis is (hopefully) the only bad effect.

When I was a kid, I used to watch this show Quincy MD and first learned about botulism and how deadly it was.

Decades later I heard people were injecting it in their face and I was like what?!?! 😅

As Paracelsus said:

“All things are poison, and nothing is without poison; the dosage alone makes it so a thing is not a poison.”

In other words: the dose makes the poison. Things we don’t typically think of as poisonous are indeed in high enough doses, and things we do typically think of as poisonous aren’t in low enough doses. It’s all in the dose.

Botox is toxic in incredibly small doses, yes. So we just use incredibly incredibly incredibly small dosing. Also its administered within a localized muscle, not the bloodstream where it can travel to vital organs and such.

Botulinum toxin is super toxic, not because it erodes cells, but because it stops the release of a neurotransmitter called acetylcholine, which is responsible for the contraction of muscles. When you talk, smile, or make facial expressions you use muscles in your face, and this can cause wrinkles in your skin over time. Botox paralyzes these muscles so that they can’t cause more wrinkles, and give the impression of younger looking skin.

Botox can only affect the area in which it is injected. Patients who are given Botox are instructed not to get facial massages for 1-2 weeks after injection, and it’s rare that patients find weakness/paralysis in other muscles, but that is temporary.

If anyone is interested, [here is a fabulous podcast by This Podcast Will Kill You](https://podcasts.apple.com/us/podcast/this-podcast-will-kill-you/id1299915173?i=1000471416922) about Botulism!

The toxin is diluted. A lot.
The dose is very, very, very low. And it’s injected in such a way that very little of it ends up in the bloodstream.

It’s such a small amount that if you look at a vial of it, it basically looks empty. Just a couple of specks at the bottom of the vial.