Friday, February 11, 2005

Using Botox to Control Flushing

How botox can help a hot flush

Doctors have successfully treated blushing of the neck and chest with botulinum toxin for the first time.

A woman who for years had suffered with severe blushing was completely clear four weeks after being injected with the toxin. Three other women have since had the treatment, and a trial involving 40 more women is about to start in London. Flushing, or blushing, is a major problem for thousands of women. It can occur for no apparent reason at all, or, in some people, as a result of eating some types of foods, or drinking alcohol.

Now, vascular surgeons at Hillingdon and Mount Vernon Hospitals have found botulinum toxin can be used to get rid of neck and chest flushing. The surgeons used injections of Botox or BTX-A to treat the four patients. Botulinum toxin is more widely used in cosmetic surgery to treat wrinkles, and a range of other conditions including eye twitching, squints, whiplash, headaches, migraine, excessive sweating, back pain and muscle spasms.

It may be possible that it could have some effect on the hot flushes that affect as many as one in four pre-menopausal women, although no research has been done yet. The first case the surgeons treated was a 48-year-old woman with severe flushing of the neck and chest.The woman had a long history of severe symptoms and a range of drugs had failed to help. She was given injections of BTX-A under the skin of the affected areas, and, within two weeks of the third treatment, she reported a 75 per cent improvement of symptoms. Four weeks after the final treatment she reported a complete absence of symptoms. There were no adverse effects apart from some minor bruising at the injection sites that disappeared after a few days.

Consultant surgeon Trevor Paes says: "Flushing is a very common problem. We believe this treatment method for skin flushing is simple, effective and free of significant side-effects." It is thought that botulinum toxin, produced by the bacteria that causes botulism food poisoning, works on flushing by interfering with signals between nerve cells. The surgeons became aware of the potential effect on blushing when treating patients for sweating. Mr Paes says: "We use Botox a lot for forehead sweating and we noticed that patients were coming back with their normal redness of face but with white foreheads. We tried it on one of the patients for flushing and the changes were quite dramatic."

Swedish doctors say surgery for severe facial blush is successful. They investigated around 800 patients who had the operation, which interferes with the sympathetic nervous system, and found that the incidence of blushing was significantly reduced. They also discovered that the quality of life of patients after surgery was substantially improved.The main side-effect was a change in sweating, from the upper to the lower part of the body. Increased sweating of the trunk occurred in eight out of ten patients, but 85 per cent of patients were satisfied with the result.

The doctors state: "It appears to be an effective, safe and lasting surgical method for the treatment of severe facial blushing. Side-effects are common but only rarely result in the patient regretting the operation.